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Medicare fraud occurs when a hospital, nursing home, doctor's office, hospice care facility, ambulance service, pharmacy, rehabilitation center, or any other type of healthcare provider overbills Medicare.


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Medicare fraud whistleblowers are almost always healthcare professionals. They are commonly employed as hospital administrators, nurses, hospice or nursing home workers, ambulance drivers, pharmacists, or as any other type of healthcare professionals.

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Atlanta doctor charged with Medicare Fraud
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On June 6, 2011, the US Department of Justice (DOJ) issued a press release that told of the guilty plea of Dr. Robert Williams, Atlanta, on two counts of healthcare fraud. He used a scheme to bill for group psychological therapy which he often never delivered.

United States Attorney Sally Quillian Yates said, “With so many elderly citizens and others who need specialized psychological care, this defendant ignored his duty as a doctor and became a billing machine who claimed to treat patients who were in fact dead. This blatant attempt to rip off the system took funds and care away from real live patients with real problems. Medicare and Medicaid need all the money they can get for legitimate patient care and this physician will get none of that money.”

Court documents show Williams was an Atlanta area practicing physician. He’s charged with contracting with a medical services company, from July 2007 through October 2009, to provide a variety of psychological therapy, mostly group therapy, to nursing patients in the Atlanta area.

He is said to have signed for thousands of claims to Medicare and Georgia Medicaid for the sessions, most of which were never provided.

Medicare data shows that over 55,000 claims were submitted using Williams’ provider number for group therapy, seeking more than $2,000,000 in reimbursement. In the end, he received over $750,000 in reimbursements. During the same 2007-2009 period, Williams billed Georgia Medicaid for $225,000 worth of group psychological therapy.

In fact, investigations revealed that Williams sought payment in many cases for deceased beneficiaries. In other instances, he billed for services rendered to patients who were in hospital at the time and therefore could not have received the treatment in the nursing home.

If convicted on all 10 counts of health care fraud in the indictments, Williams could get a maximum 10-year prison term and a fine of up to $250,000 on each count. A sentencing date has not yet been set.


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