A doctor and medical billing supervisor in Louisiana pled guilty last week to Federal charges that they conspired to defraud Medicare and other health insurers.
Federal prosecutors say the 66-year-old medical doctor and his 56-year-old medical billing supervisor owned and operated a pain management in Baton Rouge that, from the summer of 2005 through the spring of 2015, submitted a litany of false claims to Medicare and private insurers.
Per investigators, the scheme involved sending in claims for minor surgery the day after they took place instead of the day of the procedure. The practice, known by some as "unbundling," is a method by which unscrupulous health care providers can claim for benefits on office visits that do not otherwise qualify for reimbursement. Investigators say the doctor not only engaged in the practice himself, he also directed his subordinates, including the billing director, to falsify records supporting his own fraudulent claims.
In addition to this alleged practice, the defendant doctor was alleged to have received $336,000 in illegal kickbacks, an allegation for which he also pled guilty last week.
All told, the doctor pled guilty to one count of conspiracy to commit health care fraud, while his medical billing supervisor pled guilty one count of conspiracy to commit health care fraud and wire fraud and two counts of health care fraud. Both individuals entered their plea in the chambers of U.S. District Judge Shelly D. Dick of the Middle District of Louisiana. Neither of their sentencing dates have been scheduled, but both will occur in the same court in which they entered their guilty pleas.
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.