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Texas Medicare fraud: years in prison, millions in restitution

Many regular readers of our Austin blog are familiar with Waxahachie. The small city is a nearly three-hour drive north of us, not far from Dallas.

Two of its residents were recently sentenced for their roles in a Medicare fraud scheme. A doctor and an owner of several home health care companies each pleaded guilty to conspiracy to commit health care fraud.

The doctor was sentenced to 30 months in prison. He was also ordered to pay $18,309.171.21 in restitution. The home health care companies’ owner was sentenced to 10 years in prison and ordered to pay $51,497,930.87 in restitution, the Department of Justice said.

Four co-defendants — ranging in age from 55 to 70 — have already been sentenced in the case or are awaiting their sentences.

According to the Justice Department, the six defendants formed what appeared to be three separate companies. But the reality was that the entities operated as a single company, the DOJ said.

In a statement, the Justice Department said, “Had Medicare known of the true ownership and improper relationship between the three companies, Medicare would not have allowed these companies to enroll in the program and bill for services.”

The companies “billed at an alarming rate,” the DOJ said in a statement about the sentences.

The bottom line was that the deceptions by the group and their companies “caused Medicare to pay more than $40 million for fraudulent home health services.”

An experienced Austin health care law attorney protects your rights and interests in administrative and criminal proceedings.