Feds Allege Local Doctor Behind 'Largest Healthcare Fraud Case' in U.S. History

Feds Allege Local Doctor Behind "Largest Healthcare Fraud Case" in U.S. History

By Robert Wilonsky Tue., Feb. 28 2012 at 11:48 AM

We received a release this morning from the U.S. Attorney's Office inviting us to a noon-thirty press conference at the Earle Cabell, at which time U.S. Attorney Sarah Saldaña, Deputy Attorney General James Cole and a host of other federal officials would address "a major health care fraud enforcement action." We now know what that is, courtesy this dispatch from The Los Angeles Times: Rockwall's Dr. Jacques Roy, operating out of a DeSoto office, has been arrested and is being accused of bilking Medicare and Medicaid out of $375 million -- "the largest healthcare fraud case in the nation's history," according to the feds.

Says the piece, and another just posted by Bloomberg, Roy, his office assistant and up to 78 home health agencies recouped the dough for "nonexistent home healthcare services," which the doc used to fill bank accounts and spend on "a sailboat, vehicles and multiple pieces of property." Federal authorities, says The Times, are afraid Roy will try to flee and are asking he be kept in custody till trial. Also, says the piece:

Under the alleged fraud scheme, the doctor and his office manager in DeSoto, Texas, Teri Sivils, who was also charged, allegedly sent healthcare "recruiters" door-to-door asking residents to sign forms that contained the doctor's electronic signature and stated that he had seen the residents professionally for medical services he never provided.

They also allegedly dispatched more "recruiters" to a homeless shelter in Dallas, paying $50 to every street person they coaxed from a nearby parking lot and signed him up on the bogus forms.

That shelter, per the indictment, would be The Bridge downtown. Authorities say this has been going on since '06, and that Roy faces life in prison if convicted. More details to come, including the indictment unsealed today.

Update: The 42-page indictment, which names several other home healthcare providers in and around Dallas, is below. And here's the Department of Justice's lengthy press release announcing the seven arrests. Says Cole: "Thanks to the historic partnerships we've built to combat health care fraud, we are sending a clear message: If you victimize American taxpayers, we will track you down and prosecute you." Roy Indictment

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AltheaR

The pharmaceutical industry is often lauded for medical developments, making narcotics that save lives. However, it is equally lambasted for corrupt practices such as Medicare and Medicaid fraud, which big pharmaceutical businesses are perpetrating to the tune of billions of dollars per year. You may need a short term loan to pay for your medication

ZingZooo

You are right dude, that is totally NOT the answer, for sure.Total-Privacy dot US

NONE

but does he have a Bentley, a safe full of money at home, and wear a bow tie?

trudat

...what I want to know is why are pictures of this perp so hard to find?...I know that usually, any mean mug of Joe Blow the average ten dollar robber would be all over the daily paper and the internet...but here we have someone who's accused of getting away with 300 million plus and there are no pictures...There should (at least) be a sketch of this person. If no sketch is available, why not a mug shot? Did he still so much that he couldn't be photographed?

Max from the Sandspit

If this is true, it gives a whole new meaning to Communtiy Organiser. Wonder why bACRON didn't think of this.....

Admonkey

As Robert pointed out, above, he WAS involved in funding community organizing: for the Tea Party.

http://www.campaignmoney.com/p...

Jay

Criminals give money to politicians from both parties. Call it....professional courtesy.

Admonkey

This one apparently didn't; Other than one donation to the Texas Medical Association, it was Tea Party all the way.

Jay

So when are they going to indict those Dallas area orthodontists operating multiple "free" clinics bilking Medicaid by making fraudulent diagnosis and billing taxpayers for cosmetic orthodontics.

Why do government administered heath insurance regimes suck so very badly at preventing fraud? Is this the new reality we all face as healthcare and health insurance are incrementally nationalized: incompetent healthcare (Parkland) and Medicare/Medicaid, both of which it seems are simple to defraud on very large, ongoing scale basis.

David Haron

Persons who know of this type of fraud should contact an attorney who can bring a civil suit on behalf of the government and can share in up to 30% of a triple damage recovery. We did so on behalf of a whistleblower who sued the City of Dallas and 13 other surrounding cities for ambulance billing fraud and helped recover about $5,000,000 from those cities and a substantial sum for being fired from the City, plus attorney fees!

So the city of Dallas paid triple damages plus attorney fees! How wonderfull

No, I dont think so. Thats only if they were stupid enough to go to court, which they never are. They settle before going to court almost always!!!

JBone

A great way to take the power away from these crooked dictators we call politicians and/or guys like this scum and give it back to the people! No wonder we have a uncontrollable deficit, if everyone, including so called politicians are ripping off and defrauding the United States of America.

Guest

I agree with you David! Just like these guys did:

http://blogs.dallasobserver.co...

http://www.dallasobserver.com/...

Two Cents Worth

I guess we do things bigger in Texas, as the saying goes.

Montemalone

6 years, $375 mil, and only a sailboat and a few cars and houses to show for it?Where's the money?

Finders Keepers

I hope the FBI doesn't take it the wrong way when they catch me with a metal detector in his back yard at three in the morning (just kidding, no really, just kidding).