The CEO of a healthcare software company was convicted for his role in a more than $1 billion scheme that involved fraudulent physicians’ orders to Medicare and other payers, , according to a June 3 news release from the Justice Department.
What happened?
- Gary Cox, of Maricopa County, Ariz., served as CEO of Power Mobility Doctor Rx, a web-based platform implicated in generating fraudulent physician orders for orthotic braces, topical analgesics and other items.
- Mr. Cox and his co-conspirators targeted a large volume of Medicare beneficiaries by obtaining their personal and health information through deceptive direct mail campaigns, television advertisements and calls from overseas call centers. These individuals were then shipped medically unnecessary products.
- DMERx facilitated a network that connected marketers, DME suppliers and pharmacies with telemedicine providers willing to exchange signed orders for kickbacks. Mr. Cox and his co-conspirators were paid for brokering these arrangements and transmitting completed physician orders.
- The DME companies and pharmacies that paid bribes subsequently submitted claims exceeding $1 billion to Medicare and other payers. Medicare reimbursed over $360 million on those claims.
What’s next?
- Mr. Cox was found guilty of multiple federal offenses, including conspiracy to commit healthcare fraud and wire fraud, three counts of healthcare fraud, conspiracy to offer and receive unlawful healthcare kickbacks, and conspiracy to defraud the United States and submit false statements in healthcare matters.
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