Cardiologist who misused patient info for fraud sentenced

Sushil Sheth, M.D., a Chicago area cardiologist who surrendered his medical license, was sentenced to five years in federal prison for stealing approximately $13 million from Medicare and more than 30 other public and private health care insurance programs over roughly five years.

According to a press release issued by the U.S. Attorney’s Office, Sheth had privileges at three unnamed area hospitals and misused his access to hospital records to obtain patient information that he used to bill Medicare and insurers for 14,800 false claims for reimbursement for services he never provided to these patients.

Sheth was also ordered to pay restitution totaling approximately $13 million and he agreed to forfeit property and funds totaling more than $11.3 million that the government seized from him.

Typically waiting almost a year after the treatment was purportedly provided, Sheth submitted claims seeking payment that, when added together, had him providing more than 24 hours of medical services and treatment in a single day.

Federal agents searched Sheth’s Burr Ridge home in June 2007 and seized more than 600 uncashed checks from various insurers totaling more than $6.7 million.

“Health care fraud is one of the highest priorities of federal law enforcement. We will make every effort to recover any fraudulently obtained funds and to ensure that dishonest physicians and other medical providers do not profit from cheating Medicare and private insurers,” said Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois.

It is not clear from the official press release when the patients were notified of the misuse of their information or if any of them had discovered it on their own.

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