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

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.

Comments

[julieanderson]

01:53 AM on 02/04/2013

People who involved in medicare fraud must be sued immediately as medicare is more costly.People they strive hard in order to save money for future for health if they do fraud the common people can't able to reach it!!
http://www.medicarerhodeisland.com/

[Bidvince]

09:55 AM on 07/23/2012

We need a better system to track where the funding is spent. In saying that, we still rely on people implementing the system and people are not as reliable. Do hope all people have moral values of doing the right thing.

Joy from http://homehealthaidetrainingdot.com

[truthstriver]

05:28 AM on 03/18/2012

There's a lot of anti-white racism and negative stereotyping of Republicans in these comments. Neither make any sense in relation to this case.
$1,600 in contributions to tea party causes is chicken feed to a hundred-millionaire like Jacques Roy. Obviously, he was not a sincere supporter of tea party causes because the tea party is the sworn enemy of wasteful government spending and the fraud, like his, which inevitably follows.
And the complaints about Roy's fraud being a "white collar, white male" robbing the country blind are unfounded. This fraud was very much a multi-racial operation. Look at the courtroom sketches of Roy. Google "Dr. Roy" and "India" or "Bangladesh" and see how many hits you get, many of them very distinguished people. Roy is not an uncommon surname in that part of the world. Then look at the names of the other defendants in this case. Two of them bear the last name Akamnomu, a last name common in Nigeria. Yet another of Dr. Roy's co-defendants has the name of Charity Eleda. Google "Eleda" and you will find it is the name of a town in Nigeria. Wikipedia says Eleda is one name of a tricky and deceitful African deity. How appropriate.
Dr Roy's company, Medistat, was involved in another fraud case in January. In that case defendant Okey Nwagbara, a native of Nigeria, pleaded guilty to health care fraud totaling more than $600,000. He also pleaded guilty to fraudulently obtaining U.S. citizenship.

[original joanie]

03:32 PM on 03/03/2012

Thank you Justice for going after medical fraud. When will it be the bankers turn?

[Michael Wyman the First]

05:14 PM on 03/01/2012

Dr. Jacques Roy contributed to both the Texas Medical Association PAC and to the Tea Party Express PAC "Our Country Deserves Better". And these are only the figures thru early 2010. More recent contributions might not be included. Sheesh!

ROY, JACQUES A. DR.
ROCKWALL, TX 75087
SELF EMPLOYED/PHYSICIAN

TEXAS MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE
12/21/2010 300.00 11990130699

ROY, JACQUES MR.
ROCKWALL, TX 75087
JACQUES ROY/PHYSICIAN

OUR COUNTRY DESERVES BETTER PAC - TEAPARTYEXPRESS.ORG
08/31/2009 200.00 29935530744
10/06/2009 250.00 29935531214
10/16/2009 200.00 29935531290
11/06/2009 200.00 29935531650
01/10/2010 500.00 10990318827

[MeticulousAuditors]

03:40 PM on 03/01/2012

I used to run a homecare agency that supplied HHA's, NP, RN's etc... and we had to go through a stringent Audit conducted by the State of NJ, on behalf of Medicare/ Medicaid. If an "i" was not dotted, they would catch it and address it.
My question falls solely on the Auditors.....How did you not catch this sooner? They may need to be on trial as well.

[tpulv1]

09:25 PM on 03/02/2012

I work in home care too... and thus know that you are full of it. If an "i" was not dotted... lol.

[invirginia]

07:39 AM on 03/01/2012

Maybe if they had used that $77,000,000 to hire fraud investigators instead of buying a"fraud detecting computer" --

[Var Enyo]

06:35 AM on 03/01/2012

The real reason baggers want smaller government. So it doesn't catch up to their crimes.

[loki]

09:59 PM on 02/29/2012

but according to the Capitalist Conservative Neo Cons, its the poor and working class people who steal from the gov. Never does an capitalist.. Because when they do it, they just call it Good Business

[bromeando]

08:05 PM on 02/29/2012

Not just prosecute but pay everything back.

[banana republican]

07:58 PM on 02/29/2012

Medicare/medicaid fraud has been a big problem all along. Once Obamacare is in full swing, it will cease to be a 'big' problem. (It will be big industry)

[GaryNMaine]

08:56 PM on 02/29/2012

And you know this how?

[banana republican]

09:03 PM on 02/29/2012

In fall of 2010 there were swarms of starlings in my neighborhood preparing to migrate, and there was a lot of bird poop in my drive way. In fall of 2011, the swarms (for some reason) were 5 times bigger, and there was five times as much bird poop on my driveway. That's how I know.

[Chimoch]

02:02 AM on 03/01/2012

$4.3 billion so far in fraud has been caught. Because of the task force set up in the healthcare law. Nice try.

[phoebequeen]

07:53 PM on 02/29/2012

SPAM

[Gyice50]

07:21 PM on 02/29/2012

It's kinda hard to believe that he is the only culpable party in this action. We are to believe that he had no help, assistance, support. No one excepted bribes payoffs unexpected benfits to look the other way, just seems quite hard to beleive. In many cases of incompetance it seems to be able to grow expedentialy with well placed financial incentives.

[babby201]

06:27 PM on 02/29/2012

If it was that easy , then something is very wrong with the accounting at medicare,
you think they would have bothered to keep an eye on accounts?
But then , they are another government agency, so its not really important , if they fall short,they will just ask for more next time around.

[SaveTheMarshMouse]

07:01 PM on 02/29/2012

like our military....are they an inept government agency too?

[jel3800]

10:16 PM on 02/29/2012

in regards to fiscal adminstration .. yes

[jel3800]

05:51 PM on 03/01/2012

Do the same analysis for other major spending categories. Medicare, Income Security and Federal Pensions all grew at a faster rate - Social Secuity did grow at a slower rate but still leads Defense in total spending.
Sorry if I confused you with the 50 year view - I do think Defense is the only major category that has actually seen a decrease from any 1 year to the next. Defense has also dropped from about 15% of GDP to about 4-5% - none of the other categories have been reduced in similar way

[Chimoch]

02:03 AM on 03/01/2012

Deregulation has a habit of missing stuff like that.

[El Chingaso]

05:42 PM on 02/29/2012

Also go after HHS bureaucrats who were asleep on the job, failed to maintain adequate controls over taxpayer money and, ultimately, acted as co-conspirators in these crimes by issuing reimbursement payments. (Sick the IRS on these unwitting government dupes, too, and determine if their respective bank accounts received any "unusually" large cash deposits during the time frame in question.)

Sebelius & Holder need to look internally, as well. Criminal activity exists on both sides of the fence.