American taxpayers are footing the bill for billions of dollars in health-care fraud, which in Mississippi has included the delivery of artificial limbs to people who didn't need them.
Earlier this month, Dr. Cassandra Faye Thomas, owner of Central Mississippi Physical Medicine Inc., was arrested on charges of fraudulently billing the government for $16 million for in-home physical therapy services. She has pleaded innocent to conspiracy, health-care fraud, making false statements, theft of public money and wire fraud charges. "To the common man, that's a lot of money," said Assistant U.S. Attorney John Dowdy of Jackson. "To the taxpayer, that's a lot of money."
Since 2004, the Office of Inspector General for the U.S. Department of Health and Human Services along with the U.S. attorney's office in Jackson has uncovered pervasive health-care fraud in Mississippi, finding more than $60 million in fraud in physical therapy services alone. "The Office of Inspector General will continue to aggressively pursue those who defraud the Medicare and Medicaid programs," Lewis Morris, chief counsel to the inspector general, said in a statement. "Violations of the law will simply not be tolerated."
Medicare, a federal health insurance program for the elderly, reimburses for physical therapy performed by doctors or supervised by them. In 2007, that totalled $1.5 billion nationally. In April 2007, federal prosecutors sought help from the OIG's counsel to help prosecute these physical therapy fraud cases because resources were stretched thin from the pursuit of fraud cases related to Hurricane Katrina. Mississippi has seen six felony convictions in fraud cases involving physical therapy, and courts have ordered nearly $5.7 million in restitution. In each case, the clinics were accused of using unlicensed employees to practice physical therapy on patients whose claims were filed for reimbursement with Medicare. OIG officials say they're continuing to review physical therapy services in Mississippi and hope to pursue more prosecutions. The latest charge came against Thomas, who was originally charged in 2005. "There were some technical issues with that case that resulted in us doing further investigation," Dowdy said. "That indictment was ultimately dismissed." New charges now have been filed against Thomas, he said. She could not be reached for comment. In Mississippi, cases have gone beyond physical therapy as well.
Last week, U.S. District Judge Dan Jordan sentenced Nelson Wilson Jr., who operated BMW Prosthetics and Orthotics in Jackson, to 47 months in prison and ordered him to pay $441,305 in restitution after he pleaded guilty to Medicare fraud and fraudulently concealing assets from bankruptcy. According to court documents, the 54-year-old businessman concealed $100,000 in personal loans, an 8-acre farm in Ridgeland, a house, 17 pacer and quarter horses, jewelry and two ATVs - together valued at $202,500.
Assistant U.S. Attorney Jack Lacy told the judge Wilson would sometimes make artificial limbs for people who hadn't requested them or couldn't use them. In other cases, the prostheses weren't authorized by a doctor or fitted by qualified people. "Sometimes he would provide artificial limbs for people who didn't need them and leave them on the doorstep and the guy would say, 'What's this?' " Lacy said.
The feds aren't releasing the names of any of the victims because of the federal privacy act. Over a four-year period, Wilson billed Medicare for $15 million. Back in 2003, Wilson drew headlines for paying for the education of a Delta State University aviation student in exchange for the student agreeing to later fly the company's corporate planes. But Wilson's dream of a fleet of corporate planes vanished when his bankruptcy and conviction became a reality.