A federal jury in Boston, Massachusetts, convicted a medical doctor Tuesday for healthcare fraud, money laundering, conspiracy to defraud the IRS, and tax evasion. According to court documents and evidence presented at trial, Dr. Pankaj Merchia, of Boca Raton, Florida and Brookline, Massachusetts, was a Harvard-educated sleep doctor who controlled several sleep medicine companies. From 2017 to 2019, the defendant fraudulently billed insurance companies millions of dollars for sleep apnea machines that had not been used by his former patients for years. Merchia billed up to hundreds of thousands of dollars per patient for the medical devices, even when in some cases those patients had returned the devices to him. Merchia used the proceeds of the fraud to purchase a $2.1 million home in Brookline, Massachusetts.
Merchia also defrauded a health insurer out of over $390,000 by submitting fraudulent claims for treating his brother. After being told that he could not bill insurance for treating a family member, Merchia created a new medical business in the name of a nominee and submitted new claims so that the insurance company would continue paying the illicit reimbursement. In addition, from 2009 to 2019, Merchia did not report, or pay tax on, over $6.5 million in income he earned from his medical businesses by falsely claiming that those businesses were owned by a co-conspirator. To defraud the IRS, Merchia fabricated a sham transaction, falsely claiming that he sold his medical businesses back in 2008. To ensure that his co-conspirator did not owe taxes, they claimed deductions, spread across many years, for the fabricated sale payment.