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A physician based in the McAllen, Texas area was charged in an indictment unsealed today for his role in a $240 million health care fraud and international money laundering scheme.
Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, U.S. Attorney Ryan J. Patrick of the Southern District of Texas, Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Region and Special Agent in Charge Christopher Combs of the FBI’s San Antonio Field Office made the announcement.
Jorge Zamora-Quezada, 61, of Mission, Texas, was charged in a seven-count indictment filed in the Southern District of Texas. He was charged with one count of conspiracy to commit health care fraud, five counts of health care fraud and one count of conspiracy to commit money laundering. Zamora-Quezada had his initial court appearance earlier today. His detention hearing is tomorrow, May 15, at 2 p.m. CDT before U.S. Magistrate Judge Peter E. Ormsby in the McAllen Division of the Southern District of Texas.
The auditors found that billing errors, including overbilling of third party insurers, were rampant. Some doctors committed errors 50 percent of the time, 80 percent of the time, 90 percent of the time.
The audit was inspired, in part, by whistleblowers, resident doctors who reported blatant acts of fraudulent billing. Why didn't the audit confirm those allegations? In a 2016 memo, UNR School of Medicine Dean Thomas Schwenk explained it this way -- this audit looked for coding errors. It would not be able to identify the alleged misconduct. (June 17, 2016)
This audit found billing errors across the board, but, by design, it was never going to uncover the kind of outright fraud which had been alleged by employees. In the words of one physician whistleblower, they didn't want to find fraud. The audit found many mistakes, but it was a smokescreen.
Never know who's honest these days do ya.
originally posted by: Subaeruginosa
a reply to: xuenchen
Never know who's honest these days do ya.
Actually, its fairly fricking obvious who's honest these days.
They're usually the ones who're busting their arses every day for an honest dollar, living pay check to pay check, while been shunned by their peers.
Its the people living on easy street who seem to have a lot of people looking out for them, who you want to be wary of...