Sarah Saldaña, US Attorney with a history of fighting corruption
The owner of a Texas medical service provider was among seven people indicted in a massive health care fraud scheme that allegedly bilked Medicare and Medicaid of nearly $375 million…
The federal indictment accused Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto, Texas, of leading a scheme that billed Medicare for home health services that were not medically necessary or were not done. Also indicted were Roy’s office manager as well as the owners of three home health agencies. A federal indictment unsealed Tuesday accuses the agencies of using Roy to rack up millions of dollars in false claims…
Roy had “recruiters” finding people to bill for home health services, said U.S. Attorney Sarah Saldana, the top federal prosecutor in Dallas. Some of those alleged patients, when approached by investigators, were found working on their cars and clearly not in need of home healthcare, she said.
Medicare patients qualify for home health care if they are confined to their homes and need care there, according to a federal indictment.
Saldana said Roy used the home health agencies as “his soldiers on the ground to go door to door to recruit Medicare beneficiaries…”
The Centers for Medicare and Medicaid Services also announced the suspension of an additional 78 home health agencies associated with Roy. The agencies were collecting about $2.3 million a month, said Peter Budetti, CMS’ deputy administrator for program integrity.
Until recently, HHS could not effectively track data to identify the kind of fraud now linked to Roy, who was billing beneficiaries “off the charts” for more than five years, officials said…The department is now beefing up its data analysis and tracking other cases, Levinson said. It has also established task forces in several U.S. cities to track Medicare fraud…
Digitizing and interconnecting medical records is one of the programs vehemently opposed by Republicans and Blue Dog Democrats early days in the Obama administration. I wonder how many of the thieving cruds in this case are stalwarts of Texas conservative politics?
Health care fraud is estimated to cost the government at least $60 billion a year, mainly in losses to Medicare and Medicaid. Officials say the fraud involves everything from sophisticated marketing schemes by major pharmaceuticals encouraging doctors to prescribe drugs for unauthorized uses to selling motorized wheelchairs to people who don’t need them.
Again, the clownshow run by nutballs ranging from Mike Huckabee to Ron Paul says these are the corporate gangsters we should trust with running healthcare in the United States. Anyone see any of the vaunted “self-regulating” leaders in insurance and healthcare ever turn over a fraudster?