Fraud Vessels

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Corrupt doctor with money in his pocket

Blood vessels are tubular structures that carry blood throughout the body to tissues and organs. Veins are blood vessels that carry oxygen-depleted blood toward the heart. A Missouri doctor and his company used veins as a vessel to carry out a healthcare fraud scheme that stole nearly $150,000 from the Medicare and Medicaid programs.

The 49-year-old cardiologist from Festus and his company pleaded guilty in August to the healthcare fraud scheme. When sentenced in November, he’s looking at up to a decade in prison and a fine of $250,000. His company may be fined for $500,000.

The doctor used his cardiovascular practice to submit false and fraudulent claims to the two government healthcare programs. One of the ways people commit fraud against the programs is by falsifying when procedures are done. Court documents show that, in one claim, the cardiologist said he performed two vein procedures on two different days. He actually performed the procedures on the same day. (What’s the big deal you say? He racked up $2,000 more per patient than he was entitled to collect.) Due to the multitude of fraudulent claims over five years, records show, Medicaid and Medicare paid out $149,199 more than what they should have received.

I guess you could say that the government has cut off the blood flow to this healthcare fraud scheme. Just like a varicose vein that has become damaged and needs to be removed, lets hope that this cardiologist will no longer cause any pain to the government.

Today’s “Fraud of the Day” is based on an article,Local doctor committed fraud for more than 4 years, faces up to 10 years imprisonment, officials say,” posted on KMOV.com on August 20, 2019.

  1. LOUIS (KMOV.com) — A Festus doctor and his company have pleaded guilty to their involvement in a healthcare fraud scheme, charges say.

Court documents say Doctor Antoine Adem, 49, and his company Midwest Cardiovascular pleaded guilty on August 20 for submitting numerous false and fraudulent claims to Medicare and Medicaid between January 2014 and December 2018.

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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.