January 2007 Criminal Enforcement Report

Archive Criminal Enforcement Archive

Practitioners

In Michigan, a dentist was sentenced to 15 months in prison and ordered to pay $147,000 in restitution and a $50,000 fine for health care fraud. The dentist’s husband was ordered to pay almost $10,000 for making a false statement. The dentist submitted or caused to submit claims to insurers for services that were not rendered. The investigation revealed that claims were for services rendered when the dentist was on travel or purportedly rendered by the former owner of the practice who had been deceased since January 1996. In addition to the fraud scheme, it was revealed that the dentist, who had been diagnosed with Hepatitis, did not disclose her condition to patients or take certain precautionary measures when treating patients.

In Arizona, a podiatrist sentenced for theft of Government money was ordered to pay $55,000 in restitution. The podiatrist provided non-covered routine foot care services to beneficiaries but billed Medicare as of he performed nail avulsions or debridements.

Durable Medical Equipment

In Idaho, a man was sentenced to 4 months imprisonment, 4 months home confinement and ordered to pay a $5,000 fine for conspiracy. The man, who worked for a DME supplier, orchestrated a Medicare fraud scheme that included falsifying and forging certificates of medical necessity for oxygen services and supplies.

Public Health Related

n South Dakota, an attorney was sentenced to 3 months incarceration and ordered to pay $9,000 in restitution for health care fraud and false claims. The attorney falsely claimed to be part Native American Indian so she could receive free health care services from the Indian Health Service.

Return to Top Top