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Jury convicts TX doc of 12 counts of healthcare fraud

| Nov 24, 2020 | Health & Health Care Law, Physicians & Physicians Groups |

Feds recently accused a physician practicing at a family medicine and aesthetics group in Jefferson County, Texas of partaking in a healthcare fraud scheme. Government officials stated the doctor would prescribe medications, such as scar creams, without the patient’s consent or knowledge. When informed of a federal investigation, those gathering evidence for the investigation state the physician altered patient records and provided false information.

Evidence found during the government investigation led to multiple criminal charges.

How did the doctor respond?

The doctor maintained his innocence when faced with the charges. After a four-day courtroom battle, the jury found the medical professional guilty of 12 counts of healthcare fraud, three of aggravated identity theft, one of false statements and two of accepting kickbacks. He faces up to ten years imprisonment for each healthcare fraud conviction as well as two years for each aggravated identity theft conviction. This could lead to a lifetime of imprisonment.

What does this mean for other doctors practicing in the same area?

The case is another in the government’s crackdown on fraudulent billing practices for TRICARE funds. Based on evidence presented in this case it appears the doctor fraudulently received millions from these funds, which provide healthcare for those who serve in the military and their family. Those who bill this or other federal healthcare insurance providers like Medicare and Medicaid are wise to ensure their practices follow all applicable regulations. Healthcare practices can achieve this goal through various means, including internal audits. A failure to do so can result in similar allegations of wrongdoing.


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