Promises, Promises

9

It is common for deceptive medical professionals to offer treatments or cures to Medicaid or Medicare patients, then bill the government insurance programs for services that were not medically necessary or not provided. A former Philadelphia-area podiatrist, who took a Hippocratic Oath promising to “do no harm” to his patients, not only created the potential for harm to occur to his patients, but also stole from the federal government by submitting nearly $5 million in fraudulent claims.

Over seven years, the foot doctor submitted the fraudulent claims to Medicaid, Medicare and four private insurance companies. (Perhaps the fraudster figured that no one had time to analyze every little bill or claim that was submitted for reimbursement. Well, he was wrong.)

The former 59-year-old podiatrist pleaded guilty to almost $5 million in health care fraud. He will serve eight years in prison plus three years of supervised release. In addition, he will pay $4,960,295 in restitution to Medicaid, Medicare and the private insurers. (That must hurt worse than a bone spur coupled with plantar fasciitis.)

This criminal was one of 301 people charged in a nationwide Medicare-fraud bust that occurred across 36 federal districts and amounted to $900 million in fraudulent payments. This type of fraud preys upon underprivileged patients who are relying upon their doctors’ promises to receive relief from painful conditions or treatment for injuries. While this deceptive podiatrist did not keep his promise to his patients to heal them, the government kept its promise to protect its health care program beneficiaries.

Source: Today’s “Fraud of the Day” is based on an article entitled, “Havertown podiatrist sentenced to 8 years in $5M health-care fraud,” posted by Philly.com on February 7, 2017.

A former Delaware County podiatrist was sentenced Tuesday to eight years in federal prison after pleading guilty to nearly $5 million in health-care fraud, an amount he must now pay back.

The U.S. Attorney’s Office in Philadelphia said Stephen A. Monaco, of A Foot Above Podiatry in Havertown, submitted fraudulent bills to Medicare and Medicaid for that amount for podiatric procedures that were not performed or ones that were not medically necessary between January 2008 and Oct. 31, 2014.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.