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Tuesday, April 12, 2016

Unlicensed Physician Pleads Guilty to Role in Detroit-Based $6.2 Million Medicare Fraud Scheme

An Ohio man pleaded guilty to fraud charges for his role in a scheme to defraud Medicare out of approximately $6.2 million while he acted as an unlicensed physician at a Detroit in-home physician services company.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI Detroit Division 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.

Cecil Alexander Kent Jr., 58, of Eastlake, Ohio, pleaded guilty yesterday before U.S. District Judge John Corbett O’Meara of the Eastern District of Michigan to one count of conspiracy to commit health care fraud, two counts of health care fraud and five counts of making false statements relating to health care matters.  Sentencing is scheduled for Aug. 16, 2016, before Judge O’Meara.

Kent admitted that while he was employed at B&M Visiting Doctors PLC (B&M) and while he was unlicensed, he saw patients and falsified related patient records, including medical documents and billing documents, all under the name of a licensed medical doctor.  He admitted that among those documents falsified were prescriptions for controlled substances, such as Fentanyl, that he personally wrote using the name and U.S. Drug Enforcement Administration (DEA) number of a licensed physician.  Kent knew that Medicare did not pay for patient visits performed by unlicensed individuals, but that such claims were nonetheless submitted to Medicare through B&M, he admitted.

Charles McRae, 61, an unlicensed physician and part owner of B&M, and Alvin Williams, 65, an unlicensed physician, both of Detroit, were charged in the same indictment as Kent and pleaded guilty for their participation in this scheme to defraud.  McRae and Williams will be sentenced in July 2016. 

The FBI and HHS-OIG investigated this case, which was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.  Trial Attorney Melissa Aoyagi and Assistant Chief Robert Zink of the Criminal Division’s Fraud Section prosecuted the case.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 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.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov

Healthcare Fraud
Updated April 12, 2016