A Missouri physician whose Medicare and Medicaid billing privileges were terminated pleaded guilty to fraudulently using his father's name to bill the government payers.
Justin LaMonda, MD, 41, of Moberly, Mo., had his Medicare Part B privileges revoked Dec. 20, 2018, after it was determined he submitted reimbursement claims for services performed while his medical license was suspended for 30 days in 2017, according to a March 14 Justice Department news release. His Medicare provider number was terminated Sept. 12, 2019.
Dr. LaMonda admitted that as early as Dec. 20, 2018, he and his father — who is also a physician — agreed to bill services performed by the younger physician as though they had been administered by his father, according to the release. After the younger physician's Medicaid billing privileges were terminated, the pair expanded their agreement to include those claims as well.
The younger physician instructed his billing personnel to use his father's billing provider number on claims for payment, referrals to other healthcare providers and durable medical equipment orders, according to the release. Dr. LaMonda's father would transfer him funds when payments were received.
The scheme caused losses of $537,322 to Medicaid and Missouri Medicaid, according to the release. He faces up to five years in prison and a $250,000 fine.