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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.
Doctor Pleads Guilty to Role in $54 Million Medicare Fraud Scheme
- Partner|
Denise Barnes is a former U.S. Department of Justice (“DOJ”) Trial Attorney who focuses her practice on compliance, white collar and regulatory investigations, and complex commercial litigation. She represents clients in ...