Livingston Doctor Charged With Health Care Fraud

Authorities have charged a North Jersey doctor with seven counts of health care claims fraud for allegedly billing multiple insurance carriers for medical procedures he reportedly didn’t perform himself or that were not performed at all.

According to the New Jersey Office of the Attorney General, Gautam Sehgal, 52, of Livingston, a neurologist with practices in Newark, Perth Amboy, Clifton, Elizabeth, South Orange and Paterson, has been indicted by a state grand jury for seven counts of health care claims fraud in the second degree for allegedly filing fraudulent bills to insurance carriers.

Sehgal was also charged with one count of second-degree insurance fraud and one count of third-degree theft by deception in connection with the alleged fraudulent claims, authorities stated.

According to an indictment handed up in Middlesex County Superior Court, Sehgal allegedly filed seven, fraudulent health care claims, stating he had performed a diagnostic procedure known as needle electromyography (EMGs) on seven patients.

However, in six of the cases an unlicensed technician - not Sehgal - performed the procedures, prosecutors allege.

In the case of the seventh claim, no needle EMG was performed at all, prosecutors charge.

According to the indictment, Sehgal allegedly filed potentially fraudulent claims to nine carriers between July of 2008 and October of 2013. The health care claims indictments stem from seven claims submitted between February 2011 and October 2013 to 21st Century Insurance Company, Travelers Insurance Company, Encompass Insurance Company and Metropolitan Life Insurance Company.

Prosecutors stated that the theft by deception charges stem from the above claims and earlier claims allegedly submitted to Allstate Insurance Company, Farmers Insurance Company, Progressive Insurance Company, AIG Insurance Company and NJ Cure Insurance Company.

According to prosecutors, second-degree crimes carry a sentence of five to 10 years in state prison and a criminal fine of up to $150,000; third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000.

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