Gautam Sehgal, an Indian origin neurologist from North Jersey, was indicted February 9, 2016 for alleged insurance billing fraud.
Sehgal (52) is alleged to have billed insurance carriers for medical procedures he did not perform himself or that were not performed at all.
Sehgal allegedly filed seven health care claims fraudulently stating he had performed a diagnostic procedure known as needle Electromyography (EMGs) on seven patients.
According to the indictment, in six of the cases an unlicensed technician performed the procedures instead of Dr. Gautam Sehgal. In the seventh claim, no needle EMG was performed at all.
Gautam Sehgal was charged with seven counts of health care claims fraud in the second degree; one count of second-degree insurance fraud; and one count of third-degree theft by deception in connection with the alleged fraud claims.
The indictment shows Sehgal filed potentially fraudulent claims to nine carriers between July 2008 and October 2013. The health care claims indictments stem from seven claims submitted between February 2011 and October 2013 to: 21st Century Insurance Company, Travelers Insurance Company, Encompass Insurance Company, and Metropolitan Life Insurance Company. The theft by deception charges stem from the above claims and earlier claims submitted to: Allstate Insurance Company, Farmers Insurance Company, Progressive Insurance Company, AIG Insurance Company, and NJ Cure Insurance Company.
If convicted, Gautam Sehgal potentially faces three to ten years of prison time and a criminal fine of $15,000-$150,000.
The indictment is merely an accusation and Gautam Sehgal must be presumed innocent until proven guilty.
Sehgal practices in Newark, Perth Amboy, Clifton, Elizabeth, South Orange and Paterson, all in New Jersey,