Los Angeles, California - A former doctor was sentenced to 24 months in federal prison for engaging in a multi-faceted Medicare fraud scheme, and also for illegal prescribing thousands of opioid painkillers and muscle relaxants.
Kain Kumar, 56, of Encino, was sentenced by United States District Judge Philip S. Gutierrez. Kumar was also ordered to pay financial penalties totaling more than $1 million, consisting of $509,365 in restitution, $494,900 in asset forfeiture, and a $72,000 fine.
Kumar pleaded guilty in April 2019 to one count of health care fraud and one count of distribution of hydrocodone. He practiced internal medicine, maintained medical offices in Palmdale, Rosamond, and Ridgecrest and surrendered his medical license last year.
From February 2011 until May 2016, Kumar defrauded the Medicare health care benefit program by prescribing unnecessary home health services in exchange for the payment of illegal kickbacks to him from a La Verne-based home health agency called Star Home Health Resources, Inc. According to the indictment in this case, Medicare paid $4,398,599 to Star based on the illegal kickback-tainted referrals from Kumar.
In furtherance of this scheme, Kumar caused false and fraudulent claims for reimbursement to be submitted to Medicare for Medicare beneficiaries that he did not personally examine or for patients he only briefly examined. Kumar also prescribed drugs that were not medically necessary and which were paid for by the Medicare Part D program.
Additionally, Kumar admitted in his plea agreement that between February 2013 and January 2016, Kumar – without a legitimate medical purpose – prescribed 23,826 pills of the opioid drug hydrocodone (commonly sold under the brand name Vicodin or Norco) and 38,459 pills of the muscle-relaxer carisoprodol (sold under the brand name Soma). Kumar directed his office staff – who were not medical professionals – to issue prescriptions for these drugs to patients even though Kumar had not examined the patients. Kumar directed his office staff to sign his name on prescriptions for opioid drugs and also provided his staff with pre-signed prescriptions. In one instance, although Kumar examined a patient only once on the patient’s very first visit, and thereafter he caused prescriptions to be issued to the patient for hydrocodone and carisoprodol on a monthly basis for approximately a year and a half even though Kumar did not actually see the patient for any subsequent physician examination.
Kumar is the fifth and final defendant sentenced in this case. Elaine C. Lat, 50, of Fontana, was Star’s chief operating officer and the case’s lead defendant. She is serving a 30-month prison sentence in this matter after pleading guilty in May 2017 to one count of conspiracy and four counts of paying illegal kickbacks. Three other defendants, including Lat’s parents, each pleaded guilty to criminal charges and were sentenced in this matter.
This case was investigated by the FBI, the U.S. Department of Health and Human Services, Office of Inspector General, and the Drug Enforcement Administration.
This matter was prosecuted by Assistant United States Attorneys Alexander F. Porter of the Major Frauds Section, Jonathan S. Galatzan of the Asset Forfeiture Section, and Trial Attorney Claire Yan of the Fraud Section in the Criminal Division of the U.S. Department of Justice.
