Whenever someone is facing federal fraud charges, they are likely to face a difficult legal battle as federal officials aggressively prosecute the cases for which they are responsible. On Houston doctor is in the process of fighting federal charges for supposedly committing multiple instances of health care fraud.
According to the prosecution, the doctor submitted over $5.2 million in false claims for Medicare reimbursements. The doctor allegedly referred 352 patients for in-home care, a service none of them actually needed. Despite these serious accusations, the 62-year-old physician says he did not knowingly commit these acts of fraud.
During court proceedings, the doctor admits that he did not look at each case file as carefully as he could have, but he says he relied on the judgment of the agencies that sent him the cases for his approval. At the time he signed the referrals, he believed that all of the patients were actually qualified for the care he approved.
Furthermore, the doctor, who is dealing with severe kidney and eye problems, said that he thought the patients were his own or were referred to him by his personal nurse practitioner.
The agencies responsible for sending the files to the Houston-based doctor admitted guilt during their criminal trials for fraud, which took place last year. During those particular proceedings, the people charged indicated that the doctor was included in their operation.
The notion that the doctor did not knowingly or intentionally commit acts of health care fraud may prove to be consequential in the outcome of the trial. If this testimony does not lead to the charges being reduced or dropped, and a conviction is handed down, it could play a significant role in the doctor's sentencing. Furthermore, his poor health could also influence the court's final judgment. Keeping this in mind, whatever the court decides should accurately reflect all aspects of the evidence and testimony presented.
In rejecting the criminal charges leveled against the physician, his attorney noted, "This man is not a thief. This man was deceived."
Source: The Houston Chronicle, "Houston doctor blames agencies in Medicare scam," Terri Langford, May 23, 2012