A doctor in Michigan was convicted last week of knowingly and intentionally billing Medicare for services he never provided and inappropriately prescribing drugs.
According to an article on Michigan Live, “Federal prosecutors accused Mikhayl Soliman, 62, of receiving more than $3 million in fraudulent Medicare claims for home health visits between January 2007 and July 2012.”
Investigators discovered that Soliman, who owned Soliman Medical Center and Soliman Home Visiting Physicians in Wayne, billed Medicare for home health care visits that were never actually performed.
Soliman boldly billed Medicare for visits that took place on dates when he was traveling outside the U.S., even going so far as to bill for services exceeding 24 hours in a single day. In addition to falsifying home medical visits, Soliman also prescribed drugs in a medically irresponsible manner. Many of the prescribed drugs were either sold on the street or used to perpetuate patient addictions.
This conviction comes after a three year long investigation into Soliman’s practice which uncovered plenty of evidence to support the case against him. The doctor is scheduled to be sentenced on January 21, 2016. This case is just one of many that have cost the federal health care system billions upon billions of dollars in recent years.
What is Medicare Fraud?
According to The Free Dictionary, (McGraw-Hill Concise Dictionary of Modern Medicine), “Medicare fraud is defined as any unlawful act which results in the inappropriate billing of Medicare for services by a healthcare provider, including physicians, hospitals and affiliated providers.”
Other cases involve fraud by other methods such as the ones listed below as defined by the National Association of Medical Fraud Control Units:
- False credentials: The qualifications of a licensed provider are misrepresented.
- Substitution of generic drugs: Pharmacy substitutes generic drugs for name brand drugs, billing Medicaid for the cost of the name brand drug and pocketing the difference.
- Billing for unnecessary services or tests: Provider falsifies a diagnosis and symptoms in order to obtain payments for unnecessary tests and/or equipment.
- Kickbacks: A nursing home owner or operator requires another provider to pay the owner/operator a certain portion of the money received for rendering services to patients in the nursing home.
- False cost reports: A nursing home owner or operator includes personal expenses in its Medicaid claims.
Obama Administration Steps Up on Medicare Fraud
In an attempt to get a handle on unmerited charges, the Obama administration has stepped up its auditing and enforcement efforts to stop doctors, hospitals and other medical facilities from cheating on their billings.
According to an article in The Fiscal Times, “the cost-cutting effort involves diligent reviews of reporting procedures as well as a ‘comprehensive corrective action plan’.”
If you work in any area of the medical or pharmaceutical field, it’s imperative to be aware of these types of fraud and the punishment that may result from such illegitimate practices. It’s also vital to realize that simply being the subject of a fraud investigation can leave a blemish on your record that may never go away regardless of whether you are found innocent or guilty.
If you are facing charges for Medicare or Medicaid fraud please contact my office immediately. In order to come through such an ordeal you will need the help of an experienced attorney who is familiar with the local legal system and is qualified to advocate on your behalf.
248-348-7400 or 586-530-1000