Ohio Doctor charged with Medicare conspiracy targeting Washington residents

 An Ohio Doctor has been charged in a fraudulent medical supply scheme that targeted elderly Washington residents.

Thomas Andrew Webster, M.D., 50, of Sylvania, Ohio was charged with one count of Conspiracy to Violate the Anti-Kickback Statue by targeting elderly Medicare and TRICARE beneficiaries throughout Washington and other states, according to a press release from the U.S. Attorney for the Eastern District of Washington's Office.

The conspiracy charge carries a maximum sentence of up to five years in prison.

“Telemarketing schemes that target and exploit the elderly are especially pernicious because they prey on those who are often most in need of a doctor’s independent judgment that is not tainted or biased by the doctor’s own personal financial interest,” said U.S. Attorney Vanessa Waldref.

Medicare and TRICARE provide health insurance coverage for eligible health care services, including, under certain eligibility conditions, for Durable Medical Equipment (DME).

DME is eligible for reimbursement if it is ordered by a physician who is treating the beneficiary for a specific illness or injury.

Between May 2021 and September 2023, Dr. Webster lived in Olympia, Washington and was a licensed physician in the state.

According to the press release from the U.S. Attorney's Office, Webster engaged in a telemarketing scheme to obtain beneficiary identifying and medical information by using telemarketers to contact Medicare and TRICARE beneficiaries in the Eastern District of Washington 

Dr. Webster then used the information to create fake medical records that reflected a doctor visit that never took place, and medical orders for DME.

Dr. Webster then signed the fraudulent medical documentation and physician orders, which were then sold to DME companies that used the orders to bill Medicare and TRICARE falsely and fraudulently, according to the U.S. Attorney's Office. 

Medicare and TRICARE reportedly paid more than $13.7 million in fraudulent DME orders over the two years of the scheme, with Dr. Webster receiving $839,565 from Medicare and TRICARE for fraudulent telemedicine visits that never took place.

Popular posts from this blog

IMPORTANT UPDATE: Ohio Medicaid is upgrading its provider enrollment system

Effective August 1, 2022, ODM will not be accepting new provider enrollment applications or continue any in-progress enrollment applications through the MITS Provider Enrollment System. Details on the process for enrollment of new OhioRISE providers from August 1 to October 2022 will be communicated prior to August 1st. Effective October 1, 2022, all provider enrollment applications must be submitted using Ohio Medicaid’s new Provider Network Management (PNM) portal. After its implementation, the PNM portal will be the single point for providers to complete provider enrollment, centralized credentialing, and provider self-service. Provider Network Management Portal and Centralized Credentialing Beginning on October 1, 2022 the Provider Network Management (PNM) portal will accept Medicaid provider enrollments and carry out centralized credentialing functions. This transition will reduce administrative burden for providers and enable providers to focus on the more meaningful and importan
Read more

Medical Billing Companies Spill About Outsourcing Operations

  A recent survey of medical billing companies shows a positive outlook on revenue cycle outsourcing, with many seeing payment collection as an opportunity. Nearly two-thirds of medical billing companies have a rising positive outlook about the current state of the revenue cycle outsourcing industry, according to a recent  survey  from Tebra. The practice growth technology company recently surveyed 277 medical billing company owners, leaders, and team members serving independent practices and clinics in the US. The majority of respondents belonged to companies that serve less than ten practices and clinics. Medical billers are optimistic about the future of the industry despite increased competition, healthcare consolidation, and other unfavorable macro forces. About 43 percent—up from 27 percent in 2018—reported outsourcing of medical billing as a significant opportunity to leverage technology to optimize services, reduce repetitive tasks, and boost revenue.
Read more

How the marriage of primary care and behavioral health is driving the EHR industry

Image
  As more primary care providers integrate behavioral health services into their practice, EHR platforms must evolve to meet the needs of healthcare providers and their patients. The U.S. is suffering from a mental healthcare crisis. According to the   National Alliance on Mental Illness  (NAMI), one in five adults in the U.S. experience a mental health disorder each year, but less than half (47.2%) received treatment in 2021. These data points become even more devastating when you consider that suicide is the second leading cause of death among children age 10- to 14-years-old, with one in six kids age 6- to 17-years-old suffering from a mental health disorder every year. The silver lining here, if there is one, is that deep-rooted stigmas attached to behavioral healthcare are finally losing their crushing grip on our patient populations as more people openly discuss mental health issues. Another step in the right direction: two years after the pandemic resulted in alarming waves of s
Read more