Michigan Doctor Pleads Guilty to Role in $2.5 Million Medicare Fraud Scheme
A Southfield, Michigan-based doctor pleaded guilty today for his role in a scheme involving approximately $2.5 million in fraudulent Medicare claims for home health and physician services that were medically unnecessary, not provided and procured through the payment of illegal kickbacks.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, Special Agent in Charge Timothy R. Slater of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.
Thomas Mays, M.D., 65, of Farmington Hills, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Sean F. Cox of the Eastern District of Michigan. Sentencing has been scheduled for Sept. 20, 2019, before Judge Cox.
As part of his guilty plea, Mays admitted that he offered and provided kickbacks in the form of prescriptions for controlled substances to Medicare beneficiaries who agreed to accept his purported physician services and referrals for home health care services. He further admitted that he prescribed medically unnecessary home health care services to Medicare beneficiaries. The prescriptions, in turn, were used by home health agencies to bill Medicare for home health services purportedly provided to Medicare beneficiaries. Mays billed Medicare for physician services that he purportedly provided to Medicare beneficiaries that were medically unnecessary, never provided and acquired through kickbacks, he admitted.
According to admissions made in connection with his plea, from 2012 to 2018, the intended losses to Medicare as a result of the scheme were approximately $2.5 million.
The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision of the Criminal Division’s Fraud Section. Trial Attorneys Jay McCormack and Tom Tynan of the Fraud Section are prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.