Feds: Texas doctor among 7 accused in largest health care scam in US

Posted in the Georgetown Forum

DOC

Milton, Canada

#1 Feb 28, 2012
Feds: Texas doctor among 7 accused in largest health care scam in US

By msnbc.com staff and news services

DALLAS — The owner of a Texas-based medical service provider is among seven people indicted in what authorities say is the largest health care fraud scheme in U.S. history, bilking Medicare and Medicaid of nearly $375 million.

The federal indictment alleges Dr. Jacque Roy, who owns Medistat Group Associates in DeSoto, of leading a scheme that billed Medicare for home health services that were not medically necessary or were not done.

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The indictment alleges that from January 2006 through November 2011, Roy or others in the scheme certified more Medicare beneficiaries for home health services and had more patients than any other medical practice in the U.S.


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Roy, 54, and the other defendants, who have been taken into custody, were expected to appear Tuesday afternoon before a judge in Dallas federal court. Others charged in the scheme include owners and employees of health care businesses.

The Centers for Medicare and Medicaid Services also announced the suspension of an additional 78 home health agencies associated with Roy based on credible allegations of fraud against them.

U.S. Attorney Sarah Saldana said that Roy used the home health agencies as "his soldiers on the ground to go door to door to recruit Medicare beneficiaries."

“Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services and billing Medicare for those services,” according to the indictment.“One defendant allegedly paid recruiters $50 for each beneficiary the recruiters could deliver from a Dallas-area homeless shelter.”

A person answering calls at Medistat in DeSoto declined to speak with msnbc.com .

Health care fraud is estimated to cost the government at least $60 billion a year, mainly in losses to Medicare and Medicaid.

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