Former Physician Pleads Guilty to Health Care Fraud Scheme
KANSAS CITY, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that a former Kansas City, Mo., physician who lost his medical license due to an earlier fraud scheme, pleaded guilty in federal court today to his role in a fraud scheme that involved disability examinations of veterans.
Wayne W. Williamson, 74, of Kansas City, waived his right to a grand jury and pleaded guilty before U.S. District Judge Howard F. Sachs to a federal information that charges him with health care fraud.
Williamson was a medical consultant at Industrial Medical Center (IMC) during various periods beginning at least as early as 2013 through at least March 2015. IMC was a medical clinic in Independence, Mo.; among other things, it was a drug and DNA testing center, had contracts with various entities to provide medical services to patients, and provided drug testing and physical examinations for drivers of commercial motor vehicles.
Williamson was formerly a medical doctor but voluntarily surrendered his medical license in 2010 after he pled guilty to health care fraud; conspiracy to distribute Oxycotin, Percocet, and Xanax; and harassing or attempting to harass an investigator with the Missouri State Board of Healing Arts. Williamson was sentenced to three years in federal prison and permanently excluded from participation in Medicare or Medicaid programs.
Williamson performed disability examinations for the Department of Veterans Affairs under IMC’s contract with Logistics Health, Inc., to determine the extent of veterans’ impairments and eligibility for benefits. This was done in violation of Logistic Health’s contract with the Department of Veterans Affairs, which required that disability examinations be conducted by credentialed providers and that the examiners must have a clear and unrestricted license and not be excluded from participation in the Medicare or Medicaid programs. However, after the only trained and licensed provider at IMC left on July 16, 2013, Williamson conducted the examinations.
IMC falsely represented that a physician had completed and electronically signed the Disability Benefits Questionnaires. IMC submitted invoices to Logistics Health to be paid for 209 disability examinations on 53 veterans. In turn, Logistics Health submitted invoices to the Department of Veterans Affairs for the disability examinations performed by its subcontractor, IMC. The Department of Veteran’s Affairs paid Logistics Health $39,155 for the disability examinations performed by its subcontractor, IMC.
Under the terms of today’s plea agreement, Williamson must forfeit $39,155 to the government.
In April 2014, Logistics Health contacted the Department of Veterans Affairs—Office of Inspector General hotline and reported the fraudulent activity. Because a credentialed provider did not conduct the disability examinations, the Department of Veterans Affairs had to re-adjudicate all those claims. Some veterans had to be physically re-examined, and others had their claim file reviewed.
Under federal statutes, Williamson is subject to a sentence of up to 10 years in federal prison without parole. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.
This case is being prosecuted by Assistant U.S. Attorneys Cindi S. Woolery and Jane Pansing Brown. It was investigated by the Department of Veterans Affairs—Office of Inspector General, the Department of Transportation—Office of Inspector General, the Department of Labor—EBSA and the Department of Health and Human Services—Office of Inspector General.