Doctor and Nurse Practitioner Plead Guilty to Making False Claims to Medicare and Medicaid

St. Louis, MO – Dr. Brij R. Vaid, M.D., 58, of Ladue, MO, and Donna A. Waldo, 59, of Saint Louis, MO, each pleaded guilty to one count of making a false claim to Medicaid or Medicare.  Dr. Vaid appeared today before U.S. District Judge Audrey G. Fleissig who accepted his plea and set his sentencing date for January 30, 2020.  Ms. Waldo pleaded guilty on October 23, 2019, and will be sentenced on January 28, 2020.

According to the plea agreements, Dr. Vaid was a medical doctor who operated St. Louis Internal Medicine (SLIM), where he saw patients at his medical office in St. Louis County, Missouri.  Waldo was a nurse practitioner and advanced practice registered nurse.  Waldo worked under the supervision of Dr. Brij Vaid at SLIM.      

As alleged in the Superseding Indictment, Dr. Vaid had a large number of patients who received Schedule II controlled substance prescriptions typically every 30 days, including opioid pain relief drugs such as Oxycodone® and Hydrocodone and anti-anxiety drugs such as Xanax®.  Dr. Vaid was the only person at his office who had the credentials to legally prescribe these pain management and anti-anxiety drugs, 

Dr. Vaid traveled frequently, including trips to New Jersey and India.  Given the number of patients needing drugs and his own scheduling challenges, Dr. Vaid often signed numerous prescriptions for controlled substances in advance of patients' visits -- before patients had even visited the office and had an examination. Dr. Vaid instructed his staff, including Waldo, to provide these pre-signed prescriptions for controlled substances to patients later, in his absence.  After these office visits, Dr. Vaid and Waldo caused claims for reimbursement to be presented to Medicare and Medicaid in which they represented that Dr. Vaid had met face-to-face with the patients and engaged in complex medical decision making during the office visits.   

In her plea agreement, Waldo admitted that she saw patient G.J. in the SLIM medical office on February 27, 2014.  At the time of the patient visit, Waldo was aware that SLIM could bill Medicaid under Dr. Vaid’s provider number for an office visit where the patient was seen by Waldo, but only if Waldo was acting under Dr. Vaid’s direct personal supervision, which required Dr. Vaid’s physical presence in the office during the office visit with patient G.J.  At the time of the G.J. patient visit on February 27, 2014, Dr. Vaid was out of the country and unable to provide any direct personal supervision.

In his plea agreement, Dr. Vaid admitted that on February 23, 2015, he was out of the country.  Waldo saw patient B.T.  Dr. Vaid knew that Ms. Waldo would be seeing patient B.T. while Dr. Vaid was in India.   Dr. Vaid caused the presentation of a false claim to Medicare related to the February 23, 2015, office visit. This claim, submitted under CPT code 99214 to Medicare, falsely stated that Dr. Vaid had provided a face-to-face office visit with patient B.T. when he was really out of town.

In his plea agreement, Dr. Vaid further admitted that he violated the terms of his probation agreement with the Missouri Board of Registration for the Healing Arts when committing this offense.

These charges carry a maximum possible penalty of five years imprisonment, a fine of $250,000 or both imprisonment and a fine.  In determining the actual sentences, a judge is required to consider the U.S. Sentencing Guidelines, which provide recommended sentencing ranges.

This case was investigated by the Office of Inspector General for the U.S. Department of Health and Human Services, the Drug Enforcement Administration, the Medicaid Fraud Control Unit of the Missouri Attorney General’s Office, and the U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, with critical assistance from the U.S. Customs and Border Protection, U.S. Department of Homeland Security and the Missouri Department of Health and Senior Services, Bureau of Narcotic and Dangerous Drugs.