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Jury finds TX doctor guilty of health care fraud

The Department of Justice (DOJ) recently arrested a Texas physician based on allegations of conspiracy to commit health care fraud, conspiracy to solicit and receive health care kickbacks and false statements relating to health care matters. Overall, the government claims the physician falsely billed Medicare for approximately $16 million in unnecessary services or services that patients did not receive.

First allegations: Conspiracy to commit health care fraud

The first criminal charge involves allegations the physician conspired to commit health care fraud by allegedly billing the government for services that were either medically unnecessary or never provided.

Second allegation: False statements relating to health care matters

The government supported the claim that the physician conspired to commit health care fraud by presenting evidence the physician signed false or fraudulent plans of care from January of 2012 through August of 2016. The prosecution argued the physician used this information support fraudulent Medicare claims.

In addition to leading to health care fraud, the government stated the physician’s false statements in relation to health care matters were also a crime.

Third allegation: Conspiracy to solicit and receive health care kickbacks

The prosecution also presented evidence the physician billed home health agencies a “patient ‘fee’” when they received her patients. This fee was then paid by the home health agency. The government argued this “fee” was a guise. Instead, the prosecution claimed the fee was an illegal kickback payment from the facility to the physician.

Jury finds in favor of government

The trial lasted six days. After reviewing the evidence, the jury ruled in favor of the government. The sentencing will occur at a later date.

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