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DOJ charges Texas billing clerk with health care fraud

The United States Department of Justice (DOJ) continues its focus on health care fraud investigations involving National Football League (NFL) players. The agency recently announced another round of criminal charges. As discussed in a recent post, the agency indicted ten players earlier this month for health care fraud crimes. This round of criminal charges involves a billing clerk that was allegedly affiliated with a health care fraud scheme that involved another, former NFL player.

What was the alleged health care fraud scheme?

The accused worked as a billing clerk for Dr. Les Benson. In the seventies, Dr. Benson played professional football for the Dallas Cowboys. After getting a medical degree he opened a practice that focused on physical therapy.

According to the report, the government has accused the physician of providing monetary compensation whenever the billing clerk over billed for services provided by the clinic. The government has accused the woman of taking these payments in exchange for filing fraudulent claims as well as training others within the clinic to make similar fraudulent claims.

The woman fought the charges. Her case took five days in front of a federal jury. Ultimately, the federal jury convicted the billing clerk of six counts of health care fraud. Sentencing will occur in March of 2020.

What is the takeaway lesson?

This case provides yet another example of the broad reach of the government when pursuing health care fraud charges. The government can, essentially, charge anyone that is connected to billing of health care fraud. As such, anyone that is under investigation for similar charges is wise to take the matter seriously

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