By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
Two South Florida doctors, both former medical directors at the mental health care company American Therapeutic Corporation (ATC), will spend 10 years in prison for their part in a $205 million Medicare fraud scheme. A U.S. district judge handed down the sentence on October 1, 2012. Click here to see the press release on the sentencing from the Department of Justice (DOJ).
I previously wrote a blog on this story, to see the details, click here.
The two doctors were each found guilty of one count of conspiracy to commit health care fraud. Each doctor will have to pay millions of dollars in restitution and serve three years of supervised release after their prison terms.
Doctors and Others Allegedly Created False Documents for Medicare Reimbursements.
Allegedly, ATC billed Medicare for hundreds of millions of dollars in services, for thousands of patients who were not qualified. The charges alleged fraudulent documents were created by the doctors and others associated with ATC. The doctors would allegedly sign patient documents without having seen or treated the patients.
ATC operated partial hospitalization programs (PHPs) throughout Florida and would allegedly bill Medicare for PHP treatments for patients in the names of the doctors. Included in these submissions to Medicare were claims for patients who were allegedly ineligible for PHP treatments. ATC allegedly did not provide legitimate PHP treatment, but illegally changed patient medical records to justify claims that were submitted.
Don't Wait Until It's Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.
The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
What are your thoughts on this blog? Is the sentence these physicians received too long? Please leave any thoughtful comments below.
U.S. Department of Justice. "Two Miami-Area Doctors Sentenced to 10 Years in Prison for Participating in $205 Million Medicare Fraud Scheme." FBI. (October 1, 2012). Press Release. From: http://www.justice.gov/opa/pr/2012/October/12-crm-1187.html
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Tag Words: Medicare, Medicare audits, Medicare fraud, termination of Medicare billing privileges, Centers for Medicare & Medicaid Services (CMS), corrective action plan (CAP), request for reconsideration, physicians, medical groups, medical practices, fraud prevention, Medicare number revocation, Medicare termination, OIG special agents, FBI, Medicare Fraud Strike Force, defense attorney, defense lawyer, Florida defense attorney, Florida Medicare lawyer, Florida Medicare attorney
"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.