Feds Announce Largest Home Health Fraud Scheme | KERA News

Feds Announce Largest Home Health Fraud Scheme

The owner of a Texas medical service provider is among seven people indicted in a health care fraud scheme that allegedly bilked Medicare and Medicaid of nearly $375 million.

The federal indictment alleges Jacques Roy led a scheme that billed Medicare for home health services that were not medically necessary or were not done. Roy is a doctor who owned Medistat Group Associates in DeSoto, Texas. The indictment was made public Tuesday.

Others charged in the scheme include owners and employees of health care businesses. The indictment alleges that from January 2006 through November 2011, Roy or others certified more Medicare beneficiaries for home health services and had more patients than any other medical practice in the U.S. Phone messages and emails left with Medistat were not immediately returned.

- Associated Press

Press release follows:

REMARKS AS PREPARED FOR DELIVERY BY ASSISTANT ATTORNEY GENERAL LANNY A. BREUER OF THE CRIMINAL DIVISION AT THE DALLAS HEALTH CARE FRAUD ENFORCEMENT ACTION PRESS CONFERENCE DALLAS

Thank you, Deputy Secretary Corr.

Today, the Medicare Fraud Strike Force is taking aim at the largest alleged home health fraud scheme ever committed.

As the Deputy Attorney General noted, this is also the largest single case ever brought by the Strike Force, as measured by the amount of alleged fraudulent billings. According to the indictment, Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services and billing Medicare for those services. One defendant allegedly paid recruiters $50 for each beneficiary the recruiters could deliver from a Dallas-area homeless shelter.

The Strike Force is a uniquely successful partnership between the Justice Department’s Criminal Division and nine of our U.S. Attorneys’ Offices. By using data analysis and other techniques, we are targeting, and putting an end to, Medicare fraud schemes in hotspots across the country. Just last year, we carried out the two biggest health care fraud takedowns in history, together involving more than 200 defendants and over $500 million in alleged fraudulent billings.

Since 2009, the Strike Force has charged more than800 defendants with alleged fraud of over $2.2 billion. These serious crimes have serious consequences. Last year, an owner of a mental health care corporation in Miami that was billing Medicare for unnecessary and illegitimate treatments, was sentenced to 50 years in prison. His co-ownerswere each sentenced to 35 years in prison.

In Dallas, and the eight other Strike Force cities, the Criminal Division and our partners in the U.S. Attorneys’ Offices will continue to crack down on Medicare fraud and hold accountable those stealing from the public fisc. Thank you. I’d now like to turn it over to my friend and partner, U.S. Attorney Sarah Saldaña.