Court tightens rules for prosecutors looking to peruse the e-mail of people they've indicted

Punyamurtula Kishore MD a.k.a. MAD DOG MILLIONAIRE , Brookline Doctor Pleads Guilty, Sentenced to Jail and Ordered to Pay $9.3 Million for Running
Medicaid Kickback and False Billing Scheme
Punyamurtula Kishore MD a.k.a. MAD DOG MILLIONAIRE to Surrender Medical License, Sentenced to House of Correction
BOSTON – A Brookline doctor has pleaded guilty, was
sentenced to jail, and has been ordered to pay $9.3 million in
restitution for running an intricate Medicaid fraud scheme involving
millions of dollars in taxpayer funds, Attorney General Maura Healey
announced today.
Dr. Punyamurtula Kishore, 64, along with his company Preventive
Medicine Associates, Inc. (PMA), pleaded guilty on Monday in Suffolk
Superior Court. PMA pleaded guilty to charges of Medicaid Kickbacks (8
counts), Medicaid False Claims (19 counts) and Larceny over $250 (11
counts). Dr. Kishore pleaded guilty to one count of Larceny over $250.
“Dr. Kishore orchestrated a complex kickback scheme to funnel a
lucrative drug screening business to his laboratories and then billed
taxpayers millions of dollars for those services,” AG Healey said. “This
case exhibited blatant theft of state funds that were supposed to go
toward care for some of our most vulnerable residents. This is fraud
that undermines the integrity of our health care system.”
Today, Superior Court Judge Janet Sanders sentenced Kishore to 360
days in the House of Correction, with 11 months to serve and the balance
suspended for 10 years. As a condition to his sentence, Kishore has
also agreed to surrender his medical license. Judge Sanders also ordered
Kishore and PMA to pay, jointly and severally, a total of $9.3 million
in restitution.
Dr. Kishore previously owned and managed PMA, a network of 29 medical
branches throughout Massachusetts, including physician office
laboratories and one independent clinical laboratory. Based on the AG’s
investigation, Dr. Kishore used bribes, or kickbacks, to induce sober
house owners to send their residents’ urine drug screening business to
his laboratories for testing. Residents were typically screened three
times per week.
A urine drug screen may be billed to MassHealth by a physician if the
screen is medically necessary. Drug screens generally are billed to the
MassHealth program for approximately $100 to $200. Dr. Kishore
manipulated his business relationships with sober house owners to
illegally obtain tens of thousands of drug screens paid for by
MassHealth for sober house residents who were never treated by PMA
providers.
In September 2011, Dr. Kishore and PMA were indicted,
and individually charged with Medicaid Kickbacks (8 counts), and
Medicaid False Claims (8 counts). In November 2013, Dr. Kishore and PMA
were indicted on additional charges of Medicaid False Claims (11 counts)
and Larceny over $250 (11 counts) for billing MassHealth for millions
of dollars in drug screens using the names of PMA physicians and nurse
practitioners who were not actually treating the patients or determining
the drug screens to be medically necessary. State regulations require
that the services must be medically necessary and the provider must be
physically present and actively involved in the treatment of the
member.
Two other individuals previously pleaded guilty to one count of
Medicaid Kickbacks in connection with their involvement in Dr. Kishore’s
scheme to defraud MassHealth. In June 2012, Damion Smith, 42, of New
Jersey, president of Fresh Start Recovery Coalition, was sentenced to
two years in the House of Correction suspended for two years with
probation. Carl Smith, 69, of Dorchester, manager of New Horizon House,
pleaded guilty in January 2015 and was sentenced to two years in the
House of Correction suspended for two years with probation.
The case against Thomas Leonard of Malden, the part owner and manager
of the Marshall House, a sober house located in Malden, is ongoing.
John Coughlin of Carver, president of Gianna’s House Inc., which
operates several sober houses located in Wareham, New Bedford, and
Sandwich, began his trial today in Suffolk Superior Court.
This case, first referred to the AG's Office by MassHealth, was
prosecuted by Assistant Attorneys General Angela Neal, David Scheffler,
and Lee Hettinger of AG Healey’s Medicaid Fraud Division with the
assistance of victim witness advocates John Malone and Amber Anderson.
The case was investigated by Erica Schlain and Denise Long of the
Attorney General’s Office, Massachusetts State Police assigned to the
Attorney General’s Office, Examiners from AG Healey’s Computer Forensics
Lab, Special Agents from the Boston Office of the United States
Department of Health and Human Services Office of the Inspector General,
and investigators from the Massachusetts Insurance Fraud Bureau also
assisted in this case.