Complaint Filed Against Dr. Russell and Dipti Shah under RICO Act
All State Insurance companies have filed a complaint in the US District Court against Las Vegas doctor couple, Drs. Russell Shah and Dipti Shah (budding Bollywood singer) and their medical entities. The action is brought under the Federal Racketeer Influenced and Corrupt Organization Act (RICO Act) along with other Nevada laws.
Dr. Russell and Dipti Shah are accused on seven counts for medical fraud specifically – Conduct of Enterprise through Racketeering; Conspiracy (both under RICO Act); Fraud and Intentional Misrepresentations; Conspiracy to Defraud; NV State RICO Violations; Innocent Victim Enterprise Violations; Constructive Trust and Unjust Enrichment.
Court filings accuses Dr. Dipti Shah participated in each of the wrongful acts, omissions and conduct as described below. Along with Dr. Dipti Shah, her husband Dr. Russell Shah, a non-board certified neurologist, also participated in each of the wrongful acts, omissions and conduct as described below. The complaint also alleges that Plaintiff All State is informed and believe that there are various physicians, attorneys, and entities in Las Vegas and Henderson that have conspired with defendants Dipti and Russell Shah to defraud All State.
The complaint involves payments All State made to, and/or on behalf of, claimants who were involved in automobile accidents. All State has provided listing of hundreds of claimants who had interactions with Shahs since 2008. Claimants were billed for medical services for their personal injuries between 2007 and 2014.
It is alleged the treatment provided was based upon a standardized pattern developd by Dr. Dipti Shah and Dr. Russell Shah with the express purpose of creating inflated medical bills that would be used to leverage artificially enhanced settlement values to be paid by insurance companies. Shahs presented All State with grossly exaggerated bills for treatment that was medically unnecessary for claimants.
Further, allegations include Shahs having with a financial interest in University Urgent Care and other entities and directly referred or indirectly caused to be referred patients among the Shahs owned entities. This referral of patients within the entities amounted to an illegal self-referral in violation of federal laws. With regard to the actual treatment of patients both Dr. Shahs were instrumental in carrying on the fraudulent scheme.
Plaintiffs (All State) further allege that Defendants Dr. Dipti and Russell Shah prepared and/or caused to be presented, between 2007 and 2014, medical reports and billing records that falsely reported symptoms, complaints, and injuries for each of the claimants which were either exaggerated or not supported at all by the facts of the accidents, that made pre-programmed, unsubstantiated findings and diagnoses and which prescribed treatment plans which were more consistent with generating large medical bills rather than patient-centered and evidence- based treatment of the patients’ actual clinical conditions.
It is alleged that Shahs’ fraudulent scheme would begin by requiring the claimants to execute a lien that required payment for the medical services provided to be made out of any settlement. Since the payments were made from settlement proceeds, it was the hope of Defendants to get the medical specials as high as possible by inflating their bills of for billing for services never provided. This was accomplished by providing and billing for unnecessary medical procedures.
Also alleged that Shahs were involved with “upcoding” and there is evidence of billing for services using billing codes that indicate a substantially higher level of care than what was actually provided.
On other note, Shahs were never politically involved or donated to any of the political campaigns for the local and/or state wide races till the last election cycle. Both, Dr. Russell and Dipti Shah along with their business Radar Medical Group donated copious amount totaling $18,000 to numerous candidates during the 2014 & 2015 election cycle who were running for the local and state wide offices. The above donation includes $8,500 in In-Kind contribution for catering, when the duo hosted a meet and greet with NV Governor Brian Sandoval.
On his website, Dr. Russell Shah introduces himself as – “As the son of a physician, I’ve always been interested in helping people, and I believed that to be the physician’s purpose. Of course, I believe it more now than ever, and I feel that fulfilling this role is as much a privilege as a responsibility. Part of that responsibility, as I see it, is to serve the best interests of the patient. For me, this means precise and thorough testing, a complete and accurate diagnosis and objective recommendations for treatment. My advanced training and volume of experience with EMGs enables me to offer state-of-the-art testing, a high level of ability interpreting EMG results and a rapid turnaround time.
“I also believe my duty to work in a patient’s best interests means taking an objective, measured, even conservative approach. As a diagnostician, objectivity is a governing principal. It is my conviction that patients deserve that same objectivity when it comes to recommending treatment options. Yet, I know that it’s just as important that patients are informed, involved and cared-for with the compassion, concern and honesty every person deserves.”