Come for the Groupon, Stay for the Unnecessary Services: Doctor and Owner Convicted in Multimillion Dollar Fraud Scheme

February 27, 2019 | Strategic Insights for Health System

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A doctor and a hospital owner in Texas were found guilty of their roles in a multimillion dollar healthcare fraud scheme, according to a February 22, 2019, release from the U.S. Department of Justice (DOJ). The doctor and owner were convicted of one count of conspiracy to commit healthcare fraud, 17 counts of healthcare fraud, and 3 counts of money laundering. At trial, evidence was shown that both submitted false and fraudulent claims for tests that were not medically necessary or not provided and then billed at the hospital for a higher reimbursement rate. Another physician, who previously pleaded guilty to conspiracy to commit healthcare fraud, is awaiting sentencing.

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