Fox Valley Surgeon Indicted on Fraud
By John Lee, The Post-Crescent, Appleton, Wis.
Mar. 13–A surgeon who operates a clinic in Appleton has been indicted on federal charges that he defrauded an insurance company of nearly $755,000.
The 87-count indictment against Dr. Gope Hotchandani was issued by a grand jury Feb. 12 and was unsealed Feb. 28.
The case is being handled in U.S. Western District Court in Grand Rapids, Mich.
The indictment alleges Hotchandani committed health care fraud by misrepresenting conditions of patients and it seeks forfeiture of $754,912 representing proceeds obtained through the fraud.
The Web site for Hotchandani Laser and Vein Center says he operates clinics in Appleton and Green Bay, and in Iron Mountain and Marquette, Mich.
Hotchandani is board certified in general surgery and a member of laser and cosmetic surgery groups, according to his Web site.
An employee who answered the phone at Hotchandani’s Appleton office Wednesday said the doctor had no comment on the indictment.
The alleged fraudulent billings all involve Blue Cross Blue Shield of Michigan.
Nancy Zepnick, an assistant to Steven Biskupic, the U.S. attorney for the Eastern District of Wisconsin, said the office would not comment on whether Hotchandani is the subject of a grand jury or investigation by that office.
“Until a case is either a complaint or an indictment they will not comment on it,” she said.
The first 30 counts of health care fraud involved patients who were treated for hereditary hemorrhagic telangiectasia. The HHT Foundation says the condition is a genetic disorder of the blood vessels that is characterized by “nosebleeds and characteristic red spots, and which affects about one in 5,000 people.”
More serious problems may include hemorrhages in the brain, liver, lungs or other organs.
The charges include bills for five patients, who were identified only by initials in the indictment, and billing from February 2003 through February 2004.
The remaining counts, also for 2003 and early 2004, concern bills for seven patients who were charged for Omnilux treatments.
The charges concern claims for “upcoded evaluation and management services, billing at the highest level of office visit codes that did not accurately reflect the actual service provided.”
Omnilux is used for treatment of dermatological conditions including acne, sun damage, non-melanoma skin cancers, skin rejuvenation and wound healing after elective surgery, according to medical Web sites.
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