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Unlicensed Physician Guilty in Medicare Fraud


A 60-year-old, former Detroit-area physician pleaded guilty for his role in an $11.5 million health care fraud scheme. The man, formerly of Brownstown Township, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud.

 

According to court documents, the former physician admitted that, beginning in approximately September 2009 and continuing through February 2012, he held himself out as a licensed physician and purported to provide physician home services to Medicare beneficiaries, when actually his medical license had been revoked and he was not licensed to practice medicine in Michigan.

 

Court documents allege that the former physician operated his scheme out of a medical practice known as House Calls Physicians P.L.L.C., which was located in Allen Park, Michigan, and owned by a co-conspirator. The former physician prepared medical documentation that licensed physicians signed as if they had provided services to Medicare beneficiaries, when, in fact, they had not. The services were then billed to Medicare as if the licensed physicians had performed them.

 

Court documents further allege that, between approximately May 2008 and October 2012, House Calls Physicians billed Medicare more than $11.5 million for the cost of physician home services. Of that amount, the former physician caused the submission of approximately $1.1 million in false and fraudulent physician services claims.

 

At sentencing, which will be scheduled at a later date, the former physician faces a maximum penalty of 10 years in prison and a $250,000 fine.

 

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