Toe The Line Or Do The Time: Wyoming Judge Sentences Colorado Doctor For Medicare Fraud
A Wyoming federal judge sentenced a Fort Collins podiatrist working in Wyoming for eight counts of Medicare fraud, according to a news release from Acting U.S. Attorney John Green on Friday.
U.S. District Court Judge Alan Johnson sentenced Dr. Michael Thomas, 55, to serve six months in prison and pay a $20,000 fine -- $2,500 for each count -- for trimming toenails and billing Medicare for a more serious foot procedure, according to court records.
From December 2011 through November 2016, Thomas created bogus medical records that falsely reported clinical evidence to justify Medicare coverage for nail debridement -- reducing the length and thickness of the nail often with a high-speed burr -- even though he did not properly examine a Medicare beneficiary and did not find the reported clinical evidence.
The criminal information document filed in federal court on April 3 lists eight beneficiaries -- one for each count -- for procedure performed and billed on June 3, 2016 for $52 each procedure. Medicare reimbursed Thomas $34.48 for each procedure.
Thomas also fraudulently submitted claims to Medicare for reimbursement for nail debridement when he only trimmed the beneficiary's toenails, and when he did not provide any service at all to the beneficiary.
During the time of the scheme, he submitted about $507,698 in claims for nail debridement. Medicare reimbursed him about $289,983, according to court records.
Johnson also ordered Thomas to pay $40,460 in restitution to Medicare and complete two years of probation after his prison term.
The news release does not explain why Johnson did not order Thomas to pay the full $289,983 reimbursed by Medicare. A spokesman for the U.S. Attorney's Office did not immediately return a call for comment on the apparent discrepancy.
Green said in the news release that health care fraud is a serious crime that deserves time behind bars.
“Even the short prison sentence imposed here sends a clear message to health care providers that stealing from American taxpayers will not be tolerated," he said.
This case was investigated by special agents from the U.S. Department of Health and Human Services’ Office of Inspector General, the Federal Bureau of Investigation, and the Wyoming Medicaid Fraud Control Unit.