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TX doctor gets 5 years imprisonment for Medicare fraud

The United States Department of Justice (DOJ) recently built a successful case against a Texas doctor. In this case, the DOJ stated the physician who owned and operated a medical clinic in Houston was signing false and fraudulent “plans of care” for home health services. In reality, the feds state the home health services were either not medically necessary, never provided or both. Instead of providing a service for her patients, the DOJ claimed that from January 2012 through August 2016 the physician was using false documents to fraudulently file for payment from Medicare. Ultimately, they state she was part of a larger scheme that led to over $16 million in funds from false or fraudulent claims to Medicare for home-health services. The prosecutors state that she also personally received over $30,000 in kickbacks connected to this scheme.

How did the physician handle the allegations?

Dr. Yolanda Hamilton maintained her innocence when facing these allegations. This led to a trial before a federal jury. During the six-day trial, the jury convicted the accused of one count of conspiracy to commit health care fraud, one count of conspiracy to solicit and receive health care kickbacks and two counts of false statements related to healthcare matters.

What types of penalties come with this type of conviction?

In this case, the court recently sentenced the physician to five years imprisonment. She is also ordered to pay $9.5 million in restitution. In addition to criminal penalties, the physician could also face ramifications from the state licensing board.