1. 18 USC §1513 provides in pertinent part as follows:

"Whoever knowingly, with the intent to retaliate, takes any action harmful to any person, including interference with the lawful employment or livelihood of any person, for providing to a law enforcement officer any truthful information relating to the commission or possible commission of any Federal offense, shall be fined under this title or imprisoned not more than 10 years, or both. Whoever conspires to commit any offense under this section shall be subject to the same penalties as those prescribed for the offense the commission of which was the object of the conspiracy."

2. Beginning in and about1998, Dr. Vuyyuru spoke with the Petersburg City Police regarding his concerns of possible commission of federal offenses related to Medicaid and Medicare fraud associated with billings for unnecessary procedures by various physicians at Southside Regional Medical Center. 

3. In and about early 1999, Dr. Vuyyuru spoke with the United States Attorney’s office regarding his concerns of possible commission of federal offenses related to the national “federal physician self-referral law” (or “Stark Law”), and violation of the anti-kick back federal statute, prohibiting physicians and others who would solicit or pay anything of value in exchange for or in order to induce the referral of Medicare or Medicaid patients. See 42 USC §1320a-7b(b), which Dr. Vuyyuru believed was occurring by Southside Physicians Limited, LLC, owned and operated by various Specialist physicians at Southside Regional Medical Center, in addition to issues related to Medicaid and Medicare fraud associated with billings for unnecessary procedures by various physicians at Southside Regional Medical Center. 

4. In summary, the Stark Law[1] prohibits physicians from making referrals for a "designated health service," payable by Medicare or Medicaid, to any entity with which the physicians have a financial relationship. A financial relationship means either an ownership interest or a compensation arrangement. The law is wide-ranging. For example, a physician's own practice or group practice may be an entity to which referrals are prohibited. Penalties for violating the Stark Law include denial of payment for the service, civil monetary penalties, or even the possibility of being excluded from the Medicare or Medicaid programs.
   
   
   "Designated Health Service." For purposes of the Stark Law, a "designated health service" is a service that falls within one of eleven categories of services (e.g., radiology or certain other imaging services, inpatient and outpatient hospital services). Both the performance of and interpretation of a CT or MR scan in a physician's office or freestanding facilities may be considered "designated health services" under the category of radiology or certain otr "in office ancillary services," which are those services furnished by the physicians themselves, another physician in the same group practice, or employees of the physician or of the physician's group practice, if certain requirements are met. A key determinant of this exception is whether a group of physicians may be considered to be members of a "group practice" for Stark Law purposes? A determination that needs to be made with the assistance of counsel knowledgeable about the Stark Law.
   
   Exception for Nuclear Medicine and Certain Radiology Services. Under the Stark Law, nuclear medicine services (including PET scans, but not CT scans or radiation therapy) are excluded from the definition of "radiology or certain other imaging services." Also excluded from the definition are all x-ray, fluoroscopy, and ultrasound services that are invasive procedures requiring the insertion of a needle, catheter, tube or probe. To illustrate, diagnostic angiography and endoscopy procedures are excluded from the designated health services category of "radiology or certain other imaging services," but a CT of the chest or MR of the brain are included in the category.
   
   To the extenttrate, diagnostic angiography and endoscopy procedures are excluded from the designated health services category of "radiology or certain other imaging services," but a CT of the chest or MR of the brain are i to note, however, that if the entity were to provide and bill for a combination of services, with some of the services included and others excluded as a "designated health service," referral for such services would implicate the Stark Law.

5.        Additionally and perhaps the most significant impediment to the operation of hospital-physician ancillary service joint ventures has been the federal physician self-referral law, commonly known as “Stark II”. See 42 USC §1395nn.  Enacted in 1993, Stark II prohibits a physician from referring a Medicare or Medicaid patient to an entity which provides certain designated health services (“DHS”), if the referring physician has a “financial relationship” with the entity providing the DHS. Similarly, it prohibits the entity from billing Medicare or Medicaid for any DHS rendered pursuant to a prohibited referral. A “financial relationship” includes both an ownership interest in the entity as well as certain contractual relationships with the entity. There is a statutorily enumerated list of DHS, which includes laboratory services, certain imaging services, durable medical equipment, physical and occupational therapy and inpatient and outpatient hospital services, among others.

