Perhaps podiatrist Kenneth Mitchell, 60, of Oakland County, Michigan, never head Teddy Roosevelt’s quote, “If you could kick the person in the pants responsible for most of your trouble, you wouldn’t sit for a month.”
In January 2015, Dr. Mitchell lost his privileges to participate in the Medicare program.
Not one to be kept down by that little detail, he got back on his feet and executed a $1.8 million scheme to defraud Medicare by billing for services under another doctor’s name. So said a federal court jury when they convicted him earlier this month for the billing scheme as well as for falsification of records designed to prevent detection of his fraud and for aggravated identity theft for falsely corresponding with Medicare under the name of another physician.
According to court documents and evidence presented at trial, shortly after losing his privileges to bill Medicare back in 2015, he convinced his then-partner to enroll in Medicare and assist in opening a new clinic called Urban Health Care Group PLLC. Once the new business was set up, Mitchell continued to bill Medicare for services just as he had prior to his revocation, only now exclusively under the name of his partner.
When his scheme was discovered, Medicare suspended payments to Urban Health Care Group PLLC. To make matters worse, Mitchell then submitted false statements to Medicare regarding the fraud allegations (again, under his partner’s name) in an effort to undermine the government’s investigation and ensure the release of Medicare funds to the bank account he controlled.
Dr. Mitchell will have significantly more time to think about whether he wants to engage in another scam. That’s because he’s facing, depending on whether sentences will be concurrent or consecutive, up to 52 years behind bars. Sentencing is scheduled for January 2023.
As I’ve written before, for example see Same Old Scam, This Time Involving Medical Billing, we often see identity-theft type healthcare fraud in the context of medical billing and in the context of unscrupulous medical practice management companies. In those contexts, a third party scamster, whether someone at a third party service provider or someone working for you and sitting right there in your office, executes a scam, billing for, perhaps, non-existent services delivered to non-existent patients. Because the billing appears to be under your name, you become the target of the prosecutors who want to “bag” an unscrupulous doctor – in fact, they might even go soft on the actual criminal, allowing him or her to flip and testify against you.
To discuss what you need to do to protect yourself, contact me.
