A pair of Texas clinic workers were indicted by a federal grand jury last week on allegations that they defrauded the Department of Labor out of around $5.9 million through claims for services that were either never rendered or were intentionally miscoded.
The two women, one 47-year-old from Waco and one 41-year-old from Dallas, were each indicted on one count of conspiracy to commit health care fraud last week. According to Federal prosecutors, the duo were involved in a scheme to make claims to the Department of Labor for drug screenings that they never provided as well as intentionally miscoding claims for physical therapy and report-writing services.
Prosecutors say the two, along with other co-conspirators, employed a practice known as “upcoding,” or billing for a similar, yet more expensive, service than the one actually provided. They also allegedly charged for services that were never rendered, and allegedly conducted both fraudulent practices through clinics in Temple and Fort Worth whose primary client base was drawn from Department of Labor patients.
The practice, which allegedly began in early 2011 and continued through the spring of last year, was designed to inflate total reimbursable services, which, in turn, earned the women bonuses that were calculated on the percentage billed to the Department of Labor by their clinics. All in, prosecutors say the pair billed for around $5.9 million in fraudulent charges before the state stepped in and halted the practice.
Last week’s indictment was the product of an investigation by the Fraud Section leads the Medicare Fraud Strike Force. To date the Strike Force has charged almost 4,000 defendants with fraud to Medicare totaling over $14 billion.
The Law Offices of Bjorn Brunvand have been representing people charged with capital murder, felony drug charges, drunk driving, government fraud, and white-collar crimes for over a quarter century. Contact our office today to discuss your Tampa Bay-area state or federal charges.