A Florida resident has been found guilty of orchestrating a fraudulent scheme involving durable medical equipment (DME) that led to significant financial losses for Medicare and other insurers. The announcement was made by United States Attorney John Giordano.
Raheel Naviwala, 36, from Coral Springs, Florida, was convicted on several charges following a month-long jury trial presided over by U.S. District Judge Michael E. Farbiarz. The charges include conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to violate the Anti-Kickback Statute, and multiple counts of violating the Anti-Kickback Statute. He was acquitted of two counts of health care fraud.
“This Office is committed to prosecuting those like the defendant who seek to profit by defrauding and corrupting our nation’s medical systems,” stated United States Attorney John Giordano. “When people siphon millions from Medicare to line their own pockets, regular citizens pay the price. This case demonstrates that serious consequences will follow for such conduct.”
FBI Acting Special Agent in Charge Terence G. Reilly commented on the complexity of the scheme: “The scheme Naviwala and his co-conspirators created to steal money from the government was complex and expansive,” he said. “However, FBI Newark and our law enforcement partners have the expertise and grit to dig through mountains of data and find the fraudsters.”
Naomi Gruchacz, Special Agent in Charge with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), remarked on Naviwala's prioritization of personal gain over patient care: “The defendant convicted in this case prioritized greed over the provision of appropriate health care services to patients."
Special Agent in Charge Patrick J. Hegarty from DCIS highlighted concerns regarding TRICARE: “Mr. Naviwala’s illegal schemes put the TRICARE program and its beneficiaries at risk.”
Christopher F. Algieri from VA OIG also emphasized the impact on veterans’ services: “Schemes such as these compromise the integrity of VA’s programs and services."
During the trial, evidence showed that Naviwala acquired lists containing Medicare patients' details and employed telemarketers to persuade them into acquiring orthotic braces under false pretenses. Telemedicine doctors were paid for signing prescriptions without verifying patient needs or communicating with them directly.
Naviwala then sold these prescriptions to DME supply companies which billed Medicare, TRICARE, and other insurers for unnecessary equipment. To disguise his actions, he used sham contracts and invoices claiming marketing or consulting fees.
The investigation revealed that Naviwala personally gained over $10 million from fraudulent activities related to DME sales.
Conspiracy charges carry potential penalties ranging up to 20 years imprisonment for certain offenses along with fines per count. Sentencing is scheduled for July 29, 2025.
John Giordano credited various agencies including FBI Newark under Terence G. Reilly; HHS-OIG under Naomi Gruchacz; DCIS under Patrick J Hegarty; as well as VA OIG under Christopher F Algieri for their roles in securing this conviction.
Assistant U.S Attorneys Elaine K Lou (Deputy Chief Criminal Division), Matthew Specht (Special Prosecutions Division), Aaron L Webman (Economic Crimes Unit) represented government interests throughout proceedings against Mr Raheel Naviwalla whose defense team comprised Jamie Hoxie Solano Esq., Amy C Brown Esq., Bryan W McCracken Esq., Ifedapo Benjamin Esq all based out New York City offices respectively.