Missouri podiatrist pleads guilty to health care fraud (MO)

A St. Louis County podiatrist, Dr. Denise Hardy, 45,  recently plead guilty to a health care fraud charge in federal court in St. Louis and has admitted to over billing Medicaid and Medicare for unnecessary treatments.

Prosecutors said that Denise Hardy, D.P.M.,  lied on treatment notes from 2000 through 2005 so that Medicaid and Medicare would pay for foot care that would not otherwise have been reimbursed.

Dr. Hardy worked for South St. Louis Orthopedic Group between 1998  and 2005 and provided podiatric services at their office as well as at nursing homes, such as Lafayette Habilitation and at senior service centers at St. Anthonys Medical Center and  St. Alexius Hospital.

Denise Hardy was paid a salary of  $55,000  plus between 50 to 60 percent of the revenue she had billed each month over $12,000.
 

Source: St. Louis Post Dispatch 3-13-2009

Who performs foot surgery... (cont.)

Generally the standards of medical care will be the same from specialty to specialty, however there may be distinct differences within each sub-specialty. In addition, training and procedures will vary between the sub specialties. It is important to establish that a particular provider is trained and qualified to perform the particular surgery that may be at issue. Board Qualification and Board Certification does not guarantee that a provider is qualified or trained to perform a particular surgery.

Tip: Make sure that you request the privileges  granted to the provider by a particular hospital or surgical center in order to confirm that the facility has granted privileges to the doctor to perform surgery. Absence of privileges may help confirm that the provider received inadequate training or perhaps no training in the procedure(s) at issue.

Who performs foot surgery and provides footcare?

Foot surgery and foot care can be provided by a variety of providers, as there is overlap amongst many different medical and surgical specialties. They include podiatrists, orthopedic surgeons (with or without fellowship training in foot and ankle disease).   Dermatologists provide skin and nail treatment. Ulcer and bedsore care may   be provided by vascular surgeons and implemented by wound care nurses and physician assitantsNeurologists commonly provide treatment for neuropathy and neurosurgeons will perform nerve surgery in the foot.   Lastly, general practitioners may provide minor treatment modalities or alternatively refer to anyone of the above.

 

 

      

Podiatrist Guilty of Healthcare Fraud (Ohio)


Ohio  podiatrist, Dr. Harold M. Jones, DPM,   has been found guilty in a scheme to defraud Medicare and Medicaid. Dr. Jones, 45, recently went on trial in Cleveland on 22 counts of healthcare fraud, six counts of aggravated identity theft and 26 counts of mail fraud. The jury found him guilty on three of the counts, after three days of deliberations and not guilty on the remainder of the charges.


According to Assistant U.S. Attorney Justin Roberts, Dr. Jones had used improper billing codes, billed for services that were not rendered and also billed under a false provider number. The doctor was also accused of using another medicare provider number and person’s name in order to submit false claims for reimbursement.


Source: The News-Herald (2-24-09)

Podiatrist arrested for fraudulently selling prescriptions (New York)

A Long Island podiatrist was arrested and charged with writing and filling fraudulent prescriptions for painkillers and other drugs for personal use and resale for profit, Nassau County prosecutors said.

Prosecutors said, the podiatrist , was carrying a loaded .380-caliber handgun when he was arrested  in a Port Washington school parking lot where he was about to exchange illicit prescription drugs with another man.

Disticty Attorney Kathleen Rice said "[the podiatrist] has violated the community's trust by abusing his position as a doctor,".   "His actions are no different from a drug dealer on the street corner looking to poison our children, feed addictions, and ruin lives."

The podiatrist obtained large quantities of oxycodone,  hydrocodone, Xanax, Klonopin Vicodin, and by writing out prescription slips in the names of non patients and his family members, authorities said. The doctor then filled the prescriptions at nine pharmacies in Nassau County, Queens and Brooklyn, Rice's office said.

 

Rice's statemetn said "He would then either use the pills himself, or sell them,"
"Family members and non patients told investigators that they were unaware of prescriptions written in their names and that they had never received the medication."

 Prosecutors said that the podiatrist had gone to the Port Washington lot to provide the other man with five Klonopin pills in trade for 100 pills each of methadone and hydrocodone. Authorities said the podiatrists' handgun was found in a search by Drug Enforcement Agency investigators who arrested both men.

Newsday- February 26, 2009

 

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