Medicare Fraud: Medicare Scam Recruiters

March 1, 2012 by staff 

Medicare Fraud: Medicare Scam Recruiters, Federal law enforcement officials announced charges in the largest healthcare fraud scam in the nation’s history, indicting a Dallas-area physician for purportedly bilking Medicare of nearly $375 million after he reportedly sent out “recruiters” to round up patients and get them to sign for treatments he never provided.

The Medicare billings piled up by Dr. Jacques Roy grew so large over the last five years that the situation left outside experts wondering Tuesday why it took prosecutors so long to notice.

“To get that kind of money, you’d need to be treating a million people,” said Andrew Selesnick, a Los Angeles lawyer who represents physicians. “You’d have to have 30 locations and tons of people going through them.”

The arrest of the Canadian-born doctor, a physician for nearly 30 years, comes at a time when healthcare fraud is sharply increasing, with fewer people able to afford doctor visits and Medicare and other government programs paying less in reimbursements.

That phenomenon has prompted more healthcare providers to cut corners, with more doctors and clinicians looking for new ways to pay off expensive student loans and medical equipment, or just keep afloat in an industry that is burdened with high insurance and other costs.

Atty. Gen. Eric H. Holder Jr., in testimony Tuesday before a House Appropriations subcommittee, said federal prosecutors were fighting back. In the last fiscal year they recovered nearly $4.1 billion in funds “stolen or taken improperly from federal healthcare programs,” he said. “This represents the highest amount ever recovered in a single year.”

At the same time, Holder said, the Justice Department opened 1,100 new criminal healthcare fraud investigations, won more than 700 convictions, and initiated 1,000 civil healthcare fraud investigations.

In all, he said, for every dollar spent fighting healthcare fraud, “we’ve been able to return an average of $7 to the U.S. Treasury, the Medicare Trust Fund” and other government entities.

Roy, 54, was arrested Tuesday at his Rockwall, Texas, home, where authorities found bank statements from the Cayman Islands, a fake Texas driver’s license, and passport photos of him with and without glasses and wearing different outfits. In one room was a book titled “Hide Your A$$ET$ and Disappear.”

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