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February 28, 2012

7 accused of bilking $375M from Medicare, Medicaid

DALLAS (AP) —

The owner of a Dallas-area medical service provider and six others were indicted in a massive health care fraud scheme that allegedly bilked Medicare and Medicaid of nearly $375 million, authorities announced Tuesday.

The federal indictment accused Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto, Texas, of leading a scheme that billed Medicare for home health services that were not medically necessary or were not done. Also indicted were Roy's office manager as well as five owners of home health agencies.

The indictment alleged that from January 2006 through November 2011, Roy or others certified more Medicare beneficiaries for home health services and had more patients than any other medical practice in the U.S.

Roy, 54, and the other defendants, who have been taken into custody, were expected to appear later Tuesday before a judge in federal court in Dallas.

Phone messages left with Medistat were not immediately returned, and emails sent to the company did not go through on Tuesday. A phone number for Roy's home could not immediately be found.

U.S. Attorney Sarah Saldana said that Roy used the home health agencies as "his soldiers on the ground to go door to door to recruit Medicare beneficiaries."

For example, Charity Eleda, one of the home health agency owners charged in the scheme, visited a Dallas homeless shelter to recruit homeless beneficiaries staying at the facility, paying recruiters $50 for each person they found, the indictment alleges. A message was left Tuesday at Eleda's Dallas-based company, Charry Home Care Services, Inc.

The Centers for Medicare and Medicaid Services also announced the suspension of an additional 78 home health agencies associated with Roy based on credible allegations of fraud against them.

Health care fraud is estimated to cost the government at least $60 billion a year, mainly in losses to Medicare and Medicaid.

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