The government recently accused a doctor of fraudulently billing Medicare, Medicaid and private insurance providers for office visits totaling over $26 million. The government claims the physician billed insurance providers for “nonexistent procedures.” If supported, the allegations could lead to serious financial penalties and, depending on the details of the accusations, potential imprisonment.
A deeper look into “nonexistent procedures”
“Nonexistent procedures” are essentially those the government claims a medical provider never provided. In these cases, the prosecution is attempting to establish the accused fabricated the claim purely for financial gain.
In this case, the prosecution has stated the physician billed insurance providers for millions for nonexistent procedures from 2015 through 2020. They state they have evidence the physician billed for procedures within his clinic that allegedly occurred while he was abroad. According the government, these other locations include the United Kingdom, Spain and Ghana.
Allegations lead to criminal charges
The prosecution states this and other evidence was used to charge the doctor with health care fraud and conspiracy to commit health care fraud. According to a recent report in The Hill, the government prosecutors claim the accused told officials he was using “proceeds of fraud in the United States to establish an empire in a foreign country.”
Case provides lessons for those in similar situations
This case provides an important lesson to anyone who finds themselves the subject of an investigation based on similar charges: you have rights. One important right is the right to have an attorney present to protect your interests during the investigation. This legal counsel can review the situation and provide guidance, potentially including representation during interviews with investigating officers.