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NY doctor and physical therapist convicted for health care fraud

| May 27, 2019 | Physicians And Group Practices |

The United States Attorney for the Southern District of New York recently announced the conviction of a medical doctor and physical therapy doctor for health care fraud. The conviction was the result of a six-week jury trial and results in a total of 15 convictions for the state stemming from this same scheme. The New York State Office of the Medicaid Inspector General’s Complex Frauds and Cybercrime Unit is handling the case.

The prosecution accused the two medical professionals of conspiring together, billing Medicare and Medicaid for medical supplies and services that were either not provided or medically unnecessary. The allegations were broken down as follows:

  • Medical doctor. The prosecution accused the doctor of posing as an owner for medical clinics. This is a violation of state law, which requires doctors own and operate medical clinics. The government also accused the physician of signing off on “stacks of false and fraudulent medical charts” and issuing referrals for patients to seek the services of the physical therapist.
  • Physical therapist. The government successfully accused the physical therapist of creating an appearance of physical therapy, when no physical therapy was actually provided. As such, the prosecution accused the physical therapist of falsely billing Medicare and Medicaid.

The case provides a valuable lesson for medical doctors: be careful what you sign. If another person asks you to review and sign a medical chart, make sure you take the time to know what you are signing. A failure to review the documents could result in allegations of health care fraud.

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