The United States filed a civil complaint against Nueva Vida Multicultural/Multilingual Behavioral Health, Inc. and its owner and principal, Dr. Ghodrat Pirooz Sholevar, alleging that they violated the False Claims Act and state common law by billing Medicaid for psychiatric medication management appointments (known as “med checks”) and other services that did not occur as billed. In its complaint, the United States alleges that Nueva Vida provided psychiatry and therapy services to economically disadvantaged adults and children at three locations in Philadelphia under the Medicaid program. Among the services that Nueva Vida provided were med checks, appointments during which a psychiatrist is supposed to assess the efficacy and effects of a prescribed drug, including controlled substances, on patients within the doctor’s care. The United States alleges that between at least 2009 and 2017, Nueva Vida and Sholevar fraudulently billed Medicaid for thousands of med checks as though Sholevar had met with each patient for at least 15 minutes — when in reality, Sholevar spent well below the required time meeting with patients.
Among other things, the United States alleges that the defendants repeatedly billed Medicaid for days during which Sholevar allegedly performed more than 84 full-length med checks on the same day, which would amount to at least 21 hours of appointments. According to the United States, the defendants also repeatedly billed Medicaid for services that were never provided—because the relevant patients were receiving in-patient treatment at different hospitals at the alleged time of service. The United States also alleges that Nueva Vida failed to adhere to corporate formalities and was merely an alter ego for Sholevar. As a result, Sholevar personally pocketed millions of dollars in compensation through his control over Nueva Vida and defendants’ fraudulent billing, with an annual income as much as double the median compensation for child psychiatrists in Philadelphia. The United States’ civil lawsuit seeks damages for the false Medicaid claims submitted by defendants as well as the imposition of civil penalties.
