- Cigna Settles FCA Allegations for $172 Million, Demonstrating DOJ’s Part C Focus
- Verizon Cooperates with DOJ related to Cybersecurity Allegations
- Justice Department Demonstrates its Focus on Part C Fraud with Martin’s Point $22.5 M Settlement
- DOJ, BIS and OFAC Issue Tri-Seal Compliance Note
- Booz Allen Pays $377 M to Settle Improper Indirect Cost Allegations
- NextGen’s $31 M Settlement of an Alleged False Certification and a Kickback Violation
- Things Just Got Interesting: A Disclosure, A Lawsuit and A False Claims Act Settlement
- Genotox resolves AKS parallel investigation with the DOJ
- Self-Disclose to Avoid Self-Sabotage: Clarifying DOJ’s Criminal Corporate Self-Disclosure Policy for US Attorney Offices
- With Recent Enforcement Action, DOJ and FTC Join the FCC in Targeting the Use of Ringless Voicemails
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White Collar + Fraud + Investigations + Compliance
On Tuesday, the Department of Justice announced that Texas doctor, Daniel Canchola, pled guilty to conspiracy to commit wire fraud related to his role in signing orders for durable medical equipment and genetic testing resulting in more than $54 million false and fraudulent claims to Medicare. The DOJ alleged that Canchola received approximately $30 in exchange for each signed doctor’s order authorizing DME and cancer genetic tests that were not legitimately prescribed, not needed or not used. Notably, Canchola only received $466,000 in kickbacks, but the amount submitted to Medicare in connection with the fraudulent claims was over $54 million.
This case is particularly egregious because Canchola signed doctor’s orders for testing without seeing, speaking to or otherwise treating the patients. This is an excellent example of how a relatively small amount of kickbacks can taint the claims submitted to the federal healthcare programs associated with a much larger amount—in this case over $54 million. Engaging in kickbacks can result in significant exposure to companies that far exceeds the kickback paid.
Finally, it should come as no surprise to practitioners in this space that, in addition to facing considerable prison time (up to 20 years), Canchola will be excluded from participating in the federal healthcare programs in the future. A criminal plea or guilty verdict in this context will generally result in an exclusion--a fatal blow for healthcare companies.
A link to the DOJ’s announcement of the guilty plea is provided below.