U.S. charges 28 in 'sprawling' Dallas healthcare fraud scheme

Reuters News
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Posted: Nov 16, 2015 8:08 PM

DALLAS (Reuters) - Twenty-eight people from the Dallas-Fort Worth area have been charged with bribery, conspiracy and other crimes in a "sprawling" healthcare fraud scheme that cost the U.S. government $8.7 million, federal prosecutors said on Monday.

Others could also be charged in a scheme that involved bribery by a public official, unnecessary medical treatment, fraudulent billing and falsifying medical documents, said John Parker, U.S. attorney for the Northern District of Texas.

Defendants include doctors and medical professionals, a senior claims examiner in the U.S. Department of Labor and 21 people who said they suffered on-the-job injuries that prevented them from returning to work, Parker said.

The defendants are accused of billing the Labor Department's Office of Worker Compensation Programs more than $9.5 million and collecting $8.7 million in claims, he said.

They face from one to 15 years in federal prison.

The charges resulted from a two-year investigation by special agents with the U.S. Postal Service and the Department of Labor.

“Their dogged determination and skilled investigative techniques were crucial in exposing and dissecting this sprawling corruption scheme,” Parker said.

According to prosecutors, the scheme began when former and current federal postal and Veterans Affairs employees claimed their injuries prevented them from working.

Under worker compensation rules, injured workers could receive 66 to 75 percent of their wages tax-free or possibly a lump-sum payment if a doctor deemed the injury required treatment or prevented the employee from working.

The scheme involved cooperation among the employees, medical professionals and federal claims examiners who benefited from government payouts and bribes, federal authorities said.

Breaking up the operation will prevent $11 million in future payments for claims, authorities said.

(Reporting by Marice Richter in Dallas; Editing by Dan Whitcomb and Peter Cooney)