The United States Attorney’s Office recently announced a physician has pled guilty to criminal health care fraud charges. The charges are the result of a health care fraud investigation that led to over 15 criminal charges for four medical professionals.
More on the charges: What was the result of the health care fraud investigation?
Based on information gathered from the investigation conducted by the Federal Bureau of Investigation (FBI) and the Defense Criminal Investigative Service’s (DCIS) Southeast Field Office, the United States Department of Justice (DOJ) accused the physician, along with another physician and two registered nurses, of various health care fraud crimes. The criminal charges include conspiracy to commit health care fraud, mail fraud, conspiracy to distribute and dispense a controlled substance, disturbing and dispensing a controlled substance and conspiracy to pay and receive health care kickbacks. The group was accused of defrauding a federal health care program, TRICARE, which benefits military members, veterans and family members.
The controlled substance in question was a compounded medication. One example specifically included within the indictment was a medication that used ketamine. The investigation resulted in evidence that questioned the thoroughness of the physician’s exams before prescribing the medication. The physician would allegedly conduct video-chat sessions but did not gather enough information to determine if the medication was medically necessary.
More on the case: What were the penalties?