Our Georgia and South Carolina healthcare law firm has learned that the United States Department of Justice issued a press release announcing a resolution by settlement of fraud and abuse allegations levied against a Detroit physician, Gerald Daneshvar M.D. Due to our focus on healthcare law, our law firm follows legal developments in the healthcare industry.
Dr. Daneshvar was criminally charged and, following a two-week jury trial, convicted of one count of conspiracy to commit health care fraud. His alleged co-conspirators and co-defendants were Stephen Mason, M.D. and Leonard Van Gelder, M.D. Mason and Gelder plead guilty to conspiracy to commit health care fraud. These doctors were alleged to have worked for Lake MI Mobile Doctors, which provided physician home visits to homebound patients who were Medicare beneficiaries. However, according to the Government’s evidence at trial, Dr. Daneshvar billed Medicare for patient visits where the patient was not really sick or homebound and, along with his codefendants, conspired to bill Medicare at the highest rates even though the patient visits were short or unnecessary. For doing so, these physicians received greater compensation from Mobile Doctors.
Mobile Doctors’ CEO plead guilty in a related case; he was sentenced to 15 months in prison. Another physician, who worked out of Mobile Doctors’ Chicago office, went to trial, lost, and was sentenced to 40 months in prison.
All healthcare providers should be mindful of the legal, financial and career hazards that attend the prospect of being deemed, by the OIG or other law enforcement, to have engaged in fraud and abuse. The United States Office of Inspector General (OIG), through its “Medicare Strike Force,” continues to aggressively pursue fraud and abuse in the healthcare industry. According to the OIG, the Medicare Strike Force Teams are able to combine the resources of Federal, State and local law enforcement to challenge a variety of types and schemes of healthcare fraud and abuse. There are Medicare Strike Force offices in Brooklyn, Detroit, Chicago, Los Angeles, Dallas, Tampa and Miami. The OIG explains that “Strike Force teams have shut down health care fraud schemes around the country, arrested more than a thousand criminals, and recovered millions of taxpayer dollars.” The Federal Government’s efforts in this regard have reaped significant dividends for the Federal taxpayer. For example, the OIG has announced that, with the assistance of state and federal entities, in 2017 more than 400 defendants in 41 federal districts were charged with participating in fraud schemes involving about $1.3 billion in false billings to Medicare and Medicaid. In 2017 alone, 295 Medicare exclusion notices were issued to healthcare professionals based on unlawful activities. The OIG has published a fact sheet entitled “2017 National Health Care Fraud Takedown” touting the OIG’s recent successes in combatting fraud and abuse. According to the press release, “[s]ince its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.”
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Source: DOJ press release
Disclaimer: Thoughts shared here do not constitute legal advice. Please consult with an attorney to discuss your legal issue.