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Being naive is no defense to Medicare fraud

Another doctor has been convicted for playing a part in a multi-million-dollar Medicare fraud scheme. The guilty verdict shows that even being "extremely naïve" is not a valid defense to Medicaid fraud charges.

The situation involved a $13 million operation in Houston in which marketers were used to find people to pose as patients and have unnecessary tests performed so that the government could be charged.

The marketers were supposedly paid $100 kickbacks for every "patient" they recruited. The so-called patients were paid $50 for their cooperation, the Houston Chronicle reported.

After the 64-year-old Houston doctor was convicted, his lawyer said the doctor was "extremely naive and his record doesn't suggest otherwise."

The lawyer said that the doctor only worked at the phony clinic a couple of days a week and did not have any interaction with the "patients" until moments before the visits, and he had no way of knowing that the patients were being paid.

But being naïve is not a defense.

All that mattered was that the doctor signed off unnecessary tests for hundreds of patients and permitted the clinic staff to bill Medicare using his physician number.

Unfortunately, this is another example of a doctor getting caught up in a sophisticated Medicare fraud scheme. This time, a 59-year-old Houston man was said to be the ringleader. He ran numerous clinics in Houston and Conroe, according to prosecutors.

Avoid committing a crime with pro-active legal assistance

The government has been coming down extremely hard on anyone who is believed to be defrauding the Medicare or Medicaid system, including physicians.

The best way to avoid inadvertently getting into trouble is by making sure that your practice is completely in-line with Medicare and Medicaid compliance policies.

Learn about how Rivas Goldstein LLP helps Texas helps physicians and health care providers comply with the law, including the Stark law and the Anti-Kickback Statute, here.

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