Health Care

Seven Indicted In $375 Million Medicare Scam

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A Texas doctor and six others were indicted Tuesday on charges they defrauded Medicare and Medicaid to the tune of nearly $375 million dollars.


From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.


And I'm Audie Cornish. In Texas, federal prosecutors have indicted seven people in a massive health care fraud scheme. The group, led by a doctor, defrauded Medicare and Medicaid of nearly $375 million.

From Dallas, NPR's Wade Goodwyn reports on what the government says is the largest scam ever tied to a single physician.

WADE GOODWYN, BYLINE: The alleged scheme was audacious. According to the indictment, Dr. Jacques Roy, a Canadian who moved to Alabama and then to Texas, first recruited a web of home health care agencies. Then these agencies would go door-to-door and sign up patients. Some of the people who filled out forms got cash. Some got groceries or food stamps. Some were promised free medical services. Some apparently were signed up without their knowledge.

Deputy Attorney General James Cole.

JAMES COLE: The indictment alleges that Dr. Roy's company, Medistat, consisted of just four doctors and approximately 15 nurses. Yet for the five years covered by the indictment, Dr. Roy's company is alleged to have certified more Medicare beneficiaries for home health services and had more beneficiaries under its care than any other medical practice in the country.

GOODWYN: That would be 11,000 individual Medicare beneficiaries who either got services that were not medically necessary or, in many cases, never rendered at all. The indictment details how Dr. Roy and his nurses would go down to Dallas' state of the art homeless shelter called The Bridge and try and sign up the homeless. The Bridge security guards and staff eventually became suspicious and informed Roy and his staff they could not see or treat or sign up patients in The Bridge courtyard nor on the sidewalk outside the facility. But prosecutors say that didn't stop them. They simply rented a room at a church down the street and steered the homeless there.

Deputy Attorney General Cole said it was quite an operation. Thousands of people moving through these HHAs all leading to Dr. Roy and his collaborators.

COLE: These services were provided by more than 500 home health care agencies, or what are called HHAs. In turn, these HHAs and Medistat are alleged to have fraudulently billed Medicare for more than $350 million and Medicaid for more than $24 million.

GOODWYN: The alleged conspirators were said to be living the good life in Rockwall, a suburb of Dallas on Lake Ray Hubbard: beautiful houses, big boats, nice cars. But they are facing the prospect of spending the rest of their lives in federal prison.

Wade Goodwyn, NPR News, Dallas.

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