KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Texas Doctor Charged In $375 Million Medicare Scam

Federal authorities charged the Dallas-area physician and five owners of home health-care agencies with a scheme that included registering homeless people for home health care services they never received.

The Wall Street Journal: Doctor Accused Of Big Medicare Scam
Federal agents on Tuesday arrested a Dallas-area doctor accused of bilking Medicare of $350 million over a five-year period, in what the government called the largest Medicare fraud scheme by dollar value linked to a single physician. According to documents filed by the Justice Department in Dallas federal court, 54-year-old Dr. Jacques Roy carried out the fraud with the help of his office manager and home health-care agencies (Zimmerman and Radnofsky, 2/29).

The Washington Post: Texas Doctor Charged in $375 Million Health-Care Scam, The Largest Of Its Kind
A Texas doctor and five owners of home health-care agencies were arrested Tuesday on charges that they fraudulently billed Medicare and Medicaid nearly $375 million in what authorities described as the largest case of its kind (Horwitz, 2/28).

Los Angeles Times: $375-Million Medicare Fraud: Dallas Doctor Accused In Record Case
Federal law enforcement officials announced what they called the largest healthcare fraud case in the nation's history, indicting a Dallas-area physician for allegedly bilking Medicare for nearly $375 million in billings for nonexistent home healthcare services. Top Justice Department officials, working for several years to stem a rampant rise in healthcare fraud around the country, also revealed Tuesday that 78 home health agencies that were working with the physician, Dr. Jacques Roy, will be suspended from the Medicare program for up to 18 months (Serrano, 2/28).

The New York Times: Seven Charged In Health Care Fraud
The federal authorities in Dallas arrested a Texas doctor and six others Tuesday in a home health care scheme that the authorities said cheated the government out of nearly $375 million in Medicare and Medicaid fees. It was so brazen, they said, that it involved registering homeless people for home health care services they never received (Thomas, 2/28).

NPR: Texas Doctor Indicted In Record Medicare Fraud Case
A massive Medicare and Medicaid fraud scheme has been shut down by federal authorities. One doctor in Texas, Jacques Roy, was allegedly responsible for nearly $375 million in fraudulent billing (Goodwyn, 2/29).

The Texas Tribune: Texans Accused of $375 Million Health Care Fraud
Only Medicare patients who are home bound qualify for home health services. Officials with CMS said home health agencies are under intense scrutiny when they enroll, because their services are expensive (Aaronson, 2/28). 

Bloomberg: Texas Health-Care Services Accused By U.S. Of $374 Million In Phony Bills
Seven people in Texas billed U.S. government health programs for $374 million in services that weren't provided or necessary in the largest at-home health-care fraud scheme, according to the Justice Department.  A doctor, the office manager of his practice and five owners of at-home health agencies were arrested yesterday on charges related to their participation in the fraud, the department said in a statement. In court papers, the U.S. described door-to-door efforts to recruit thousands of patients who didn't need services, a boiler room where falsified documents were signed and overseas bank accounts (Stern, 2/29).

The Dallas Morning News: Rockwall Doctor Who Owns DeSoto Medical Firm Among 7 Accused In Bilking Medicare, Medicaid For $375 Million
A Rockwall doctor's brazenness in allegedly charging the government for fake services, along with regulators’ newfound ability to analyze bills faster, helped dismantle the nation's largest home health care fraud ever orchestrated by a single physician, prosecutors said Tuesday. The doctor and six associates were charged with recruiting fake patients among Dallas' homeless population and elsewhere, then falsifying records that earned the defendants $375 million over a five-year period, authorities said(Drahan, 2/28). 

The Associated Press: 7 Accused Of Bilking $375M From Medicare, Medicaid
A Texas doctor has been charged with running a massive health fraud care scheme with thousands of fraudulent patients and intermediaries allegedly offering cash, food stamps or free groceries, to bilk Medicare and Medicaid of nearly $375 million. A federal indictment unsealed Tuesday charges Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto, Texas, and six others in an alleged scheme to bill Medicare for home health services that were not properly billed, not medically necessary or not done (Lozano and Merchant, 2/28).

The Hill: Obama Administration Credits Health Reform Law For Record-Setting $375M Fraud Bust
The Obama administration announced Tuesday that federal law enforcement officials have arrested a Texas doctor and the owners of five home health agencies on charges they defrauded Medicare and Medicaid by a record-setting $375 million over five years. The administration credits a joint initiative created in 2009 between the departments of Justice and Health and Human Services for the indictment (Pecquet, 2/28).

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