by Brian Mahany
Federal prosecutors in Dallas charged a Texas physician and 6 others in a massive healthcare fraud. They say the defendants defrauded taxpayers of as much as $374 million dollars by making false claims to Medicare and Medicaid. Their crime spree went on for years before being caught.
Healthcare fraud is nothing new. Not a week goes by without some small nursing home operator, physician’s practice or home health agency being accused of bilking Medicare. Ultimately those crimes hurt all of us – higher healthcare costs and less availability for people truly in need. Lately, however, the crimes have become more brazen.
Recently we reported a medical group that was performing unnecessary cardiac surgical procedures, allegedly just to make more money from Medicare. Patients were left in great pain just so a few doctors could boost their pay. The Texas indictment is also in a category all to itself.
Prosecutors say that Dr. Roy Jacques and his partners at Medistat Group Associates “certified more Medicare beneficiaries for home health care and had more patients than any other medical practice in the United States.” They say Dr. Jacques was also a fraud and a thief.
Medical billing fraud of that magnitude involves many people. One physician alone can’t bill that much or see that many patients. Conspiracies of this size are rare – the more people involved, the higher the risk that someone “blows the whistle.” In fact, most healthcare fraud is exposed by remorseful participants or by coworkers who realize a crime is being committed.
According to the indictment, a business manager working for the defendants appears to be the person who came forward and cooperated with investigators. In our opinion, whistleblowers are the true heroes. Until someone comes forward, authorities often have no clue who is legitimate and who is breaking the law.
Prosecutors say that Jacques and his co-defendants billed for services not performed and performed services not medically necessary. The enterprise became so large that at one point the government claims that Jacques was telling associates to give out cash and groceries to Medicare beneficiaries to get them to sign up for medical services – services they didn’t need.
To many people, this type of activity is harmless yet it hurts everyone. In many places, there are waiting lists to receive medical assistance. That means that some go months without care while a handful of doctors and nurses submit hundreds of millions of dollars in false claims. The tab for those claims, of course, is picked up by the taxpayers.
If you are aware of healthcare fraud, or any other type of fraud involving taxpayers money, you may be able to collect a large cash award for your information. The United States and many state governments have whistleblower laws – often called “false claims acts” or the “Lincoln law” – that entitle whistleblowers to receive a significant percentage of any monies recovered by the government. In a case this size, that could be tens of millions of dollars.
The law firm of Mahany & Ertl presently has the largest accepted false claims case in the nation. Whether it be our $2.4 billion whistleblower case against Allied Home Mortgage or something much smaller, we proudly represent whistleblowers and insure they receive proper respect and compensation.
If you are aware of mortgage, healthcare, highway, defense or other billing fraud involving taxpayers, give us a call. All inquiries are kept in strict confidence. For more information contact attorney Brian Mahany at (414) 704-6731 (direct) or by email at
Mahany & Ertl – America’s Fraud Lawyers. Offices in Milwaukee, Wisconsin; Detroit, Michigan; Portland, Maine & Minneapolis, Minnesota. Services available in most jurisdictions.