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Last of Texas Medicare fraud sentences handed down

A 52-year-old Texas woman was recently sentenced to serve 10 years in a federal prison and ordered to pay more than $23 million in restitution to Medicaid and Medicare. The FBI said the sentence was the last to be handed down in “a massive health care fraud case” run by Dr. Jacques Roy.

Roy was sentenced this past summer to 35 years and ordered to pay restitution of more than $268 million. The FBI said that the doctor and his co-conspirators — several of whom were nurses — perpetrated a home health care fraud involving thousands of patients.

The stiff sentences in the case make it plain that the government places a high priority on matters involving possible fraud in the federal Medicare and Medicaid programs.

“It’s sad when people in the medical community who enjoy a level of trust and responsibility choose to callously take advantage of sick and elderly patients,” said an FBI agent who helped investigated the case in Dallas.

Prosecutors showed that the defendants recruited people with Medicare coverage to receive home health care services. Some of those improperly recruited were in a homeless shelter. The doctor and nurses then falsified documents to make it appear that the recruits were eligible for home health care that was not medically needed.

Roy approved care plans for 11,000 Medicare beneficiaries, prosecutors said. The FBI agent said “it was the largest single-physician home health care fraud in the country.”

While fraud is always unacceptable, the illegal activities of a few bad actors should not tarnish the reputations of everyone else in the home health care industry. If you face investigation, it is imperative that you have legal representation to protect your rights and interests.