5 physician fraud cases in 2 weeks

Here are five physician fraud lawsuits Becker's has reported on since June 10:

1. David Young, MD, a physician from Fredericksburg, Texas, was convicted for submitting more than $70 million in fraudulent claims for orthotic braces and generic tests. Dr. Young submitted tests for more than 13,000 beneficiaries, receiving $475,000 in illegal kickbacks. 

2. William McMiller, MD, a physician in Oak Park, Ill., was sentenced to eight years in prison for his role in a $1.2 million Medicaid fraud scheme. Dr. McMiller owned Dr. Bill's Learning Center and offered tutoring services as well as clinical therapy and psychiatric services. He submitted numerous claims to the Illinois Medicaid program for psychotherapy and medical services that weren't provided.

3. Former Alabama physician Francene Aretha Gayle, MD, pleaded guilty in federal court alongside her wife for her role in a $2.3 million fraud scheme involving illegal opioid prescription. The pair billed payers millions of dollars for patient visits that Dr. Gayle was supposed to have conducted but were instead conducted by other clinic staff. These patients were also allegedly given opioid prescriptions pre-signed by Dr. Gayle.

4. Gustavo Kinrys, MD, a Natick, Mass., psychiatrist, was sentenced to eight years and three months in prison for a $19 million Medicare and private insurance fraud scheme. Between January 2015 and December 2018, Dr. Kinrys sought and received $19 million in reimbursements for unrendered services. As part of the scheme, he billed Medicare and private insurers $10.6 million for thousands of transcranial magnetic stimulation sessions he never provided. 

5. New York City-based ophthalmologist Sheldon Rabin, MD, and his ophthalmology practice will pay $2.4 million to resolve allegations he submitted claims for medically unnecessary procedures, among other allegations, in violation of the False Claims Act. From 2013 to 2016, Dr. Rabin and his practice billed Medicare and Medicaid for procedures, tests and other services that were either unnecessary or could not have been performed because the ophthalmologist was not in his office.

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