No one should doubt the seriousness with which law enforcement officials take allegations of health care fraud. Two Detroit-area doctors have recently pleaded guilty to health care fraud charges and are facing harsh punishments.
A psychologist was recently sentenced to serve 51 months in a federal prison for his involvement in a $3 million scheme that officials said defrauded Blue Cross Blue Shield of Michigan.
The 54-year-old reportedly submitted claims to the insurer for services he never performed. Over a three-year period, he received $3,163,172 from the company for those fraudulent claims.
As part of his sentence for the fraud and for money laundering, he was ordered to forfeit that amount.
Officials said the psychologist had used the funds to buy property, furniture and liquor licenses in hopes of opening a hotel in Arcadia, a tiny town on the shores of Lake Michigan, about four hours northwest of Ann Arbor.
Also in legal trouble: a Farmington Hills doctor who has pleaded guilty to a pair of state charges of Medicaid fraud. The 56-year-old apparently submitted false claims to the joint state-federal government health care program.
She also pleaded guilty to a count of putting false information in medical records, according to a news report.
She is also accused of billing for procedures she never performed. The Michigan Attorney General said an investigation of the doctor’s records determined that she had billed for more treatments than she could have possibly performed. She was also accused of billing for procedures while she was out of the state or country.
If you are being investigated, or suspect that you are a target a health care fraud investigation, you should contact an attorney experienced in Medicare, Medicaid and private insurance fraud defense.