Durban - A Pinetown doctor guilty of medical aid fraud has escaped jail with a suspended sentence and a fine.
Sentencing Dr Kalpesh Ramcharan to a R30 000 fine and a 10-year prison sentence which was conditionally suspended, Durban Regional Court magistrate Delia Turner said the doctor had been motivated by greed.
“Your modus operandi is that once you are caught out, you repay the money. It’s very sad that you’ve dabbled in this type of crime and lowered yourself to do this kind of thing,” Turner said.
The doctor had pleaded not guilty to 18 counts of fraud relating to the periods 2011 and 2012.
According to the charge sheet, he submitted various claims, ranging from about R100 to just over R1 000, for patients he claimed to have treated at his Chatsworth practice.
However, the complainants, many of them nurses, said the doctor had never treated them.
Many had said their medical aid was already exhausted when the claims were submitted. They had alerted the Government Employees Medical Scheme (GEMS), which had investigated the matter.
During her judgment in April, Turner said she found the State witnesses to be credible and Ramcharan’s version to be weak.
He had claimed he had treated a lot of the people for whom he had made claims, but she found this improbable, saying that as soon as the allegations arose, he had refunded the medical aid scheme. She felt that this had in fact strengthened the State’s case.
Turner had acquitted him on four of the 18 fraud counts.
Yesterday, the probation officer testified on her recommendation that Ramcharan be given a wholly suspended sentence, and also one of correctional supervision.
The State felt a prison sentence was more appropriate due to the inconvenience experienced by the complainants.
The probation officer told the court that while she considered the impact on the victims, she looked at the doctor’s circumstances and the nature of the offence and felt correctional supervision would be more beneficial, and a prison sentence would be “too harsh”.
During arguments for sentencing, prosecutor Surekha Marimuthu referred to Ramcharan’s disciplinary case before the Health Professions Council of South Africa on another matter concerning unprofessional conduct.
“He was found guilty in 2012 and was fined R40 000. and was suspended from practising for two years, which was suspend-ed for five years on condition that he did not commit a similar offence. I assume that the HPCSA will take today’s court sentence into consideration and discipline him,” she said.
Marimuthu argued that a suspended sentence, fine or a correctional supervision sentence would be a slap on the wrist and would not act as a deterrent, and instead asked for a prison sentence.
Referring to the HPCSA disciplinary, defence attorney Siven Samuel said the alleged offence took place after he was convicted of fraud, and that his plea explanation was taken in June 2014.
He also alluded to the fact that the doctor was one of 17 doctors targeted by a medical aid schemes’ private investigator, and made to sign an acknowledgment of debt where he had to pay back 30% of his fees.
“There appears to be some conspiracy. It is clear from his plea explanation that this was not fraud,” Samuel said.
He argued for the doctor to pay a fine instead of a jail term, saying GEMS was putting pressure on the State for a jail sentence. He said most of the money had been repaid.
Ramcharan, he said, worked at a government hospital’s acute medical unit, and argued that it was difficult to get doctors to work in the public sector.
The magistrate felt the best punishment was for Ramcharan to pay a fine, saying she was giving him a chance to stay out of jail.
Samuel said Ramcharan would appeal his conviction.
Daily News