Health Care Fraud — sufficiency of the evidence

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United States Court of Appeals For the Seventh Circuit

Criminal

Health Care Fraud — sufficiency of the evidence

Where the defendant sought reimbursement for tests he ordered in the absence of any justification and fabricated charts to justify his actions, the evidence was sufficient to convict him of health care fraud.

“[T]here was ample evidence from the patients and undercover officers that the patients did not report the symptoms recorded by Chhibber or that he ordered tests without examining the patients at all. For example, for the section 1347 counts, Chhibber submitted claims to Blue Cross for (1) an electrocardiogram and pulmonary function test for an undercover agent which Chhibber justified by claiming that the agent suffered shortness of breath, a symptom that the agent neither reported nor displayed; (2) an echocardiogram and a transcranial Doppler scan for another undercover agent which Chhibber justified by claiming that the agent had heart murmurs, syncope and collapse, when the agent had never reported syncope and collapse and when Chhibber never mentioned the alleged heart murmur to the agent and never noted any proper investigation in the chart; and (3) an electrocardiogram, a pulmonary function test, an echocardiogram and a carotid Doppler for a twenty-eight year-old patient who came to Chhibber’s office to obtain a nursing school registration physical, tests Chhibber justified by claiming the woman had complained of chest pain, shortness of breath and dizziness, symptoms she never reported. In addition, Chhibber diagnosed this patient with a heart murmur and a carotid bruit, both very serious conditions (especially for a twenty-eight-year-old patient) and yet never mentioned these diagnoses to the patient and never told her the results of any of these tests. In combination with Dr. Herdeman’s testimony and that of the corporate representatives, this evidence was more than adequate to support the conviction on the section 1347 counts.”

Affirmed.

12-2728 U.S. v. Chhibber

Appeal from the United States District Court for the Northern District of Illinois, Conlon, J., Rovner, J.