Former CEO Arrested in Major Healthcare Fraud Case in the US

Tonmoy Sharma, a 61-year-old former CEO of Sovereign Health, has been arrested at LAX on charges of orchestrating a massive healthcare fraud scheme. Accused of submitting over $149 million in false claims and paying illegal kickbacks, Sharma's case highlights systemic abuse in the healthcare system. Alongside co-defendant Paul Jin Sen Khor, who managed cash operations, Sharma faces severe penalties if convicted. The ongoing investigation by federal authorities reveals alarming tactics used to manipulate insurance claims and enroll patients unlawfully. This case raises significant concerns about healthcare practices and regulatory oversight.

By Narendra Chaudhary Jun 5, 2025, 14:47 IST

Healthcare Fraud Allegations Against Tonmoy Sharma

Guwahati, June 5: A 61-year-old man from Assam, who previously served as the CEO of the now-defunct Sovereign Health Group, has been apprehended at Los Angeles International Airport (LAX) due to an eight-count federal indictment related to a significant healthcare fraud scheme in the United States.

Tonmoy Sharma, who graduated with an MBBS from Assam Medical College in 1987 before relocating to the US, is accused of masterminding a sophisticated fraud operation that involved submitting over $149 million in fraudulent claims to private health insurers and disbursing more than $21 million in illegal kickbacks for patient referrals.

Once recognized as a pioneer in schizophrenia research and treatment, Sharma held medical licenses in both India and the UK. However, the indictment reveals a troubling pattern of systemic abuse within the healthcare system.

Alongside Sharma, his co-defendant, Paul Jin Sen Khor, 45, who managed cash operations at Sovereign, has also been arrested.

Khor faces charges of conspiracy and providing illegal remuneration, disguised as "marketing hours." He has pleaded not guilty and has been released on bond.

If convicted, Sharma could face a maximum statutory sentence of 20 years in federal prison for each count of wire fraud.

Both defendants could also face up to five years in federal prison for conspiracy and ten years for illegal remuneration charges.

Reports indicate that Sovereign Health allegedly overbilled insurers from 2014 to 2020 and employed aggressive, misleading tactics to attract patients.

According to the indictment, Sharma instructed staff to entice patients under false pretenses and established a fraudulent foundation to gather personal information—including names, dates of birth, and Social Security numbers—to unlawfully enroll individuals in private insurance plans.

To obtain coverage outside of official enrollment periods, Sovereign employees, following Sharma's directives, made false statements on insurance applications.

These included fabricating qualifying life events and altering income figures to ensure patients qualified for government-subsidized insurance under the Affordable Care Act, which provided significantly higher reimbursement rates than Medicaid.

Sovereign submitted over $29 million in fraudulent claims to insurers for unauthorized urinalysis tests.

Notably, under Sharma's direction, the company billed for comprehensive urinalysis screenings, including through its lab, Vedanta Laboratories Inc., without proper authorization from healthcare providers.

Currently, the case is under investigation by the FBI, the US Department of Health and Human Services Office of Inspector General, and the California Department of Health Care Services.