Primera Medical Group Execs Charged With Healthcare Fraud

ATLANTA, GA -- The CEO and COO of Atlanta-based Primera Medical Group have been arraigned on federal charges that they submitted more than 4,500 fraudulent claims for allergy treatments. CEO Shailesh Kothari and COO Timothy McMenamin have been charged for their alleged roles in the scheme, in which prosecutors say they sought more than more than $8.5 million in insurance payments after submitting the claims.

“Healthcare fraud not only betrays the trust a patient places in their providers, but costs everyone when their insurance premiums rise because of it,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “The FBI is committed to ensuring that funds given to healthcare providers are not abused and are used only for medically necessary services for patients.”

According to prosecutors, Primera Medical Group was a health clinic in Atlanta that focused its practice on preventative wellness, specifically corporate wellness, concierge care, and allergy testing. Kothari is a doctor of chiropractic medicine who was licensed to practice in Georgia since January 2009.

Primera Medical Group hired market research companies across the U.S. to recruit patients to participate in allergy testing. Patients were told that there would be no out-of- pocket expenses and that their insurance would cover the costs, in addition to being paid $65 to $100 for participating in the test.

A patient’s blood was purportedly drawn so that it could be sent to a laboratory for allergy and other testing. Primera allegedly then billed the patient’s private insurer for multiple procedures.

As of July 2016, Primera Medical Group allegedly billed insurers for hundreds of blood tests that were not completed. When an insurance company requested records to support the bills, Kothari allegedly asked McMenamin to create false laboratory reports to submit to the insurance company. McMenamin allegedly created the false reports and sent them to the insurance company.

Additionally, when a patient requested the results of a laboratory test that was not completed, McMenamin allegedly created false laboratory results for those patients and sent them.

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