May 24, 2012

Physician Sentenced for Private Health Insurance Fraud

von Briesen & Roper, S.C.
Meghan C. O'Connor
von Briesen & Roper, S.C.
Friday, December 23, 2011
Administrative & Regulatory / Criminal Law / Business Crimes / Health Law & Managed Care / Insurance Reinsurance & Surety / Litigation / Trial Practice
All Federal
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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.

©2012 von Briesen & Roper, s.c

About the Author

Meghan C. O'Connor

Meghan O’Connor is a member of the Health Care Practice Group. Her practice focuses on general health law including managed care and provider contracting, risk management, and regulatory compliance.

Prior to joining von Briesen, Meghan worked for the Centers for Medicare and Medicaid Services where she consulted with states regarding federal health law, regulation and policy, evaluating managed care contracts and conducting compliance reviews.

moconnor@vonbriesen.com
414-287-1586
www.vonbriesen.com

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