A McAllen, Texas, physician and one of his employees were indicted for their alleged roles in a $3.5 million Medicare fraud scheme.
The U.S. Justice Department alleges that Osama Balhir Nahas, MD, 67, and Isabel Moreno Pruneda, 50, paid kickbacks to adult day care companies to gain Medicare beneficiary information.
The pair and others allegedly used their access to the facilities to perform unnecessary medical tests and procedures and order prescriptions for expensive, unneeded medications, according to an Aug. 19 Justice Department news release.
Many of the patients had their own primary care physicians who were not consulted prior to or after the examinations, the Justice Department alleges. Most of the patients were elderly or disabled and lacked the capacity to consent to the services.
Marketers also allegedly paid Dr. Nahas and Ms. Pruneda kickbacks in exchange for ordering unnecessary lab tests and prescriptions. Ms. Pruneda allegedly forged patients signatures on consent forms connected to the fraudulent testing and prescriptions.