ATL physician accused of $975K health care scam
An Atlanta physician scammed Medicaid and Medicare for $975,000 for group therapy for nursing home patients, many of whom were either dead or hospitalized, federal prosecutors say.
Dr. Robert Williams, 72, was arraigned Friday in federal court on fraud charges that could cost him 10 years in prison and a $250,000 fine.
Prosecutors said Williams collected $750,000 for 55,000 Medicaid claims for group psychological therapy allegedly provided at a number of local nursing homes from July 2007 through October 2009. He pocketed $225,000 from the more than 40,000 Medicare claims he submitted over the same period.
Many of the patients were deceased at the time they were purported to be receiving therapy, prosecutors said. Others had been hospitalized and were not in the nursing home when the billed services were provided, they said.
“Dr. Williams allegedly stole Medicaid funds that were specifically allocated for the care of some of Georgia’s most vulnerable citizens: the elderly,” Georgia Attorney General Sam Olens said in a prepared statement.
Heres the complete news release from U.S. Attorney Sally Quillian Yates’ office:
DOCTOR INDICTED FOR SUBMITTING
FRAUDULENT BILLS TO MEDICARE AND MEDICAID
Williams Regularly Submitted Medical Claims for Deceased
Patients or Patients that Did not Qualify for Care
ATLANTA, GA – ROBERT WILLIAMS, 72, of Atlanta was arraigned today before United States Magistrate Judge C. Christopher Hagy on federal healthcare fraud charges.
United States Attorney Sally Quillian Yates said, “As a physician, this defendant had a duty to protect his patients and look out for their interests first. He has been charged with crimes that reflect his misuse of his position and the trust placed in him, all at the expense of his elderly patients, Medicare and Medicaid.”
“Dr. Williams allegedly stole Medicaid funds that were specifically allocated for the care of some of Georgia’s most vulnerable citizens: the elderly,” said Georgia Attorney General Sam Olens. “Our office is committed to protecting Georgia taxpayers and the recipients of Medicaid by aggressively pursuing prosecutions of Medicaid fraud.”
Brian D. Lamkin, Special Agent in Charge, FBI Atlanta Field Office, stated, “Healthcare fraud in the U.S. costs consumers billions of dollars, irrespective of whether the victim is the U.S. Government in the form of Medicaid/Medicare fraud, or healthcare insurance companies. Healthcare providers exhibiting sheer greed through extensive fraudulent billing, such as the allegations in today’s indictment of Dr. Williams, are driving up healthcare costs and are depriving those that really need medical help as provided by these government funded programs.”
According to United States Attorney Yates, the charges and other information presented in court: WILLIAMS is a licensed physician, practicing in the Atlanta area. From approximately July 2007 through October 2009, he contracted with a medical services company to provide group psychological therapy to nursing home patients in a variety of nursing homes. Under his signature, thousands of claims were submitted to Medicare and Georgia Medicaid seeking reimbursement for group psychological therapy that WILLIAMS purportedly provided to beneficiaries at several nursing homes in the Atlanta area. In many instances, however, WILLIAMS did not actually provide the therapy.
From July 2007 through October 2009, Medicare claims data indicate that over 55,000 claims were submitted on behalf of WILLIAMS for group psychological therapy seeking reimbursement for over $2,000,000, and ultimately causing Medicare to reimburse WILLIAMS over $750,000. For the same time period, over 40,000 Medicaid claims were on behalf of WILLIAMS for group psychological therapy, causing Georgia Medicaid to pay out over $225,000.
A review of WILLIAMS’ claims showed, however, that in many cases, he sought payment for services provided to beneficiaries who were deceased at the time he purportedly rendered the care. In two cases, the patient died over a year before they were allegedly seen by WILLIAMS in the nursing home. Numerous claims were submitted to Medicare and Medicaid for group psychological therapy when the beneficiary was hospitalized at the time of service and, consequently, could not have received care at the nursing home as represented.
The charges carry a maximum sentence of 10 years in prison and a fine of up to $250,000. In determining the actual sentence, the Court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders. WILLIAMS was indicted by a federal grand jury on February 22, 2011.
Members of the public are reminded that the indictment only contains charges. The defendant is presumed innocent of the charges and it will be the government’s burden to prove the defendant’s guilt beyond a reasonable doubt at trial.
This case is being investigated by Special Agents of the Federal Bureau of Investigation and the Georgia Bureau of Investigation.
Assistant United States Attorneys Kurt R. Erskine and Nick Oldham are prosecuting the case.
For further information please contact Sally Q. Yates, United States Attorney, or Charysse L. Alexander, Executive Assistant United States Attorney, through Patrick Crosby, Public Affairs Officer, U.S. Attorney’s Office, at (404) 581-6016. The Internet address for the HomePage for the U.S. Attorney’s Office for the Northern District of Georgia is www.justice.gov/usao/gan.