6.        Physician investors in a joint venture providing any of the enumerated DHS would be prohibited from referring their Medicare and/or Medicaid patients to the venture and, similarly, the venture would not be permitted to bill Medicare or Medicaid for DHS provided upon referral from the physician investors. While this virtually eliminates the opportunity for hospitals and physicians to partner on many ancillary service ventures (such as the operation of a laboratory or physical therapy facility), there do remain certain opportunities that the federal government has recognized would not run afoul of Stark. In particular, when the first phase of the Stark II regulations were published in 2001, the Government expressly acknowledged that surgical services rendered in an ambulatory surgery center (“ASC”) could be provided by a surgeon investor in the ASC so long as any DHS (e.g., diagnostic imaging services, lab tests) provided at the ASC were billed and reimbursed as part of the all inclusive reimbursement rate, rather than pursuant to a separate fee for each DHS. Significantly, there are a wide range of specialty surgical services (e.g., gastroenterology, ophthalmology) which can be rendered at an ASC. Consequently, the regulators’ willingness to expressly acknowledge that surgical procedures performed in an ASC do not constitute DHS opens the door for hospitals and physicians to pursue collaborative efforts without violating Stark.

7. The Anti-Kickback Statute.   The federal anti-kickback statute makes it a crime for anyone to solicit or pay anything of value in exchange for or in order to induce the referral of Medicare or Medicaid patients. See 42 USC §1320a-7b(b). In the early 90’s, the Office of Inspector General (the “OIG”), the arm of the Department of Health and Human Services which is responsible for the civil enforcement of the federal anti-kickback statute, began to target certain joint ventures involving health care providers, which the OIG believed to be sham arrangements designed to funnel payments (in the form of dividends or other return on investment) to physician investors in exchange for the referral of their patients to the joint venture. The now famous Hanlester Laboratories case as well as an OIG “Special Fraud Alert on Joint Ventures Arrangements” (reprinted at 59 Fed. Reg. 65372 (December 19, 1994)) effectively shut the door on hospital-physician joint ventures for many years.

8.        Several developments from the OIG seem to suggest a more relaxed view of hospital-physician joint ventures under the anti-kickback statute. First, in 1998, the OIG promulgated long awaited safe harbor regulations, which provide protection from prosecution (both civil and criminal) under the anti-kickback statute. Included in that group of safe harbors was an exception for certain ASCs that were jointly owned by a hospital and physicians. 42 CFR §1001.952(c)

9.        More recently, the OIG, through the advisory opinion process, has indicated an even greater willingness to allow certain hospital-physician ventures to operate within the confines of the anti-kickback statute. In Advisory Opinion No. 03-12, the OIG blessed a joint venture between a hospital and a group of radiologists on staff at the hospital to own and operate an imaging (MRI) center. The OIG based its favorable opinion on the existence of a number of safeguards that the parties carefully incorporated into the joint venture documents to prove that the physicians investors or those employed or controlled by the hospital investor would not be induced to refer their patients to the imaging center. Of additional significance (perhaps primary importance) was the fact that the physician investors were radiologists who generally are not in a position to refer patients to an imaging center.

10.        While this guidance from the OIG is qualified and certainly should not be interpreted to suggest that the OIG intends to open the floodgates to all ancillary service joint ventures, it does signal a more relaxed attitude toward such ventures. Indeed, a legitimate joint venture whereby both parties negotiate the terms at arms’ length, make real investments and share the risks and rewards in proportion to their investments should withstand scrutiny under the anti-kickback statute. On the other hand, the OIG just recently issued a “Special Advisory Bulletin” reminding the industry that sham arrangements, whether they be in the form of contractual arrangements or characterized as joint ventures or partnerships, will be prosecuted if the purpose of the arrangement is to funnel payments to referral sources. See OIG Special Advisory Bulletin on Contractual Joint Ventures (April 2003) available on the OIG website

11. After listening to Dr. Vuyyuru, the Assistant U.S. Attorney, directed, FBI agent to Dr. Vuyyuru to follow up on these concerns.

