Ophthalmologist Charged in Health Care Fraud Scheme Involving More Than $3 Million in Fraudulent Claims

A press release from the FBI, below, raises questions not only about fraud, but false notations in patients’ charts about treatment and the security of their charts. I am pleased to see that HHS was involved in this investigation and just wonder whether any corrective plan has been issued for the Temple University School of Medicine with respect to the claim that stacks of patient charts were left outside the defendant’s office. What security was in place outside his office?

PHILADELPHIA—Dr. Joseph J. Kubacki was charged today in a 144-count indictment with health care fraud and making false statements in health care matters, announced United States Attorney Zane David Memeger. The indictment alleges that Kubacki was the Chairperson of the Ophthalmology Department of the Temple University School of Medicine and also served as the Assistant Dean for Medical Affairs. According to the indictment, between 2002 and 2007, Kubacki caused thousands of false claims to be submitted to health care benefit programs with false charges totaling more than $3 million for services rendered to patients whom Kubacki did not personally see or evaluate.

Defendant Kubacki allegedly directed staff employees in the Ophthalmology Department to bring to his office the charts of patients seen by other physicians in the Ophthalmology Department. As a result, it is alleged that large stacks of patient charts frequently were stacked outside Kubacki’s office door at the main campus of Temple University Hospital. The indictment alleges that, after defendant Kubacki collected the patient charts, he would make notations in the charts falsely indicating that he had personally seen and evaluated the patients. It is alleged that Kubacki would then sign the patient charts and would fill out fee slips for the services that he falsely claimed to have provided to the patients. According to the indictment, Kubacki was outside of Pennsylvania in other locations on some of the days that he claimed to have treated patients, including Las Vegas, Nevada, Sarasota, Florida and Indian Wells, California. As a result, health care benefit programs, including Medicare and private health insurers, allegedly made payments on fraudulent claims in excess of $1.5 million. The indictment further charges that Kubacki made false statements in the medical records of patients attesting that he had personally seen the patients, when, as Kubacki knew, he had created these false records solely for the purpose of submitting fraudulent billings to health care benefit programs.

Joseph J. Kubacki Destin, FL 61

If convicted, the defendant faces a substantial term of imprisonment, a fine of $36 million, mandatory restitution, and three years’ supervised release.

The case was investigated by the U.S. Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation and is being prosecuted by Assistant United States Attorney Anthony Kyriakakis.

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