Agents distribute money to doctors in envelopes.

BENGALURU: Searches by the income tax department over the past three days on medical establishments in Bengaluru have blown the lid off a huge scam involving tax evasion and doctor referral fee that runs into several crores of rupees.

Investigating officials carried out searches on two IVF clinics, doctors and five diagnostic centres, including the residence and office of a wellknown fertility expert.

On Saturday, the office of the director general of income tax (investigation), Karnataka and Goa region, Bengaluru, said they seized Rs 1.4 crore in cash, 3.5kg jewellery and bullion, apart from foreign currency and detection of foreign bank accounts.

The searches at five medical diagnostic centres resulted in establishing various methods whereby doctors are paid for referring medical tests. The commission varied from lab to lab but the median range of normal commission for doctors is 35% in case of MRI tests and 20% in case of CT scans and other lab tests. These payments were disguised as marketing expenses.

The payment of referral fees to doctors was made in many ways. One method is cash payment on a fortnightly basis. Advance in cash paid to doctors as a kind of imprest cash from which the actual referral fees payable is adjusted. The advance is again recouped on a fortnightly basis The I-T department communication said in some cases, referral fees paid to doctors by cheque is disguised and shown in books as professional fees. In such cases, there’s an agreement with doctors by which they are taken as in-house consultants. However, they neither come to the diagnostic centres, see patients nor write reports. This payment is a disguised referral fee.

There are even some revenue-sharing agreements with some doctors by which a referral fee is paid by cheques, the department said.

Business via chits

Some labs employ commission agents whose job is to distribute money to doctors in envelopes. These agents insert a small chit in these envelopes while giving it to doctors, which contain the details of patient referred by the doctor, doctor’s name, tests done, amounts billed against the tests, and commission to be given to the doctor and the date on which the test was done.

It’s seen that doctors are very particular about the amounts: where they don’t get their 'due', they return the envelopes and the dispute is later settled with the labs.

