At Patient Options we want you to be aware of everything that happens in your office. Even if it your practice a close knot family affair you need to always analyze what is happening so that you do not commit healthcare fraud of any kind. Patient Options will give you protection against six accusations… Time of Service, Anti Kickback Laws, Civil Monetary Penalties, False Claims Act, Dual Fee Schedules, and Inducement Violations. Let’s look at healthcare fraud that landed a Rheumatologist’s wife in hot water.
The wife of Dr. Jorge Zamora-Quezada, the rheumatologist accused of committing health care fraud, was arrested Thursday on similar charges.
Meisy Angelica Zamora was arrested by federal authorities on charges of conspiracy to commit health care fraud, according to a criminal complaint.
The complaint alleges that between 2000 and 2018, she held a supervisory role in her husband’s practice, the Center for Arthritis & Osteoporosis in Edinburg, and as such participated in a scheme to over-treat patients in order to defraud health insurers.
A practice manager told investigators that Zamora was actively involved in supervising employees, who raised complaints with her about having to meet quotas for medical procedures due to fear of raising them with her husband, Dr. Zamora-Quezada, according to the complaint.
Another employee, a billing supervisor, alleged that Zamora participated in weekly and bi-weekly meetings that focused on increasing productivity and quotas.
“The focus was on increasing revenue through ordering more tests and procedures, regardless of what patients actually needed,” the compliant stated. “(The billing supervisor) stated that Meisy Zamora was ‘all about the money.’”
Additionally, employees stated she participated in the “alteration and manufacture” of medical records, according to investigators, and a medical assistant there claimed employees were instructed to create false and fictitious medical records in response to grand jury subpoenas served on the medical practice in January and March 2017.
Her husband was arrested in May on charges of conspiracy to commit health care fraud, five counts of health care fraud, and one count of conspiracy to commit money laundering.
Thanks to The Brownsville Herald and Berenice Garcia for their article found here.