Doctor pleads guilty to involvement in $54 million Medicare fraud scheme | Takeover bid

A Texas doctor pleaded guilty today to his role in a $54 million scheme to defraud Medicare by prescribing durable medical equipment and genetic testing for cancer without ever seeing, talking to or treating patients.

According to court documents, Daniel R. Canchola, 49, of Flower Mound, agreed to electronically sign orders for durable medical equipment (DME) and cancer genetic tests that he knew were being used to submit more than $54 million in false and fraudulent Medicare claims. . From August 2018 to April 2019, Canchola received approximately $30 in exchange for every doctor’s prescription he signed authorizing orders for genetic tests for EMR and cancer that were not legitimately prescribed, not necessary. or unused, totaling more than $466,000 in bribes. Medicare beneficiaries for whom Canchola prescribed EMR and cancer genetic testing were targeted by telemarketing campaigns and at health fairs and pressured to undergo cancer genetic testing and receive EMR independently of medical necessity.

Canchola pleaded guilty to conspiracy to commit wire fraud. He is due to be sentenced on March 15, 2023 and faces a maximum sentence of 20 years in prison. A federal district court judge will determine any sentence after considering US sentencing guidelines and other statutory factors.

Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Chad E. Meacham for the Northern District of Texas; Acting Special Agent in Charge Jason E. Meadows of the Office of Inspector General of the Department of Health and Human Services (HHS-OIG) Dallas Region; and Chief William Marlowe of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.

HHS-OIG and MFCU investigated the matter.

Acting Deputy Chief Brynn Schiess of the Criminal Division’s Fraud Section is prosecuting the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force program. Since March 2007, this program, made up of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who have collectively billed the Medicare program more than $19 billion. Additionally, the Centers for Medicare & Medicaid Services, in conjunction with the Office of the Inspector General of the Department of Health and Human Services, is taking steps to hold providers accountable for their involvement in drug fraud schemes. Health care. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.