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Demystifying Medicine One Month at a Time

Fraud. Breathtaking Fraud. [Alleged]

Not always, apparently.

This week the Medicare empire of Dr. Jacques Roy of Texas came crashing down.

Dr. Roy and his business partners have been accused by federal investigators of fraudulently billing Medicare (i.e. you and me) $350 million.

That’s a lot of band-aids. No matter how expensive they are.

The bills were run up in a mere six years. Rounding up a tad, that averages out to $60 million per year. Five million dollars a month of Medicare billing.

The allegations include falsely enrolling seniors for home health services they neither requested, were eligible for, or ever received. It seems the doctor and his associates simply found people with names and ages, and issued bills for services in their names.

Dr. Roy’s company, Medistat, with only six doctors on staff, supposedly provided service to more than 11,000 Medicare patients. This made Medistat the largest single Medicare home health provider in the country.

You’d think this would be an instance where ‘blending in’ would’ve been a better criminal strategy.

Outliers, beware.

No comments on why it took five years to bring the charges. Better late than never.

Does it mean anything that Dr. Roy is Canadian? Clearly he saw more economic opportunity in our wild-West, ‘free-market’ medical system than he did back home where things are a bit more ‘controlled.’

Letters

Great op-ed in the NY Times last week by H. Gilbert Welch of Dartmouth. I blogged previously about his excellent book, Overdiagnosed.

I recommend his op-ed. It’s a succint version of the thesis of his book.

You’ll like the letters to the editor in response to his piece.¬†They’re linked here.

1 Comment

  1. Congrats on the letter to the editor! Wow, NPR and the NYTimes in less than one month!

    You’re right–it shouldn’t have taken so long to bring charges against Dr. Roy. My husband has worked with two doctors who have been arrested, but not for such a huge thing as this. One stole shoes from Nordstrom Rack and the other for stalking/fondling a patient. Of course these crimes are terrible, but they only affect the parties involved, not the whole country. Good grief.

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