Colorado Podiatrist Sentenced to Prison for Health Care Fraud
A Fort Collins podiatrist was sentenced to serve six (6) months in prison and pay a $20,000 fine for fraudulently billing Medicare for routine foot care services, announced Acting United States Attorney John Green.
According to court filings, Dr. Michael Thomas, age 55, pleaded guilty to eight counts of health care fraud arising from a scheme to bill Medicare for toenail trimming, which is not covered by Medicare, as if it were nail debridement, which is a more serious procedure that may be covered if certain clinical criteria are met. As part of the scheme, Thomas created medical records that falsely reported clinical evidence which would justify Medicare coverage for nail debridement even though Thomas did not properly examine the beneficiary and did not find the reported clinical evidence. Thomas also fraudulently submitted nail debridement claims to Medicare when he only trimmed the beneficiary’s toenails, and when he did not provide any service at all to the beneficiary. Thomas employed this scheme to defraud Medicare for at least five years from December 2011 through November 2016.
In addition to the prison sentence and fine, Thomas must pay $40,460 in restitution to Medicare and complete 2 years of supervised release at the end of his prison term.
"Health care fraud is a serious crime that deserves time behind bars," said Acting U.S. Attorney John Green. "Even the short prison sentence imposed here sends a clear message to health care providers that stealing from American taxpayers will not be tolerated."
Steve Hanson, Special Agent in Charge, United States Department of Health and Human Services, Office of Inspector General, Kansas City Region, stated, "In order to protect our Medicare and Medicaid programs from unscrupulous health care providers, our office will continue to work with our law enforcement partners to pursue those who overbill our programs for services they did not provide to our beneficiaries."
The sentence was imposed on June 22 in Cheyenne by the Honorable Alan Johnson, United States District Court Judge for the District of Wyoming.
This case was investigated by special agents from the United States Department of Health and Human Services’ Office of Inspector General, the Federal Bureau of Investigation and the Wyoming Medicaid Fraud Control Unit, and prosecuted by the United States Attorney’s Office for the District of Wyoming.