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Jacques Roy, Texas Doctor, And Cohorts Arrested On Charges Related To $375 Million Health Care Fraud

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HOLDER AND SEBELIUS
Health and Human Services Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder oversee joint anti-fraud efforts for federal health care programs. | AP

Federal authorities arrested a Texas physician and six others today on charges they bilked Medicare and Medicaid of $375 million from 2006 until last November.

Officials from the Justice Department and the Department of Health and Human Services staged a press conference in Dallas Tuesday to announce the unsealing of indictments against Dr. Jacques Roy, 54, and others they allege had conspired to defraud Medicare and Medicaid through a network of home-health companies. The others arrested are Cynthia Stiger, Wilbert James Veasey Jr., Cyprian Akamnonu, Patricia Akamnonu, Teri Sivils and Charity Eleda, all of Texas. The Centers for Medicare and Medicaid Services, which administers those programs, has also suspended federal payments to78 home-health care companies affiliated with Roy.

It's the largest case of alleged health care fraud brought against a single physician since the departments of Justice and Health and Human Services stepped up joint operations in 2007, according to the agencies. "Thanks to the historic partnerships we've built to combat health care fraud, we are sending a clear message: If you victimize American taxpayers, we will track you down and prosecute you," Deputy Attorney General James Cole said in a news release. Numerous government agencies from Justice and Health and Human Services were involved in bringing the case.

Private- and public-sector health care fraud costs Americans $60 billion a year, Attorney General Eric Holder said in 2010.

Health and Human Services Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder oversee joint anti-fraud efforts for federal health care programs.

Their two agencies initiated the Medicare Strike Force Program five years ago under President George W. Bush. They bolstered their collaboration after President Barack Obama took office in 2009, when the departments created the Health Care Fraud Prevention and Enforcement Action Team. The Obama administration pledged to devote more resources to detecting Medicare and Medicaid fraud as it happens rather than just chasing after large sums of money already paid out.

Demonstrating the difficulty of that strategy, the Department of Health and Human Services acknowledged last week that a $77 million fraud-detecting computer system has not yet lived up to expectations, the Associated Press reported. Since going online last summer, the system has blocked only one improper payment for a savings of $7,591.

In all, the Obama administration reclaimed $4.1 billion in improper payments from health care programs and charged 1,430 individuals with fraud in 2011, according to a statement the White House Office of Management and Budget issued Tuesday.

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