Texas Tea Party Express Contributor, Doctor Jacques Roy, Charged With Largest U.S. Health Care Fraud. Had Book, “Hide Your A$$et$ And Disappear”

Yesterday, Texas doctor Jacques Roy, a financial supporter of the Tea Party Express and their multimillion dollar political action committee, Our Country Deserves Better*, was arrested by federal Medicare Strike Force authorities on multiple charges that he fraudulently billed Medicare and Medicaid nearly $375 million since 2006. The indictment alleges Roy, and six others, with a scheme whereby they falsely certified more than 11,000 individuals for home health services, and then illegally billed Medicare or Medicaid.

Among other allegations, federal authorities assert that Dr. Roy and his Medistat Group Associates often employed recruiters to visit homeless shelters in search of individuals for Dr. Roy to medically certify for home health care services. Dr. Roy then allegedly certified a false “plan of care” for these persons, indeed, no services were provided. The indictment includes this example:

Dr. Roy would “make home visits to that beneficiary, provide unnecessary medical services and order unnecessary durable medical equipment for that beneficiary. Medistat would then bill Medicare for those visits and services.”

In June 2011, even after CMS suspended provider numbers for Dr. Roy and Medistat based on credible allegations of fraud, Dr. Roy continued the fraud under another provider number, it is alleged. A court appearance in the case is expected today, around 2:00 p.m. (CST) These alleged crimes carry sentences up to 10 years per count; Dr. Roy presently faces nine counts of health care fraud.

Here’s the local coverage, courtesy of NBCDFW.com:

View more videos at: http://nbcdfw.com.

At the press conference announcement, Department of Justice Deputy Attorney General James Cole revealed,

“The conduct charged in this indictment represents the single largest fraud amount orchestrated by one doctor in the history of HEAT [Health Care Fraud Prevention & Enforcement Action Team] and our Medicare Fraud Strike Force operations”

Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division continued,

“Today, the Medicare Fraud Strike Force is taking aim at the largest alleged home health fraud scheme ever committed. According to the indictment, Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services, and billing Medicare for those services.”

The alleged fraud is both wide and deep,

According to the indictment, Dr. Roy owned and operated Medistat Group Associates P.A. in the Dallas area. Medistat was an association of health care providers that primarily provided home health certifications and performed patient home visits. Dr. Roy allegedly certified or directed the certification of more than 11,000 individual patients from more than 500 HHAs for home health services during the past five years. Between January 2006 and November 2011, Medistat certified more Medicare beneficiaries for home health services and had more purported patients than any other medical practice in the United States. These certifications allegedly resulted in more than $350 million being fraudulently billed to Medicare and more than $24 million being fraudulently billed to Medicaid by Medistat and HHAs.

HHS Inspector General Daniel R. Levinson explained further,

“Using sophisticated data analysis we can now target suspicious billing spikes. In this case, our analysts discovered that in 2010, while 99 percent of physicians who certified patients for home health signed off on 104 or fewer people – Dr. Roy certified more than 5,000.”

According to Montreal, Quebec’s, CBCNews, federal agents raided the former Quebecois doctor’s home in June 2011,

“and among the items seized were:

A fake Texas driver’s licence with Roy’s picture and the name Michel Poulin

A Canadian birth certificate in the name of Michel Poulin and an application for a Canadian passport and social insurance number in that name

Bank deposit slips for an account in the Cayman Islands

A copy of the book Hide Your A$$et$ and Disappear, A Step-by-Step Guide to Vanishing Without a Trace.”

* More to follow today on this topic,
particularly Dr. Roy’s Tea Party Express connection.