Memphis-Based Methodist Le Bonheur Healthcare and Methodist Healthcare-Memphis Hospitals Pay $7.25 Million to Settle Allegations that They Violated the False Claims Act
Dr. John J. Cauthon, 51, of Murfreesboro, Tennessee, was sentenced yesterday in U.S. District Court to two years in prison for healthcare fraud, announced Don Cochran, U.S. Attorney for the Middle District of Tennessee. Cauthon was indicted in October 2015 on seven counts of healthcare fraud and was found guilty on four counts, after a jury trial in September 2017.
In sentencing Cauthon, Chief U.S. District Judge Waverly D. Crenshaw, Jr., noted that Cauthon had accepted no responsibility for his actions and showed no remorse. Chief Judge Crenshaw found that Cauthon caused an intended loss of $218,000, and ordered restitution of approximately $83,252.63.
Cauthon is a podiatrist in Murfreesboro who contracted to provide podiatric services to residents of nursing homes located throughout Tennessee.
According to court documents, between May 2014 and August 2015, Cauthon engaged in a scheme to defraud Medicare, TennCare, and BlueCross BlueShield of Tennessee, by submitting $200,000 in fraudulent claims for a surgical procedure for nail avulsions, which he did not perform.
At trial, numerous witnesses from nursing homes across the state of Tennessee testified that Cauthon never performed the avulsion procedures that he claimed he performed; including in some instances, claiming that he had performed more than 30 avulsions in a single day. Nursing home residents also testified that Cauthon simply clipped their toenails. Former employees also testified that Cauthon directed them to bill Medicare for services that were medically unnecessary and directed them to fit bed-ridden patients in nursing homes with ankle braces, which served no medical purpose.
This case was investigated by the Tennessee Bureau of Investigation; the U.S. Department of Health and Human Services - Office of Inspector General; and the United States Attorney’s Office for the Middle District of Tennessee. Assistant U.S. Attorneys Henry Leventis and Ryan Raybould prosecuted the case.
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