Monday, July 22, 2013

Local Physician, Clinic, and Nurse Practitioner Indicted on Health Care Fraud Charges

ST. LOUIS, MO—Dr. Mel Lucas, Patterson Medical Clinic Inc., and nurse practitioner Robyn Levy were indicted on multiple health care fraud related charges for their alleged false billing for services never rendered and false statements in patients’ medical records.
According to the indictment, from June 2008 to June 2011, the Patterson Medical Clinic Inc. and osteopath Mel E. Lucas billed Medicare, Tricare, and private insurers for more X-rays than were actually taken. The clinic had X-ray equipment in-house. The indictment also alleges that from 2008 to 2011, the clinic and Dr. Lucas billed for Lucas’ services on 573 occasions when he was actually out of town or in Cabo San Lucas, Mexico.
The indictment states that insurers were also billed for Lucas’ services on Fridays, when he did not come into the clinic. Instead, the patients were seen by medical assistants, who took their vital signs and drew their blood or gave them an injection. Lucas reviewed the records when he returned and billed insurers as if he had actually examined the patients.
Finally, the indictment alleges that Patterson, Lucas, and nurse practitioner Robyn Levy also billed insurers for an FDA-approved drug when Lucas had actually bought a non-approved version in Canada for hundreds of dollars less. The patients were not told they were receiving a drug that was not FDA-approved.
Lucas, of Florissant, Missouri, and Patterson Medical Clinic Inc. were indicted by a federal grand jury on eight felony counts of health care fraud and seven felony counts of false statements related to health service. Levy was indicted on two felony counts of health care fraud and three felony counts of false statements related to health service.
If convicted, each count of health care fraud carries a maximum penalty of 10 years in prison and/or fines up to $250,000 and each count of making false statements carries a maximum of five years in prison and/or fines up to $250,000. In determining the actual sentences, a judge is required to consider the U.S. Sentencing Guidelines, which provide recommended sentencing ranges.
Additionally, upon a finding of guilt, the defendants will be subject to forfeiture, which will require them to forfeit to the government all money derived from their illegal activity.
This case was investigated by the Department of Health and Human Services-Office of Inspector General and the FBI. Assistant United States Attorney Dorothy McMurtry is handling the case for the U.S. Attorney’s Office.
As is always the case, charges set forth in an indictment are merely accusations and do not constitute proof of guilt. Every defendant is presumed to be innocent unless and until proven guilty.

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