Doctor indicted
By KIM HOYUM, Journal Staff WriterArticle Photos
Dr. Gope Hotchandani was indicted Feb. 12 by a federal grand jury sitting in Marquette. Hotchandani is the medical director of four aesthetic clinics in Marquette, Iron Mountain, Appleton, Wis., and Green Bay, Wis.
The indictment alleges Hotchandani systematically committed insurance fraud when billing insurance company Blue Cross Blue Shield of Michigan in 87 instances between February 2003 and April 2004.
It reads, in part, “Hotchandani executed his scheme and artifice, in part, by routinely using incorrect diagnosis codes to misrepresent the actual condition being treated.” All 87 counts originate from insurance claims made through the Marquette and Iron Mountain offices. As of Wednesday, no charges had been filed against Hotchandani in Wisconsin.
Counts one through 30 of the indictment allege Hotchandani misrepresented claims to Blue Cross by treating patients for conditions including spider veins, rosacea and varicose veins, but using an insurance code that indicated they were being treated for a rare inherited condition of the blood vessels.
Treatment for conditions such as varicose or spider veins would have been non-reimbursable, the indictment states.
Counts 31 through 87 of the indictment allege Hotchandani billed Blue Cross for a higher level of office visit than he actually provided in instances of light therapy treatment for acne. It alleges insurance codes were used on the claims for these visits that indicated complex medical decisions and lengthy face-to-face meetings with a doctor, when in reality the treatments involved the patient sitting beneath a light for about 20 minutes, often without a nurse or doctor in attendance.
The grand jury also made a monetary judgment against Hotchandani for $754, 912, which it determined to be the amount of proceeds he allegedly obtained as a result of fraud.
An employee at Hotchandani’s Green Bay office said Wednesday the doctor would not comment on the indictment.
Hotchandani was formerly a general surgeon at Dickinson County Healthcare System, but has not been employed there since he opened his private aesthetics practice, according to the hospital’s public relations department.
He remained board certified as a general surgeon during the alleged incidents that led to the charges, according to the indictment.
The case was sealed by the court until Feb. 28 to allow the investigation to be completed and Hotchandani to be notified of the proceedings against him. No court date had been set in the case as of Wednesday.
