Healthcare Compliance Perspective:
It is essential that healthcare providers conduct background investigations on vendors to verify that they do not have any criminal offenses related to the delivery of services under Medicare or Medicaid or any felonies related to the unlawful prescription or distribution of controlled substances.
A U. S. Attorney recently announced the guilty plea by former Warren County, Kentucky, physician to multiple charges of unlawful distribution and dispensing controlled substances and healthcare fraud.
The formerly licensed physician in the Commonwealth of Kentucky, was initially indicted by grand jury in Bowling Green on June 10, 2015. According to the terms of the plea agreement, the doctor agreed to serve a sentence of 96 months in prison and pay restitution in an amount to be determined at sentencing on May 7, 2018.
Today’s plea agreement covers criminal activity between 2006 and September 19, 2013, in Warren County, Kentucky. The accused admitted to conspiring with members of his office and others to knowingly and intentionally distribute and dispense, not for a legitimate medical purpose in the usual course of professional practice, these controlled substances: Methadone, Fentanyl, Hydrocodone and Clonazepam and Oxymorphone.
The doctor also admitted to falsely and fraudulently billing various healthcare benefit programs, including Medicare and Medicaid and others during this same timeframe. The fraudulent billings resulted from the submission of claims for medically unnecessary spirometry tests and electrocardiogram(EKG/ECG) tests for patients.
The former licensed physician is subject to forfeiture to the United States government of any proceeds derived from his unlawful activity in the offenses and forfeiture of his license to practice medicine.
