United States of America v. Ankita Singh

Toledo, Ohio, criminal defense lawyer represented the Defendant charged with healthcare fraud, in violation of 18 U.S.C. § 1347.



In 2018, while working as a hospital physician, Singh was recruited by Barton

Associates, a firm that matches physicians with various healthcare companies. Barton

introduced Singh to two telehealth companies: Real Time Physicians (Real Time) and

Expansion Medical (Expansion). She contracted with both companies between 2019 and 2021 to

perform "chart reviews.” During that time, she allegedly believed that she was reviewing and

approving medical charts for patients whom other healthcare providers had already evaluated,

and who needed durable medical equipment (DME) such as orthotic knee, wrist, and back

braces.



A Real Time representative told Singh that the contract position "involves chart reviews

in our portal,” that intake would be "done by our clinical staff for you,” and that she would

receive guidelines to evaluate whether the DME was medically necessary. "Chart review” is a

practice where a physician reviews paperwork and notes generated by another healthcare

provider who has personally treated the patient. For both companies, Singh was asked to review

and approve completed charts for patients who were purportedly in need of DME.No. 24-3655 United States v. Singh Page 3

Both companies were, in reality, perpetrating a nationwide scheme to defraud Medicare.

The companies used paperwork signed by Singh and other physicians to place orders with

providers of DME, who in turn submitted claims to Medicare.



On March 4, 2020, Singh received a voicemail from Kristine Whittaker, a representative

from Optum Insurance Company, a division of United Health Group that provides insurance

plans for Medicare beneficiaries. Singh returned the call 20 minutes later. Whittaker testified at

trial that she contacted Singh during her investigation into potentially fraudulent Medicare claims

submitted by Quality Lifestyle DME, a company not affiliated with Singh. Singh was not the

focus of the investigation, and Optum did not issue a warning to Singh concerning her DME

orders.



Whittaker recorded a contemporaneous summary of her conversation with Singh in a call

log, prepared and maintained as part of Whittaker's report concerning her investigation into

Quality Lifestyle DME. This summary of the call, which the district court excluded, reads as

follows:



Dr. Singh was asked if member [D.B.] was a patient of hers and if she ordered

orthotics for her. Dr. Singh said she did not know if [D.B.] was her patient. She

was asked if she practiced telehealth and she said yes. She said she worked with

Barton Associates and Real Time Physicians. She said she signs into a portal

where she gets documents for patients who she believes have been evaluated by

another provider. She said she might have signed off on orthotics for [D.B.]

(right knee brace with suspension sleeve billed on 10/10/2019). She was under

the impression the patients were actually examined because she said the

documents appeared to be legitimate. She said she would find document

examples and email them and gave her email address.



When Whittaker sent Singh a follow-up email so that Singh could send

documents provided by Real Time, Singh promptly forwarded that email to her point of contact

at Barton.



One year later, in March 2021, Singh was sent a letter by Humana, another healthcare

insurer, containing an informal notice intended to "remind” medical providers of the relevant

"rules and regulations surrounding the billing of Medicare claims.” The letter informed Singh

that irregularities in her DME orders were "indicative” of potential fraud.No. 24-3655 United States v. Singh Page 4

forwarded the letter to her point of contact at Barton. On May 5, 2021, Barton instructed Singh

to stop completing orders for Expansion. Singh stopped performing work for both Expansion

and Real Time that same month.



A physician who has examined a patient in need of DME will typically submit a claim to

Medicare for the payment of a medical exam corresponding to a subsequent order for DME. But

when Singh ordered DME for the patients in question, no claims were ever submitted for a

corresponding medical exam. Between 2019 and 2021, Singh ordered 11,769 braces for 3,202

Medicare beneficiaries, and Medicare paid $4,470,931.02 for these items.

No evidence showed that Singh herself ever submitted any order, claim, or request for

reimbursement to Medicare, or that she knew the amounts being billed. Singh reported as

income on her federal income tax returns all the compensation that she received for completing

chart reviews for Real Time and Expansion, which was approximately $78,000 over the roughly

three-year period.

The Defendant was found guilty by a jury.



Vacated and remanded.