$900 Million Health Care Fraud Investigation Focuses on Texas and Florida

By Peek & Toland on August 26, 2016

Investigating health care fraud has been a priority of the Obama administration in recent years, and the busts appear to be getting bigger. Federal prosecutors say they have uncovered the largest healthcare fraud to date and it’s centered on Texas and Florida.

Last month, the Justice Department announced charges against hundreds of people across the United States who are accused of being part of a $900 million Medicare fraud.

A massive health care fraud was investigated in Texas

CNN described the bust as “the largest takedown in history,” in terms of the amount that the Department of Justice said was involved and the number of participants.

Investigators allege most of the cases in question entail separate fraudulent billings to Medicaid, Medicare or both systems for treatments that were not provided.

Over recent years health care fraud has become a leading white collar crime in Texas. We have seen the arrests of a considerable number of medical professionals.

The CNN report said a doctor in Texas was charged with involvement in schemes to bill Medicare for home health services that were not necessary and were not provided.

The Department of Justice said the fraud in Texas amounted to $193 million making it the biggest player in the alleged scheme after Florida where the feds claim the fraud ran to $237 million. Dallas and San Antonio were listed as hot spots in Texas.

The investigation was carried out by the Medicare Fraud Strike Force which forms part of a joint initiative between the Departments of Health and Human Service and Justice. It was set up in 2007.

CNN reported the strike force has carried out operations which have led to more than 1,000 people being charged with more than $3.5 billion in health care fraud.

Federal investigators have shown considerable zeal in pursuing health care fraud operations. When there is pressure to get results, medical professionals risk being erroneously being drawn into investigations and losing their reputations and livelihoods.

At Peek & Toland , we represent people who have been charged with white collar crimes. Although these are not offenses of violence, they carry harsh sentences and it’s vital to get experienced legal representation as soon as possible. Contact our Austin defense attorneys here or call (512) 474-4445.


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Texas is at the Center of Health Care Fraud Investigations

By Peek & Toland on June 16, 2016

Cracking down on health care fraud is an avowed aim of the Obama administration, and some of the largest investigations have been here in Texas.

The National Health Care Anti-Fraud Association points out as much as $2.27 trillion a year is spent on healthcare and more than four billion insurance claims are processed annually. The financial losses due to health care fraud run into tens of billions of dollars a year.

Last month, a federal jury in Dallas found former Rockwall doctor Jacques Roy guilty of what the Dallas Morning News described as the largest home health fraud in the nation that involved a single doctor.

Texas is at center of health care fraud

Roy and his associates were accused of enticing Medicare patients by offering them food stamps, cash, and groceries as part of the $400 million scam. Prosecutors said he recruited fake patients, including homeless people, to make false health care claims.

A jury convicted Roy and three owners of home care agencies of heath care fraud, making false statements related to health care matters, conspiracy to commit health care fraud and obstruction of justice. When Roy was arrested in 2012, federal investigators said they had busted the largest Medicare fraud scheme ever discovered.

The FBI makes no secret of its commitment to uncovering health care fraud and new investigators have been drafted into these probes across Texas and elsewhere. On its website the FBI states.

“Health care fraud costs the country tens of billions of dollars a year. It’s a rising threat, with national health care expenditures estimated to exceed $3 trillion in 2014 and spending continuing to outpace inflation.”

Just a month before the Roy verdict, A Dallas anesthesiologist was convicted of defrauding about $10 million from the federal government.

The Dallas Morning News reported Dr. Richard Ferdinand Toussaint Jr. was convicted of seven counts of fraud. He admitted submitting bogus claims in 2009 and 2010 to United Healthcare, the Federal Employees Health Benefits Program, Blue Cross Blue Shield of Texas and other programs.

Given the fact there are federal investigators whose sole job is to look for health care fraud, you should contact an experienced Texas criminal defense attorney immediately if you are accused of these serious offenses. Doctors and other health care professionals who are convicted of these charges will lose their livelihoods and their reputations overnight.

Our highly reputable Austin-based criminal defense attorneys have a long track record in helping those charged with fraud and other white collar crimes. Call us to schedule a free no obligation consultation with one of our experienced lawyers at (512) 474-4445.

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