Doctor has been sued for Medicare fraud
Jahani settled with feds over allegation he cheated U.S. government out of $5 million
A Montrose doctor whose offices and home Wednesday were raided by agents of the U.S. Drug Enforcement Administration has a history of being sued for Medicare billing fraud.
Dr. Sam Jahani, 48, runs health-care clinics in Grand Junction and Montrose and has an office in Delta with Dr. Eric Peper. The DEA did not arrest either man or provide details Wednesday about why they were seizing medical files from the clinics and searching the doctors’ homes.
Jahani did not respond to a Daily Sentinel request for comment Wednesday.
Jahani was sued and settled with the U.S. government in 2003 on allegations he defrauded the government of $5 million in false Medicare claims, according to documents with the U.S. Department of Justice.
Jahani was accused of making the false claims through his private practice in Texas and at the Integrated Health Services Hospital in Dallas, Texas, where he was the medical director. The claim was brought to the attention of authorities by a medical social worker who worked at the Dallas hospital between May and July 1998.
Jahani admitted patients into the long-term, acute-care hospital for conditions that could have been handled in a less intensive setting. He submitted false claims to Medicare for treatment that was not performed by skilled staff and for treatments that were not sustained for the duration claimed and/or were not medically necessary, according to court records.
For example, Jahani allegedly admitted a 65-year-old woman to the hospital under the diagnosis of multiple fractures, while a therapist working with the woman said the woman’s real problem was loneliness and a broken leg. Another elderly woman allegedly was admitted for pulmonary complication, but she never had a pulmonary consultation at the hospital and left the hospital each day for outings with her husband.
The lawsuit also alleged patients admitted by Jahani were permitted to leave the hospital in the morning and return in the evening, and the hospital’s marketing director would take patients to the mall or bowling for “recreational therapy.”
Jahani currently is being sued in U.S. District Court in Denver by a Montrose woman who worked as Jahani’s manager at his Delta office, 164 W. Third St. The woman, who worked there from May 2006 to Dec. 5, 2008, alleges she was fired when she threatened to turn in Jahani for fraudulent Medicare billing.
“It was not uncommon for Jahani to see 50 to 60 patients on days which he spent approximately 6 hours in his office seeing clients. Jahani in fact instructed staff members to schedule 12 patients per hour,” the lawsuit alleges.
On those days Jahani spent six to seven minutes with each patient yet routinely billed patients under a code that indicated he spent 25 minutes with them, the lawsuit claims. The lawsuit also alleges Jahani required unnecessary follow-up visits, billed ordinary care as urgent care and billed Medicare for daily visits of hospital and nursing home patients, “when in fact these patients had not been seen by a physician.”
The woman alleged Jahani offered to set her up with her own medical billing practice, but she denied the offer. She was then fired, although she had a two-year contract to work at the practice until Dec. 28, 2008.
She said she was denied an opportunity to interview for an open position for an office manager by Hospital Administrator Tom Mingen at Delta County Memorial Hospital. The lawsuit alleges Mingen said Jahani had given her a “bad reference,” but the woman had not listed Jahani as a reference on her resume.
The complaint also said Jahani worked at the medical director for the Palisade Living Center and opened the GJ Urgent Care clinic in Grand Junction in the fall of 2008.