Texas
Related: About this forumTexas Doctor Accused of Defrauding $3.2 Million From Taxpayer-Funded Healthcare Program
The U.S. Attorneys Office is accusing Cockerell Dermatopathology (CDP) of submitting $4.2 million in fraudulent claims to TRICARE, the healthcare program for the nations military members.
The False Claims Act lawsuit was filed against Dr. Clay Cockerell, who allegedly permitted a laboratory management company to use his clinics lab license to submit false claims. These unnecessary tests were submitted to federal health insurance programs. Cockerell was nearly named chairman of Baylor Scott & Whites dermatology program in 2016, when both sides of the agreement backed out after the scheme was exposed. Cockerell was also a past president of the American Academy of Dermatology and a clinical professor of dermatology at UT Southwestern.
In March 2015, the government says Cockerell authorized management company Progen to use his clinics license to submit claims for toxicology and pharmacogenomic tests in exchange for 20 percent of net revenue from Progen for the fraudulent tests. Cockerell attempted to avoid the federal anti-kickback laws by specifying that his clinic would not provide services to federal beneficiaries like TRICARE, Medicare, and Medicaid.
The False Claims Act was first passed during the Civil War to fight the massive fraud during the war, where contractors sold the government decrepit horses, weaponry, and other equipment. The law was meant to stop government contractors from fraudulently claiming services rendered. If healthcare providers submit fraudulent claims to the federal government, they are at risk of federal prosecution. But fraudulent providers who avoid federal payers (as Cockerell intended) may still be at risk of federal prosecution. In the Forest Park Medical Center trial, prosecutors used the Federal Travel Act to prosecute providers involved in an illegal kickback scheme, even though the fraud was committed against private insurance companies rather than the federal government. This legal reasoning opens up a new avenue for federal prosecution for fraudulent claims and kickbacks an avenue that has already sentenced 14 defendants to 74 years in prison.
Read more: https://www.dmagazine.com/healthcare-business/2021/04/texas-doctor-accused-of-defrauding-3-2-million-from-taxpayer-funded-healthcare-program/
Bluepinky
(2,260 posts)When your god is money and greed, anti-corruption rules are speed bumps on the road to nirvana.