Unlicensed Physician Pleads Guilty to $6.2 Million Medicare Fraud Scheme
The government’s crackdown on Medicare fraud often uncovers some startling surprises that not only involve the actual crime(s) that have been committed, but also reveals interesting facts about the background of individuals charged with those crimes. Take for example the case of an Ohio man who pleaded guilty last week for his role in attempting to defraud Medicare out of approximately $6.2 million while acting as an unlicensed physician at a Detroit in-home physician services company. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division and the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG), along with other representatives from several other federal agencies made the announcement this month. The man, Cecil Alexander Kent Jr, pleaded guilty before U.S. District Judge John Corbett O’Meara to one count of conspiracy to commit health care fraud, two counts of health care fraud and five counts of making false statements regarding health care matters. He will be sentenced on August 16, 2016 before the same judge.
Kent admitted that while he was employed at B&M Visiting Doctors PLC (B&M) he saw patients, and falsified their records including billing documents all while being unlicensed. Moreover, Kent admitted that he falsified prescriptions for controlled substances while claiming to be a licensed medical doctor. Kent prescribed the drug Fentanyl by using the name and DEA number of a licensed physician. Medicare does not pay for patient visits by unlicensed individuals and although Kent knew this, he nonetheless submitted claims to Medicare through B&M. Two other men – Charles McRae, a part owner of B&M and Alvin Williams – were each charged in the same incident with Kent and each pleaded guilty for participating in the fraud scheme. Neither man was a licensed physician.
The FBI and HHS-OIG investigated this case as part of the Medicare Fraud Strike Force. Several other agencies and individuals participated in the prosecution of this case. Since it began in March 2007, the Strike Force has charged over 2,300 individuals who have collectively billed Medicare more than $7 billion. The initiative uses, as a tool for prosecuting cases, the Whistleblower Protection Act which protects people who provide the government with information about fraudulent activity. Such individuals are also entitled to a portion of any award collected by the government in its efforts. If you need a false claims act lawyer or whistleblower protection act lawyers you should seek one who is experienced in this area of the law. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
