A Los Angeles doctor and patient recruiter were convicted last week by a Federal jury on charges that they participated in a scheme to defraud Medicare of $33 million by billing for unnecessary and unperformed services.
Federal prosecutors say the 73-year-old doctor and the 62-year-old patient recruiter were part of a conspiracy whereby the patient recruiters were paid by two other coconspirators, one of whom was the office manager for the defendant doctor and co-owner of a home-health company, and the other who was another co-owner of the same home-health company. Upon being referred to the clinic, the doctor allegedly billed Medicare for unnecessary and unprovided tests.
In addition to claiming services on Medicare that were filed by his own office but never provided or not necessary, investigators say he referred Medicare beneficiaries to the other defendants’ home-health firm, prescribing for them various services and ordering durable medical equipment that was similarly either unnecessary or simply never provided. The owners of the home-health company also allegedly sold the doctor’s referrals to other home health and durable equipment companies as well. Altogether, prosecutors say the conspiracy attempted to defraud Medicare of $33 million, of which 2/3rds of it was paid to them by the government.
The duo were convicted in the chambers of U.S. District Judge Otis D. Wright II of the Central District of California last week, where they are scheduled to be sentenced in mid-September. The doctor was found guilty of found guilty of one count of conspiracy to commit health care fraud and 12 counts of health care fraud, while his codefendant marketer was convicted of one count of conspiracy to commit health care fraud and eight counts of health care fraud.
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