Texas is at the Center of Health Care Fraud Investigations


Cracking down on health care fraud is an avowed aim of the Obama administration, and some of the largest investigations have been here in Texas.

The National Health Care Anti-Fraud Association points out as much as $2.27 trillion a year is spent on healthcare and more than four billion insurance claims are processed annually. The financial losses due to health care fraud run into tens of billions of dollars a year.

Last month, a federal jury in Dallas found former Rockwall doctor Jacques Roy guilty of what the Dallas Morning News described as the largest home health fraud in the nation that involved a single doctor.


Roy and his associates were accused of enticing Medicare patients by offering them food stamps, cash, and groceries as part of the $400 million scam. Prosecutors said he recruited fake patients, including homeless people, to make false health care claims.

A jury convicted Roy and three owners of home care agencies of heath care fraud, making false statements related to health care matters, conspiracy to commit health care fraud and obstruction of justice. When Roy was arrested in 2012, federal investigators said they had busted the largest Medicare fraud scheme ever discovered.

The FBI makes no secret of its commitment to uncovering health care fraud and new investigators have been drafted into these probes across Texas and elsewhere. On its website the FBI states.

“Health care fraud costs the country tens of billions of dollars a year. It’s a rising threat, with national health care expenditures estimated to exceed $3 trillion in 2014 and spending continuing to outpace inflation.”

Just a month before the Roy verdict, A Dallas anesthesiologist was convicted of defrauding about $10 million from the federal government.

The Dallas Morning News reported Dr. Richard Ferdinand Toussaint Jr. was convicted of seven counts of fraud. He admitted submitting bogus claims in 2009 and 2010 to United Healthcare, the Federal Employees Health Benefits Program, Blue Cross Blue Shield of Texas and other programs.

Given the fact there are federal investigators whose sole job is to look for health care fraud, you should contact an experienced Texas criminal defense attorney immediately if you are accused of these serious offenses. Doctors and other health care professionals who are convicted of these charges will lose their livelihoods and their reputations overnight.

Our highly reputable Austin-based criminal defense attorneys have a long track record in helping those charged with fraud and other white collar crimes. Call us to schedule a free no obligation consultation with one of our experienced lawyers at (512) 399-2311.

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