Doctor Sentenced to 35 Years in Prison for $374 Medicare Fraud Scheme

A Texas doctor who was at the center of a $374 million Medicare fraud scheme, the largest in the history of the United States, was recently sentenced to 35 years in prison. It could effectively be a life sentence for the 60-year-old physician.

The statutory minimum for the 12 healthcare fraud-related convictions for Doctor Jacques Roy would have far exceeded the duration of the human life, so U.S. District Judge Sam A. Lindsay issued a 35-year sentence intended to keep the man in prison for the rest of his life.

Roy owned Medistat Group Associates PA, and was found guilty of orchestrating a home healthcare fraud involving more than 11,000 patients who were not in any legitimate need of home healthcare or skilled nursing and who were given unnecessary treatments. The court determined Roy meant to defraud Medicaid and Medicare of nearly $374 million through fraudulent building, and in addition to prison time, ordered restitution of more than $268 million.

Roy does not have any prior criminal convictions, but does have a history of wrongdoing in his career. That includes the deaths of some patients, sexual relationships with female patients to whom he had prescribed painkillers and anxiety drugs and termination from the Dallas County jail system after prescribing valium to an inmate.

Whistleblower tips can break open cases

Whistleblower actions do not just help the government avoid wasteful spending and put a stop to fraud. They can also help get menaces like Roy off the street. If you are aware of wrongdoing by an individual or organization for whom you work, speak with a knowledgeable Dallas attorney at Whistleblower Law for Managers.