A Texas mayor who is also a physician was recently indicted by federal prosecutors for a Medicare fraud scam affecting home health care and hospice services within the state.
Medicare Fraud Scam Reaches $150 Million
Altogether, the Medicare fraud scam involved $150 million in fraudulent attempted payments. Federal prosecutors brought an 11-count indictment against the mayor of Rio Bravo, Texas over the fraud. The mayor, who is also a physician, was accused of accepting kickbacks in the Medicare fraud scam to refer out patients for services for which the patients did not qualify.
During the time of the alleged Medicare fraud scam, one person owned as well as operated a company known as Harlingen. That company was a group of various entities offering health care and hospice services.
The mayor was the medical director of one of those groups. As one of the medical directors involved, the mayor is accused of receiving kickbacks for referrals of patients and personal certifications attesting that patients were eligible for services.
Multiple People Named as Key Players in Medicare Fraud Scam
Other medical directors were also accused in this Medicare fraud scam and face criminal charges of conspiracy to commit money laundering and conspiracy to commit health care fraud.
Two of those other individuals also face charges of obstructing justice for providing fictitious and false records to a federal grand jury and asking that others involved in the case do the same.
The Medicare fraud scam whistleblower came forward with information that patients were kept on hospice services for years in order to bill the federal health care program of millions of dollars.
According to the Medicare fraud scam whistleblower, the money obtained from the scam was used to buy luxury cars, jewelry, clothing, season tickets to San Antonio sports games, and real estate.
Prosecutors charged the primary physician in the Medicare fraud scam of lying to FBI agents in an interview. The physician denied accepting kickbacks from a confidential source in exchange for referrals for patients.
Whistleblowers often come forward with inside information about people who are perpetrating fraud against the federal government. Those that blow the whistle on government fraud can receive protections under the False Claims Act from retaliation and other discriminatory behavior carried out by their employer.
Whistleblowers are encouraged to come forward and share information about government fraud in order to help save taxpayer money and to ferret out fraudulent and illegal behavior.
Medicare fraud has become an increasing focus for federal regulators and whistleblower actions in recent years as the number of health care providers accused of participating in health care fraud has increased significantly.
Various cases have included allegations of Medicare fraud scams of millions of dollars and whistleblowers will continue to play a key role in raising awareness and curbing abuse.
If you think you have information about a Medicare fraud scam or similar situation, you might be a whistleblower. Schedule time to talk to the attorneys at Bradley/Grombacher today to learn more about your rights- fill out the form located on this page to get more information.