Fatal Fraud

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21295881 - ambulance paramedic unit in motion. speeding ambulance. emergency call. healthcare photo collection.

Fraud is generally not considered fatal, just costly (and really aggravating) for victims. In fact, criminals, who may have previously committed crimes such as selling drugs, often turn to fraud because they can make a good amount of money without as much risk. Today, we look at a physician from Frisco, Texas who pleaded guilty to healthcare fraud after being caught for falsifying prescriptions that hastened the deaths of his patients. (To say that is creepy is an understatement.)

 The physician, who worked for a now closed hospice provider in Frisco, joined the company as the medical director one year prior to the company shutting down. While serving in that capacity, the doc admitted to falsifying medical documents and pre-signing blank prescription forms in bulk. (The prescriptions were for controlled substances such as morphine and hydromorphone.)

Additional co-conspirators involved in the scheme filled in the rest of the information on the prescription forms. Court documents show that nurses at the hospice company administered high doses of the controlled substances to speed up patient deaths. Apparently, the physician at the center of today’s fraud article was unaware that his pre-signed blank prescriptions were being used in such a manner. (The doc’s attorney said he was horrified to find out. I’m sure the families of the deceased were equally horrified.)

So, here’s what supposedly happened. The Frisco physician’s attorney stated that he signed the bulk prescriptions out of “convenience” and never intended for the pre-signed prescriptions to be used in that way. (Fair enough, but what he didn’t consider was how his actions might make it easier for unscrupulous fraudsters to use those scripts illegally.)

The company’s CEO and other co-conspirators worked behind the scenes to enroll as many patients as possible in hospice care, including individuals who were not eligible for the services. Once enrolled, the patients received 24-hour hospice care, which incidentally received a higher reimbursement rate from Medicare than routine care. (If the patients didn’t die fast enough, the company authorized workers to overmedicate them to hasten their deaths.)

Perhaps the physician didn’t intend for his pre-signed prescriptions to be used illegally; however, today’s fraud article states that he did know that the CEO, who directed medical services, had no medical license. (And now, neither does the physician.)

The physician of the now defunct hospice provider based in Frisco, Texas pleaded guilty to a healthcare fraud scheme that stole $60 million from Medicare and caused the fatal overdosing of patients for profit. The Texas doc is one of four convicted. The other twelve engaged in the fraud scheme have an upcoming trial date set. (Death is never convenient, but neither is jail. While a lengthy prison sentence may serve as justice, no amount of time behind bars can make up for a life that was ended before its time.)

Today’s “Fraud of the Day” is based on an article entitled, “Physician pleads guilty in $60M fraud scheme allegedly linked to patient deaths,” published by Beckers Hospital Review on September 14, 2018.

A physician at Novus, a shuttered hospice provider in Frisco, Texas, has pleaded guilty to a conspiracy charge for his role in a $60 million fraud scheme that federal prosecutors say involved fatally overdosing patients for profit, according to The Dallas Morning News.

Charles Raymond Leach, MD, pleaded guilty Sept. 11 to one count of conspiracy to commit healthcare fraud. He joined Novus in 2014 and became medical director before the company shut down in late 2015. He is one of 16 defendants charged in the healthcare fraud scheme in February 2017.

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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.