NEWARK, New Jersey—A Florida man was convicted by a federal jury for his role in a durable medical equipment (DME) kickback scheme that caused millions of dollars in losses to Medicare and other insurance providers.
Following a month-long jury trial, Raheel Naviwala, 36, of Coral Springs, Florida, was convicted on Feb. 28, 2025, of conspiracy to commit health care fraud and wire fraud, one count of health care fraud, conspiracy to violate the Anti-Kickback Statute and three counts of violating the Anti-Kickback Statute. He was also acquitted of two counts of health care fraud.
According to the evidence at trial, Naviwala and his coconspirators purchased lists of Medicare patients’ names, addresses and phone numbers, and hired telemarketers to convince the patients to get DME (orthotic braces). These telemarketers pre-filled prescriptions and picked the highest-paying braces to bill to insurers. Naviwala then paid telemedicine doctors to sign the pre-filled prescriptions for braces, regardless of whether the patients needed or wanted braces. Generally, the telemedicine doctor did not speak to the patients before signing the pre-filled prescriptions.
Naviwala then sold the signed prescriptions to DME supply companies that could bill Medicare, TRICARE and other insurers for the braces. To conceal the fraud, Naviwala and his coconspirators signed sham contracts and used sham invoices that falsely represented that Naviwala was billing DME supply companies for marketing or consulting.
Naviwala also owned and operated a DME supply company that was used to bill Medicare, and which submitted claims to Medicare for up to nine braces for a single patient.
To further conceal his illegal conduct, Naviwala put multiple of his businesses in the names of nominee owners. The nominee owners generally performed no legitimate work for any company and were paid to hide Naviwala’s involvement.
Medicare and other insurers paid hundreds of millions of dollars to members of the conspiracy and paid at least approximately $100 million for DME associated with Naviwala’s companies. Naviwala personally pocketed more than $10 million in fraud proceeds.
Conspiracy to commit health care fraud and wire fraud is punishable by a maximum potential penalty of 20 years in prison. Health care fraud is punishable by a maximum potential penalty of 10 years in prison. Conspiracy to violate the federal Anti-Kickback Statute is punishable by a maximum potential penalty of five years in prison. Each count of illegal kickbacks is punishable by a maximum potential penalty of 10 years in prison. Each count is also punishable by a fine. Sentencing is scheduled for 10 a.m. on July 29, 2025, before Judge Farbiarz in Newark.
“This Office is committed to prosecuting those like the defendant who seek to profit by defrauding and corrupting our nation’s medical systems,” United States Attorney John Giordano said. “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.”