More than a dozen health care professionals in North Texas are accused of submitting hundreds of millions of dollars in false and fraudulent health care claims.
Jenny Kane/AP
More than a dozen health care professionals in North Texas are accused of submitting hundreds of millions of dollars in false and fraudulent health care claims.
Physicians, nurses and other health care workers face an array of federal charges, from conspiracy to commit fraud to offering and accepting bribes. The charges are part of a sweeping federal investigation announced Tuesday that has led to charges against about 450 people, including 90 physicians, nationwide. Authorities say the fraudulent claims totaled $6.5 billion nationwide.
In North Texas, authorities say they have identified $365 million in fraudulent and false claims and have seized more than $35 million in cash, luxury vehicles and other assets.
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“Health care fraud is not a victimless crime,” Jason Meadows, special agent in charge of the Department of Health and Human Services, said at a news conference Tuesday in Dallas. “This kind of fraud drains critical resources, steals from American taxpayers and directly threatens programs meant to serve our most vulnerable citizens.”
Related: Frisco couple arrested in $2.5 million psychic fraud scheme to cleanse curses
A look at cases
A Fort Worth physician is accused of running a years-long scheme to administer ultrasounds, EKGs and other medically unnecessary tests on student athletes with no preexisting conditions.
Prosecutors say Dr. Jason Finkelstein, 53, preyed on the fears of athletes that they could die of sudden cardiac arrest on the court or field. He offered bribes and kickbacks to athletic directors and hired sonographers without proper training to travel to college campuses around the country administering tests, the indictment says.
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At the same time, Finkelstein declared tests normal without properly examining them, the indictment says. In one case, a patient’s results were incorrectly certified as normal. He later died after his heart problems went undetected.
Finkelstein has pleaded not guilty in a federal courtroom this week in Florida. An attorney for the doctor did not return a phone call or email Tuesday from The Dallas Morning News.
From 2019 to 2024, Finkelstein submitted some $89 million in false and fraudulent claims to commercial and federally funded insurance programs, prosecutors say.
Insurance companies do not typically cover blanket cardiovascular testing, instead requiring a medical necessity. To avert that requirement, prosecutors say, Finkelstein submitted phony diagnoses of conditions, such as elevated blood pressure and hypertension.
In a separate case, a salesman for a Fort Worth company is accused of operating a scheme that submitted $1.2 billion in fraudulent claims for pricey wound coverings called skin substitutes.
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Prosecutors say Brian Rowan, 47, vice president of sales for Legacy Medical Consultants, offered illegal kickbacks, bribes and rebates to providers who used the company’s bandages.
In a statement Tuesday, Legacy Medical Consultants said, “We have been fully cooperating with the government, and we are confident the company and its employees acted appropriately.”
Skin substitutes, high-tech wound dressings derived from placenta tissue, can cost nearly $6,000 per square centimeter. Prosecutors say Rowan helped health care providers set up shell companies for the manufacturers to deposit doctors’ rebates.
Sales representatives and providers targeted elderly patients, many of whom were terminally ill in hospice care, and did not need the wound coverings, prosecutors say.
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Rowan used the sales proceeds to purchase a $47,000 Rolex watch and $1 million life insurance policy, according to court documents.
Related: Texans charged as part of alleged $14.6 billion in health care fraud