A recent case, U.S. v. Chavez, underscores the fact that federal criminal prosecution is not limited to Medicare and Medicaid fraud. A physician was recently sentenced to approximately six years in prison after he plead guilty to defrauding private insurance companies through false and fraudulent billing practices.

Earlier this year, Armando Chavez, M.D. was indicted on multiple counts of mail fraud and conspiracy in the Southern District of Texas. Prosecutors based the charges on the following fraudulent billing practices: waiving or reducing co-payments as an incentive for patients to seek treatment from Dr. Chavez; overbilling; unbundling billing codes; and billing insurance companies for services that were never performed. In addition to jail time, Dr. Chavez must also pay almost $4 million in restitution.