Linh Cao Nguyen, MD, a physician in Peoria, Ariz., pleaded guilty to engaging in a scheme to defraud multiple healthcare benefit programs.
Dr. Nguyen knowingly submitted thousands of false billing claims, causing a loss of at least $3.7 million from programs including Medicare, Tricare, Arizona's Medicaid program, Blue Cross Blue Shield and United Healthcare, according to an April 4 news release from the Justice Department.
The false claims would typically identify a medical doctor as the treating provider when in reality, another type of provider would administer the services. Dr. Nguyen falsely inflated the amount of the claim his company was paid by billing the service as though it was provided by a physician.
In addition, Dr. Nguyen created false patient records in order to conceal the scheme and avoid detection.
Dr. Nguyen agreed to pay more than $1 million in restitution to the private insurance companies.
A healthcare fraud conviction has a maximum penalty of 10 years in prison and a $250,000 fine, the release said. Dr. Nguyen is scheduled to be sentenced in May.