There are many government programs to help ensure those who need medical care receive treatment, even if they cannot afford needed care. Medicare and Medicaid are two examples and Veterans Affairs Medical Centers are another. Medical professionals can bill these programs for services rendered to certain qualifying patients. Most physicians use these programs within the bounds of the law, others see it as an opportunity for abuse and still others are wrongly accused of such abuse.
The government recently convicted a cardiology and electrophysiology specialist of such abuse.
What were the accusations? According to the United States Attorney’s Office, the physician held a contract with the Department of Veterans Affairs. This contract outlined an agreement between the government and the doctor, allowing the doctor to provide care to eligible veterans. The government has accused this physician of abusing this contract by fraudulently billing for over 350 procedures.
The government states the physician never completed the procedures. Instead, they claim he received $238,230 in payments from the VA for work that he never completed.
What are the penalties? The accused cardiologist pleaded guilty in federal court to charges of healthcare fraud. The judge presiding over the case sentenced the physician to 20 months of prison time. The judge also required the doctor pay a fine of $7,500 and over $238,230 in restitution to the United States government as well as an additional $476,460 civil settlement.
The physician is also required to complete two years of supervised release upon completion of his prison sentence.