Psychiatrist, Mental Health Clinic Settle Medicaid Fraud Allegations
- January 31, 2025
Dr. Ghodrat Pirooz Sholevar and his company, Nueva Vida Multicultural/Multilingual Behavioral Health, Inc., agreed to pay $900,000 to resolve allegations that they fraudulently billed Medicaid for medication management appointments for children and other patients that were too short to comply with applicable regulations, U.S. Attorney for the Eastern District of Pennsylvania Jacqueline C. Romero announced January 27.
According to a press release, a medication management appointment is required to prescribe, and monitor the effects of, certain drugs for mental health conditions. Medication management appointments must be at least 15 minutes to be fully reimbursable and documentation of the actual time in clock hours that services were provided is a condition of payment for Medicaid.
However, the government alleged that Nueva Vida regularly submitted false claims for medication management appointments performed by Sholevar that were not at least 15 minutes long and were likely substantially shorter. Nueva Vida billed for more medication management appointments than could be completed in a single workday if each appointment were 15 minutes long as required, the release said.
The settlement resolves allegations only and there has been no determination of liability.