BOSTON — A Massachusetts doctor has agreed to plead guilty in connection with a multi-million-dollar health care fraud scheme in which she allegedly defrauded Medicare for genetic testing services she never provided.
Le Thu, 69, a Boston-based emergency medicine physician, has agreed to plead guilty to two counts of making false statements relating to health care matters, U.S. Attorney Leah Foley said in a statement. A plea hearing has not yet been scheduled.
Prosecutors allege that Thu billed Medicare for genetic testing of patients she never communicated with for over three years.
As a result, prosecutors allege Thu caused laboratories to submit approximately $35.3 million in claims to Medicare based on doctors’ orders with “materially false representations,” for which Medicare paid approximately $25.3 million.
According to the charging documents, from in or about March 2017 through in November 2020, Thu “knowingly and willfully engaged in a scheme to deceive the Medicare Program in connection with payments for genetic testing for beneficiaries.”
Specifically, Thu allegedly signed and/or caused other people with no medical training to sign and submit false medical documents and orders for beneficiaries’ genetic testing. This was generally not covered by Medicare and made it appear that Thu was providing legitimate services, prosecutors said.
Thu allegedly signed or caused these orders to be signed “that falsely claimed she had consulted with beneficiaries, conducted examinations prior to ordering genetic testing, obtained consent, and/or would use the testing results to treat the beneficiaries,” prosecutors said.
Prosecutors allege that Thu did not communicate with, examine or provide any medical services to Medicare beneficiaries in connection with any of the false orders submitted.
Prosecutors allege that in one of the orders, Thu stated, among other things, that the test results would “assist [Thu] in making patient-specific clinical decisions” and would “directly impact [Thu’s] patient’s medical management.”
Prosecutors said for that alleged false order, a third-party lab billed Medicare approximately $5,368, for which Medicare paid approximately $2,886.
In another order for genetic testing, Thu allegedly falsely said the test results would “determine [a] patient’s medical management and treatment decision.” A third-party laboratory billed Medicare for over $24,052 for that order, prosecutors said.
For each charge of making false statements relating to health care matters, Thu faces a sentence of up to five years in prison, three of supervised release and a fine of up to $250,000 or twice the gross pecuniary gain or loss, whichever is greater.
This is a developing story. Check back for updates as more information becomes available.
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