Virginia Psychiatrist Uzma Ehtesham Pleads Guilty to Federal Healthcare Fraud Charges

November 7, 2020

ABINGDON, Va. – Uzma Ehtesham, a Wise, Virginia psychiatrist who defrauded Virginia Medicaid and Medicare by fraudulently billing these programs for services, pleaded guilty today to federal health care fraud. Acting United States Attorney Daniel P. Bubar and Virginia Attorney General Mark Herring announced today.

Ehtesham, 52, waived her right to be indicted and pleaded guilty today to a one-count Information charging her with health care fraud.

“Through Ehtesham’s fraud scheme, she stole funds from Virginia Medicaid and Medicare, which provide an essential safety net for our most vulnerable residents. When someone defrauds that system, the Department of Justice, and our partners with the Virginia Attorney General’s Office will hold them accountable,” United States Attorney Bubar said today. “I am thankful to the many local, state, and federal partners who assisted in this complex investigation.”

“Health care fraud not only undermines an important system that provides critical medical services to tens of thousands of Virginias but it also wastes hundreds of thousands of taxpayer dollars,” said Virginia Attorney General Mark Herring. “I want to thank my Medicaid Fraud Control Unit for their continued hard work to hold health care providers accountable when they defraud the system and we will continue to work with our local, state, and federal partners to pursue these cases.”

According to court documents, from 2010 to 2016, Ehtesham devised a scheme to defraud Virginia Medicaid and Medicare by billing for individual office visits when she often saw patients in groups of two to four patients per visit.

In addition, Ehtesham billed for extensive, time consuming, and costly office visits when she was conducting brief office visits consisting of five to six minutes and billed for services not supported by required documentation.

During the time of the investigation, Ehtesham was seeing in excess of 50 patients per day. Often, prescriptions were written in advance of a scheduled visit by the office staff, placed in patient files, and signed by Ehtesham during the brief patient visit. At times, Ehtesham did not employ any medically certified staff to compile patient’s vital statistics at each visit. Instead, vital statistics were copied from previous patient visits to each new visit information sheet at Ehtesham’s direction.

As part of the scheme to defraud, Ehtesham received $500,000 in fraudulently obtained processed from Virginia Medicare and Medicaid.

As part of the plea agreement, Ehtesham is required to pay a total of $1,000,000, consisting of restitution, fines, and forfeiture.

A sentencing hearing has been scheduled for January 28, 2021, at 2:30 p.m.

The investigation of the case was conducted by the Virginia Office of the Attorney General’s Medicaid Fraud Control Unit, Norton Police Department, Southwest Virginia Drug Task Force, and Virginia State Police.  The following agencies assisted with the execution of a search warrant during the investigation:  Big Stone Gap Police Department, Virginia Alcohol and Beverage Control Special Investigations Unit, Wise County Commonwealth’s Attorney’s Office, Wise County Sheriff’s Office, and Wise Police Department.  Special Assistant United States Attorney Suzanne Kerney-Quillen, a Virginia Assistant Attorney General assigned to the Major Crimes and Emerging Threat Unit, is prosecuting the case for the United States.  Virginia Assistant Attorney Generals and Special Assistant United States Attorneys Janine Myatt and Joe Hall also assisted with the investigation.

Source: “Wise Psychiatrist Pleads Guilty to Federal Health Care Fraud Charge,” news release of U.S. Attorney’s Office, Western District of Virginia, November 5, 2020, URL: https://www.justice.gov/usao-wdva/pr/wise-psychiatrist-pleads-guilty-federal-health-care-fraud-charge