Doctor Vilasini Ganesh claims courts railroaded her in fraud case

Ritu Jha-

An Indian American doctor sentenced to serve jail time starting November 10, 2021, is fighting tooth and nail, pleading with the Supreme Court to listen to her case. Early this week, on November 2, she filed an urgent petition pursuant to the Supreme Court seeking an order staying her self-surrender date of November 10, 2021, pending this Court’s resolution of her pending petition for writ of certiorari.

Dr. Vilasini Ganesh, 51, a family practitioner based in Saratoga, California, was indicted in 2016 in the Northern District of California, San Jose Division. She was convicted by jury trial in December 2017 and sentenced in August 2018. She was convicted with one count of conspiracy to commit health care fraud; one count of conspiracy to commit money laundering; multiple counts of health care fraud, and two counts for making a false statement relating to health care matters.

Her indictment stems from billing submissions to private insurers, not Medicare or Medicaid. She was acquitted of the more serious charges against her at trial, including conspiracy to commit health care fraud and money laundering. Her counts of conviction involve 5 alleged occurrences of billing submissions involving 5 dates ranging from 2011 to 2013. For this, she was sentenced to 63 months in federal prison.

She had appealed to the Ninth Circuit Court of Appeals and the Circuit issued a memorandum affirming her conviction in May 2021. A petition for rehearing was denied on July 30, 2021. The court denied a motion to stay the mandate in August 2021.

When asked why she believes she is a victim, Ganesh alleged that she has been victimized because she filed a complaint against the insurance company, and instead of her being compensated she was made the victim of fraud.

When indica News reached to Aetna for comments, Ethan Slavin, Head of National Media Relations, Aetna, a CVS Company through an email said, “While we appreciate you reaching out to us, we will not be providing a comment at this time.”

The jury has also convicted Ganesh’s husband, Dr. Gregory Belcher, as well with one count of making a false statement related to health care matters.

Meanwhile, the American Association of Physicians of Indian Origin (AAPI), the Association of American Physicians and Surgeons (AAPS) Federation of India American Physicians (FIPA) and Physician Just Equity (PJE) have written a letter to Supreme Court Justice Elena Kagan on Ganesh’s behalf.

“We request you to issue a stay order on the execution of her sentencing date which is set for November 10, 2021, pending a complete review of this matter including the use of this type of evidence,” the letter stated.

It added: “Despite alleged evidence, there wasn’t one that Dr. Ganesh had made a claim for any of these monies. Most crucial being an HCFA 1500 form with Dr. Ganesh’s signature. This is the only form that can prove that Dr. Ganesh made any claim for the monies alleged. This form does not exist in the court records and therefore is nowhere in the alleged evidence that was presented at the case.”

[HCFA 1500 form is used by the Health Care Financing Administration. It is used for health care claims. It is used to submit a bill or charge for health insurance coverage.]

The AAPI letter states: “In a review of these charges, it must be noted that Medicare and Medicaid, as well as any governmental insurance institutions, declined to participate in this lawsuit and reported that they found no discrepancies in Ganesh’s billing and had no concerns of fraud. After much discussion over the billing practices of Ganesh and her practice, the prosecutors, with no warning, produced 40,000 patient records, EOBs, graphs, tables, and paper trails. All these documents were evidence generated solely by the Insurance companies that she had made claims against. Some of the alleged evidence that had been provided dated back to before Ganesh was even a doctor.”

“In 1988 Dr. Ganesh would have been 17 years old and had not even started her medical career,” the letter states.

In an interview with indica News, Ganesh alleged that Lucy H. Koh, the US district judge, did not treat her well and that she was a victim of discrimination and prejudice.

“The prosecutors fabricated billing claims and payments from an entirely different doctor’s office to mislead the jury in the trial,” she alleged, “Not only did the judge block all my lawyers, break all my constitutional rights, but also sentenced me to 63 months in the prison system based on the amount issued in the spreadsheet, the amount issued to unknown bank accounts.”

Her attorney, Lisa Rasmussen, told indica News, “I took this case because I thought I could help demonstrate that what happened in this case, including the government’s misconduct, was not only unfair but a violation of their due process rights and fundamental right to fair trial. When I began representing the substantive issues related to Dr. Ganesh in September of 2018, there were additional substantial violations of her right to counsel that were readily apparent. I believed that the Ninth Circuit would be appalled by the things that occurred in this case, but did not seem to bother our panel at all.”

Rasmussen agreed that the government had a right to bring cases against persons they believe have violated the law, but it was imperative that the government did so in a fair and impartial manner, which she believed has not happened in this case.

Born in India, Ganesh is married and has three young children. She is also supporting her elderly mother. She came to the US as a teenager and graduated from Rush Copley Family Medicine residency program, affiliated with Rush University, Chicago, Illinois. She has her own private clinic Campbell Medical Group, Campbell, California, and her website shows had 30,000 patients.

Ganesh is licensed in the States of California and Illinois. She is affiliated with the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP), and was a teaching faculty at Stanford University.

“Today I am completely bankrupt and all our savings, my mother’s retirement savings are gone,” Ganesh told indica News.

It’s a rare and unique kind of case, said Rasmussen. “This case is unique because of the catastrophic failures of the government and its evidence. It appears the government created, or fabricated evidence to appear as if it represented fraud; when, in fact, the evidence did not demonstrate anything of the sort.”