Fort Worth Doctor Sentenced to 10 Years in Health Care Fraud Conspiracy
A Fort Worth osteopath who attempted to incinerate clinic records has been sentenced to 10 years in federal prison for his role in a $10 million healthcare fraud, announced Acting U.S. Attorney for the Northern District of Texas Prerak Shah.
Mark Kuper, the 43-year-old owner of the Texas Center for Orthopedic and Spinal Disorders (TCOSD), was indicted in June 2020. Three months later, he pleaded guilty to one count of conspiracy to commit healthcare fraud. He was sentenced Thursday by U.S. District Judge Reed C. O’Connor.
According to plea papers, Mr. Kuper admitted he conspired with his wife, Melissa Kuper, and a TCOSD physical therapist, Travis Couey, to defraud Medicare, Medicaid, and TRICARE.
The defendant admitted he fraudulently billed insurers for services the clinic never actually rendered, including physical therapy and psychotherapy, and required patients to attend these bogus appointments in order to receive Schedule II controlled substance prescriptions.
He also admitted that he gave his wife access to the secure device and passcode he used to sign controlled substance prescriptions, allowing her to improperly dispense pain medications on her own initiative, without his input.
In plea papers, Mr. Kuper acknowledged that he submitted claims stating that TCOSD had developed individualized physical therapy plans of care for each patient, knowing full well that the clinic had simply issued a boilerplate template, and for one-on-one physical therapy, even though the patients were actually meeting in groups with an athletic trainer who was not qualified to perform physical therapy.
Mr. Kuper further admitted that although he billed insurers for professional 60-minute psychotherapy sessions, most patients actually spoke with unqualified professionals for just 15 to 20 minutes – often when Mr. Kuper was out of the office.
On multiple occasions, Mr. Kuper billed as though he’d provided more than 100 hours’ work in a single 24-hour day. From 2014 to 2017, he submitted more than $10 million in claims to Medicaid, Medicare, and TRICARE.
As the scheme unraveled, Ms. Kuper attempted to destroy TCOSD documents in an outdoor fireplace at their home. The blaze destroyed their residence, but firefighters were able to recover some of the charred records from the outdoor fireplace.
Mr. Kuper also tried to cover up evidence of the fraud by accessing hundreds of electronic patient records and altering the purported treatment notes to make them appear more comprehensive.
Both Ms. Kuper and Mr. Couey pleaded guilty in September 2020 to conspiracy to commit healthcare fraud. They were sentenced to 18 months and 36 months, respectively.
A civil investigation into TCOSD began after whistleblower Richard Brown filed a qui tam suit alleging that Dr. Kuper was committing fraud through his clinic.
On May 29, 2020, the Civil Division of the U.S. Attorney’s office filed a complaint in partial intervention against Dr. Kuper, Mr. Couey, and Dr. Kuper’s clinic. The Government’s False Claims Act complaint alleged that Dr. Kuper submitted fraudulent claims for physical therapy, psychotherapy, and pain injection services to federal healthcare programs.
In addition to his guilty plea, Dr. Kuper and his clinic agreed to settle the False Claims Act lawsuit by entry of an agreed judgment against Dr. Kuper and his clinic in the amount of $11,190,222. As part of the settlement, Dr. Kuper also agreed to liquidate his real estate portfolio and other assets to satisfy the civil judgment. The whistleblower, Richard Brown, will receive 17% of the government’s recovery.
The Health and Human Services Office of Inspector General, the Defense Criminal Investigative Service, and the Texas Medicaid Fraud Control Unit, a division of the Texas Attorney General’s Office, conducted the investigation, with assistance from the Drug Enforcement Administration’s Dallas Field Division. Assistant U.S. Attorneys Lindsey Beran and Steve Fahey, NDTX Criminal Chief, prosecuted the criminal case. Assistant U.S. Attorneys Richard Guiltinan and Kimberly McCoy handled the False Claims Act case for the United States.