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Crime & Courts

State: Anchorage physician billed more than $1.1 million in fraudulent Medicaid payments

  • Author: Laurel Andrews
  • Updated: September 28, 2016
  • Published July 30, 2014

An Anchorage physician charged with fraudulently billing Medicaid over the course of four years appears to have billed more than $1.1 million for medical appointments that never took place, according to final audit numbers released by state prosecutors Wednesday.

Dr. Shubhranjan Ghosh was charged in April with fraud, tampering with evidence, and more than a dozen controlled substances charges. He was initially charged with fraudulently billing Medicaid more than $300,000, but prosecutors had said at earlier hearings that the amount would likely increase. The state says Ghosh and his former office manager Nathaniel Carter worked together to fraudulently bill Medicaid beginning in 2010.

On Wednesday, the state released the final audit numbers during a bail hearing in a downtown Anchorage courtroom. Of the $1.1 million Ghosh allegedly fraudulently charged Medicaid, his practice was paid roughly $600,000, state prosecutor Andrew Peterson said after the hearing.

Ghosh, 39, is the sole practitioner at Ghosh Psychiatric Services in South Anchorage, primarily treating children with mental health issues. Following the charges against him, Ghosh was barred from billing for Medicaid. He continues to practice, Peterson said, although his clientele has shifted and he now treats more adults.

Peterson asked the court that Ghosh, who was out on $200,000 cash bail, be barred from prescribing all opioid prescriptions, such as hydrocodone or morphine, given that the nature of the charges against him. Ghosh has been charged with 15 controlled substance charges for alleged prescribing of hydrocodone for friends and himself. These opioid prescriptions were not necessary prescriptions to allow him to continue his practice, Peterson said.

Peterson also asked Judge Philip Volland to institute either a physician-monitoring program, in which a physician would monitor the drugs Ghosh prescribes patients, or allow for the state to review his prescriptions though a prescription database monitoring program.

Defense attorney Ronald Offret argued that the bail measures already in place, which include an ankle monitor and drug testing, were enough. "It gets draconian after a while," he told the court.

Offret said the state was "trying to shut Dr. Ghosh down from his practice to make it more difficult for him."

Offret said that the main informant in the case, former office manager Nathaniel Carter, had made many of the claims against Ghosh. Carter was convicted of manslaughter in 1997 and was not credible, Offret said. Carter made a plea deal with the state in exchange for becoming an informant, prosecutors said in April.

Offret said the state made "a deal with the devil."

Judge Volland ruled that Ghosh be barred from prescribing opioids, but he declined to add additional conditions the state was seeking. If there was a concern regarding Ghosh's writing of prescriptions, the state would execute a warrant to review the prescription database, Volland said.

The allegations against Ghosh stem from investigations into his clinic that began in September after a woman working at the office tipped off investigators. The woman told investigators that she had first noticed a problem in July 2013, when she discovered a charge for a patient who hadn't been seen that day. Office manager Carter allegedly told her that he and Ghosh had been submitting false Medicaid bills for years. Carter also told her that he had created false billings for his kids, the charging documents state.

Peterson told the court during a bail hearing in April that Carter acted as an informant in the case. Ghosh told Carter during a taped conversation that the state would likely find more than $1 million in overpayments.

During the April bail hearing, Peterson also told the court that Ghosh had tampered with evidence, had written multiple opiate prescriptions for friends and that Ghosh himself had a prescription drug problem.

Ghosh Psychiatric Services began billing Medicaid in 2010 and has since billed more than $3.5 million to the government program, according to charging documents.

Ghosh is facing 18 felony charges and one misdemeanor charge, according to online court records. Those charges include scheme to defraud, tampering with evidence, and 15 controlled substance charges.

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