12. Having been informed by Dr. K. Dave of Dr. Vuyyuru’s planned activities, David Dunham, administrator of SRMC claimed to Dr. Vuyyuru that he had no knowledge of the SPL, but threatened Dr. Vuyyuru that if he did not keep quiet that he would see to it that Dr. Vuyyuru was removed from SRMC.

13. FBI agent spoke to four (4) doctors: Dr. Rice, Sr., Dr. Scraneage, Jr., Dr. to Dr. Vuyyuru that he had no knowledge of the SPL, but threatened Dr. Vuyyuru that if he did not keep quiet that he would see to it that Dr. Vuyyuru was removed from SRMC.

13. FBI agent spoke to four (4) doctors: Dr. Rice, Sr., Dr. Scraneage, Jr., Dr. Vuyyuru and Dr. A. Dave.

14.   Having been informed by Dr. K. Dave of Dr. Vuyyuru’s activities, David Dunham, administrator of SRMC informed Dr. Vuyyuru that they would cause him to be removed from the hospital.

17. Ultimately, as a result of Dr. Vuyyurs’s providing truthful information regarding the possible commission otype=1>
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    18. In year 2000 SRMC hospital authority try to move the hospital to out skirts of Petersburg and public hearing conducted and Dr. Vuyyuru opposed the move and demanded for a criminal investigation regarding the land sale and move.
    19. In year 1999 & 2000 sexual harassment to various employees and strippers in the operating rooms at SRMC and brought to the attention of Chief of staff and Mr. Dunham. Mr. Dunham refused to investigate and started threatening staff and Dr. Vuyyuru.

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19. In year 2000, 2001, 2002, 2003, 2004, 2005 & 2006 working with Mayor and delegate Dance regarding the hospital move and sale of the hospital and secret meetings at various restaurants and around city hall. Miss. Dance had various information regarding Billing fraud and sexual harassment at SRMC and brought to the attergin-top:0in' start=20 type=1>
20. In year 2000, 2001, 2002, 2003, 2004, 2005 & 2006 working with Mayor and delegate Dance regarding the hospital move and sale of the hospital and secret meetings at various restaurants and around city hall. Miss. Dance had various information regarding Billing fraud and sexual harassment at SRMC and brought to the attention of government authorities. Delegate Dance including send a legislation to stop corruption and peer review fraud bill to General assembly in 2006.

21. In year 2000, 2001, 2002 & 2003 worked with delegate Fenton Bland regarding the various fraud and sexual harassment at SRMC and took us to Attorney General Jerry Kilgore’s office regarding mine and CCP concerns at SRMC.

22. In year 1998, 1999, 2000, 2001, 2002 & 2003 Demanding the criminal investigation of Various illegal activities at SRMC Medicare and Medicaid billing fraud, kick backs, violation of stark rules, sexual harassment, patient deaths, unnecessary procedures and peer review fraud brought to the attention of Mr. Dunham and SRMC Hospital authority.

23. In year 1999, 2000, 2001, 2002, 2003, 2004, 2005 & 2006 working with NAACP regarding the harassment of minority physicians, patient deaths, billing fraud, refusing to treat indigent patients.

24. In year 1999, 2000, 2001, 2002, 2003, 2004 & 2005 filed complaints with board of medicine to investigate physician practices with gross negligence resulted in patient’s deaths and complications and Medicare and Medicaid fraud. Board of medicine controlled by Attorney generals office hushed up all the allegations despite proved to them beyond doubt.

25. In year 2001, 2002, 2003 & 2004 Contacted Center for Quality health care for Virginia and hushed up the investigation and place the hospital under deemed status. The person botched up investigation came under the influence of Mr. Kilgore, Miss. Jane Woods and Mr. Mark. Warner.

26. In year 2002 & 2003 CCP presented in writing to Kilgore and his assistants the documents and verbal presentation at Virginia Attorney generals office to bring the corruption, patients deaths, Medicare and Medicaid billing irregularities, peer review fraud, embezzling money from the hospital, sale of the hospital and various other issues at SRMC.

27. In year 2003 Jerry Kilgore didn’t investigate any of these allegations and approved the sale of the hospital for his personal benefit and to cover up the allegations due to pressure from the hospital.

28. In year 2002 & 2003 got immunity from federal government and gave some information to FBI.

29. In year 2004 SRMC retaliated and took my privileges from the hospital and report to board of medicine to investigate.

