7 accused of bilking $375M from Medicare, Medicaid

A Texas doctor has been charged with running a massive health fraud care scheme with thousands of fraudulent patients and intermediaries allegedly offering cash, food stamps or free groceries, to bilk Medicare and Medicaid of nearly $375 million.

A federal indictment unsealed Tuesday charges Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto, Texas, and six others in an alleged scheme to bill Medicare for home health services that were not properly billed, not medically necessary or not done.

The scheme was the largest dollar amount by a single doctor uncovered by a task force on Medicare fraud, authorities said.

U.S. Attorney Sarah Saldana accused Roy of “selling his signature” to home health agencies that rounded up thousands of patients’ names and billed Medicare and Medicaid for five years.

The indictment alleged that from January 2006 through November 2011, Roy or others certified 11,000 Medicare beneficiaries for more than 500 home health service agencies — more patients than any other medical practice in the U.S. More than 75 of those agencies have had their Medicare payments suspended.

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