On April 27, a 57-year-old Ohio man was found guilty of health care fraud and several other charges related to a Medicaid billing scheme. According to prosecutors, the man received around $2 million in fraudulent reimbursements from Medicaid.
Billing for X-rays that were never done
The defendant was the president of a company called Portable Radiology Services that worked with nursing homes and other long-term care facilities. Between January 2013 and December 2017, he submitted claims to Medicaid and Medicare for X-ray services that were never performed.
According to court documents, around 151 reimbursement requests were submitted for X-ray services for patients that had already passed away. Other fraudulent claims were submitted for services performed on dates and times when the patients would not have been available.
Further charges for activities during an audit
A Medicaid Managed Care Organization audited Portable Radiology Services before the indictment. During the audit, the defendant allegedly attempted to hide fraudulent activities by forging signatures and creating false medical records. These activities led to convictions for aggravated identity theft, which is a felony.
Sentencing scheduled for August
The man’s sentencing for the Medicaid fraud scheme is scheduled for August 2. He will be facing a two-year mandatory minimum prison sentence for aggravated identity theft that must run consecutive to any other sentence. Counts for false statements about a health care matter have a maximum five-year prison sentence, and each count of health care fraud has a 10-year maximum prison sentence.
Defense against Medicaid fraud charges
Running a health care services company that accepts public and private insurance can be very complicated. In some cases, mistakes in bookkeeping can look like fraud. If you were accused of participating in a Medicaid fraud scheme, you may be able to build a defense by proving that you did not intentionally falsify information in claims.