Las Vegas Physician Found Liable of Medicare Fraud
Las Vegas, Nev. – A federal jury today found Las Vegas anesthesiologist Eugene Chen, M.D. liable of committing federal health care fraud for submitting over 3,500 false or fraudulent claims to the United States Government between 1999 and 2006 for consultation services not requested or provided, announced Greg Brower, United States Attorney for the District of Nevada. Chen, 57, whose practice is located at 3230 E. Flamingo Road, was charged in a civil complaint with violating the federal False Claims Act. The trial began last Tuesday, February 10, 2009, and was presided over by U.S. District Judge Philip M. Pro.
"The Department of Justice in Nevada will continue to pursue physicians who present false claims to the Government," said U.S. Attorney Brower. "Anyone found violating the False Claims Act, faces triple the proven damages, as well as civil penalties and costs of prosecution."
The allegations against Dr. Chen pertained to Part B of the Medicare program, which is a voluntary subscription program of supplementary insurance covering items and services other than hospitalization, such as charges for medical care in physicians' offices. Medicare Part B covers only services and procedures which have been determined to be medically reasonable and necessary. Physicians are permitted to present claims under Medicare Part B for consultations which are deemed appropriate and based on the level of complexity and amount of time spent with the patient. Physicians were permitted to bill for services in an amount set by a physician fee schedule. The jury found that Chen submitted claims for consultation services that he had not been requested to perform and/or had not performed. In reliance on Dr. Chen's false certifications on the claim forms, Medicare paid reimbursements to Dr. Chen totaling approximately $421,000. This amount will automatically be tripled under the False Claims Act, to approximately $1.26 million. Medicare would not have paid such claims had Dr. Chen provided truthful information.
On April 14, 2009, a hearing will be held to determine the amount of civil penalties to be awarded to the United States under the False Claims Act. The Government is requesting between approximately $1 million and $2 million in penalties.
The case was investigated by the Department of Health and Human Services Office of Inspector General and litigated by Assistant United States Attorneys Roger W. Wenthe and Rob Edelman.
