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ST. LOUIS COUNTY — A St. Louis County doctor and nurse practitioner have admitted billing Medicaid for doctor visits when the doctor was out of the country.

Dr. Brij R. Vaid, 58, of Ladue, pleaded guilty Tuesday to a federal charge of making a false claim, a day before his trial was set to begin.

Donna A. Waldo, 59, of St. Louis, pleaded guilty last week.

Dr. Vaid admitted that his office billed Medicaid for treating a patient in 2015 as if he’d personally been there, when he was actually out of the country. Waldo admitted seeing a patient in 2014 and billing Medicaid as if Dr. Vaid were supervising her when he was not present. Both Waldo and Vaid also admitted deliberately closing their eyes “to what would otherwise have been obvious” and taking “deliberate actions” to avoid learning that Medicare and Medicaid were being improperly billed by St. Louis Internal Medicine Inc., which Dr. Vaid ran. Waldo was an advanced practice registered nurse there.

The practice was able to bill 15% more for an office visit with a doctor, prosecutors have said, and the practice also allowed Dr. Vaid to conceal the fact that patients were being prescribed drugs by Vaid when he was not in the office.

Prosecutors say Dr. Vaid also had a large number of patients who received pain medications and anti-anxiety drugs, and that he presigned prescriptions before patient visits so that they were available for staff to hand out when Dr. Vaid was out of the office. They also said he’d been repeatedly warned about his billing practices.

In 2014, Dr. Vaid’s license was suspended for two years as part of a settlement with the Missouri State Board of Registration for the Healing Arts that said he’d committed record-keeping violations for some prescription drugs. It was reinstated in 2016, but federal prosecutors say he violated the terms of his probation agreement.

As part of Dr. Vaid’s plea, both sides agreed to recommend 21 to 27 months in prison at his sentencing hearing in January. He could also face a fine and will have to repay any losses to the government. Waldo could face 10 to 21 months in prison at her sentencing hearing the same month, depending on a number of factors.