Medicare fraud is no laughing matter when you consider that it costs the U.S. government, and the taxpayers, a bundle in the form of higher taxes and inflated health care costs. Not to mention the burden placed on law enforcement and the criminal justice system trying to catch and prosecute all these criminals.
One case that comes to light in November 2014, however, may be worth a chuckle or two.
A jury in Texas has convicted a doctor and an unlicensed physician’s assistant of health care fraud. Dr. Dennis B. Barson Jr., 44, and clinic administrator Dario Juarez, 54, face prison time and substantial fines. A co-defendant, Edgar Shakbazyan, pleaded guilty in October.
It came out in the trial that fraudulent billing was made for rectal sensation tests and electromyogram studies of the anal or urethral sphincter that were never performed.
Good thing the authorities got to the bottom of this one.
In other health care news:
- Miami, Florida, resident Elsa Ruiz, 45, was sentenced to 80 months in prison for her part in ripping off Medicare for $74 million. She was also ordered to pay $45 million in restitution. Ruiz was the owner and administrator of two home health care companies. She and her co-conspirators billed the Medicare program for expensive physical therapy and home health care services that were not medically necessary or were not provided. Ruiz’s main role was arranging kickbacks to patient recruiters.
- According to a 25-count indictment, Louisville, Kentucky, chiropractor Devin Thauberger, 44, and office assistant Trish Muir, 27, conspired to submit fraudulent claims to Medicare, Passport, Anthem, Humana, Geico, Shelter, Nationwide, and other insurance carriers, for services that were never provided to patients, including times when Thauberger was out of the country. False claims were allegedly submitted on at least 11 occasions and totaled around $200,000. The accused are also charged with stealing patients’ identities and obstructing the criminal investigation.
- In the Detroit, Michigan, area Dr. Vicha Janviriya, 77, pleaded guilty to health care fraud. He admitted that from February 2006 through September 2012 he falsified medical documents and falsely certified Medicare beneficiaries as homebound or requiring home health care services. In many cases, he had never met those beneficiaries. He caused Medicare to pay approximately $1,366,496 based on his false home health certifications.