Feds Say Texas Doctor Ran $375 Million Medicare Scam
A Texas doctor and five owners of home health agencies were arrested today on charges that they are part of a nearly $375 million fraudulent home health-care ring that authorities say is the largest such case ever against a single doctor.
The doctor, Jacques Roy, 54, of Rockwall, Tex., was charged in an indictment with masterminding a Medicare fraud conspiracy over the past five years. The alleged fraud involved classifying as homebound 11,000 patients from more than 500 agencies, and then billing unnecessary services and home visits, according to the indictment filed in the Northern District of Texas.
Roy’s alleged scheme resulted in more than $350 million being fraudulently billed to Medicare and more than $24 million being fraudulently billed to Medicaid.
“The conduct charged in this indictment represents the single largest fraud amount orchestrated by one doctor,” said Deputy U.S. Attorney General James Cole. “If you victimize American taxpayers, we will track you down and prosecute you.”
Tuesday’s indictment is the latest in a series of Medicare fraud cases, which have become a centerpiece of the Obama administration’s push to cut health-care costs. A recent report indicated that health-care fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars last year, the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers by seeking payments to which they weren’t entitled.
Investigators from the Department of Health and Human Services targeted Roy’s business after analyzing Medicare billing data and finding a disproportionately large number of home health claims for which Roy was the certifying physician.