30. In year 2003 Presented to Judge Donald Kent(even though his appointment was tainted) at Petersburg circuit court the various allegations surrounding the sale of hospital and criminal wrong doings in the hospital and promised the citizens of Petersburg look into these allegations and approved the sale on the same day due to pressure from the attorneys from the hospital.

31. In year 2003 the CCP seek the Grand Jury investigation into the criminal wrong doings, fraud, sale of the hospital and various other things happened at SRMC and attorney generals office.

32. In year 2005 SRMC personally try to call Dr. Vuyyuru’s office and news paper and try to recruit the employees to sabotage the businesses.

33. In year 2001, 2002, 2003, 2004 & 2005 personally threatening Dr. Vuyyuru and threats to family members if Dr. Vuyyuru pushes any Further the grand jury investigation. Tampered with the computers and Phone-jamming from the SRMC.

34. They hired a stranger came to house and threatened me in September, 2003.

35. In year 2003,2004, 2005 and 2006 the grand Jury was delayed again, again and again not to get the justice and retaliated against Dr. Vuyyuru and took the medical  license putting pressure not testify to the grand jury.

36. In year 2004, 2005 & 2006 the news paper Virginia Times Investigated the SRMC found various criminal activity related Medicare and Medicaid billing practices and patient negligence resulting in deaths.

37. Notwithstanding, SRMC began to harass and intimidate Dr. Vuyyuru, procuring numerous baseless complaints and ultimately removing Dr. Vuyyuru’s medical privileges at the SRMC and filing with the Virginia Board of Medicine baseless complaints, knowingly, with the intent to retaliate, taking action harmful to Dr. Vuyyuru, including interference with Dr. Vuyyuru’s lawful employment and livelihood, all in retaliation for providing to a law enforcement officer truthful information relating to the commission or possible commission of a Federal offense.

38. SRMC and numerous physicians’ conspirators knew that Dr. Vuyyuru had informed law enforcement officials of concerns that he had regarding conduct related to what he believed to commission or possible commission of a federal offense.

39. Ever since I am grand Jury witness since September, 2003 regarding the corruption in the state and local government became a target for unnecessary investigation by the Attorney generals office since April, 2005 through board of medicine and physically threatening my family and individually by the hospital.

40. They hired a man named “Mathew Wolfman”from New York, to harm me on September 8^th, 2005. I got his name and where he stayed in the hotel details available. I went to assistant commonwealth attorney of local county and local police and the suspect run away.
41. The attorney general office and board of medicine threatened me by revoked my Medical license on May 18^th, 2006 after my testimony against both these agencies on May 17^th, 2006. To revoke my license Attorney generals attorney was inside the Board of medicine room along with board members falsified the evidence and revoked my license in retaliation of my testimony. Take a look at my copy of the notice which is completely against the rules medicine. This need to be criminally investigated.

42. To revoke my license the Hospital personnel killed one patient and try to kill another patient resulted in a vegetative state at John Randolph medical center. Commonwealth states in the document as per Virginia medical standard which doesn’t exist at all. The only standard is American college of Gastroenterology (ACG), American Society of Gastroenterological association(ASGE) or American Gastroenterological Association(AGA) standards only, there is no Virginia standards and no other state have separate standards.  The only expert witness for commonwealth is not even qualified lied under oath regarding his qualifications, didn’t even read or review the patient records and didn’t even read the literature testified against me. My seven expert witnesses are world renowned and who wrote the text book authors and professors from “MCV, Allegheny Medical University, University of South Carolina, Howard University and Cornell Faculty members” testified nothing wrong with the patient care rendered by    Dr. Lokesh Vuyyuru. Despite these scholarly people’s testimony still revoked my license because testifying against the Attorney Generals office, Board of Medicine and hospitals at the Special Grand Jury investigation. I need immediate protection from the court and special grand jury investigation look into Board of Medicine, both hospitals and Attorney General Office regarding tampering of witness as per Grand jury rules.
43. Please provide me the immunity and glad to provide you all the documents and tapes and witness names.

The above facts are accurate to best of my knowledge.

Yours truly

Lokesh B. Vuyyuru, M.D.,