Doctor Pleads Guilty in Case Stemming from $35 Million Medicare Fraud

Healthcare is expensive in the United States and doctors who try to beat the system by filing false Medicare claims can often reel in a large amount of money. One Boston physician broke the law by submitting phony claims for genetic testing. As these cases can be very difficult to identify and investigate, by the time the doctor was caught, her scheme had resulted in payments of $35 million. 

Le Thu was charged and agreed to plead guilty for her role in a significant health care fraud scheme targeting Medicare. Between March 2017 through November 2020, Thu allegedly orchestrated a process that involved the signing and submission of false medical documentation. Medicare typically does not cover genetic testing, but the phony documents she provided indicated that she had consulted with and examined patients, obtained their consent and intended to use the test results for treatment.

According to prosecutors, Thu did not meet, communicate with or medically assess the Medicare beneficiaries for whom these genetic tests were ordered. By submitting these false claims, Thu not only deceived Medicare but also potentially endangered patients by commissioning unnecessary tests that were not used for their medical purpose. The actions reflect a severe breach of medical ethics and legal compliance, emphasizing the need for stringent oversight in healthcare practices.

Such fraudulent activities are a direct violation of federal law relating to the integrity of healthcare claims and billing. Thu’s actions highlight critical weaknesses that can be exploited within the Medicare billing system. Disregarding the necessity and appropriateness of medical tests breaches the trust patients place in healthcare providers and the systems designed to protect them.

If you have come across a situation where Medicare or Medicaid claims are being filed with false information on them, or relate to unnecessary procedures, speaking up could earn you a monetary payment based on how much the government collects. 

Kardell Law Group represents whistleblowers and other types of matters. We can analyze the circumstances in case and assess whether you could receive an award under the federal False Claims Act.