Office of the Attorney General News Release ArchiveFriday, July 21, 2000
CORNYN AND MOSBACKER ANNOUNCE SUCCESSFUL PROSECUTION OF MEDICAID FRAUD
Houston pediatrician to pay over $1 million in restitution, damages, and penalties
AUSTIN - Texas Attorney General John Cornyn and U. S. Attorney Mervyn Mosbacker today announced that United States Magistrate Judge Nancy Johnson issued the final judgment finding that Dr. William Harold Mack, a Houston pediatrician, defrauded the Medicaid program. Dr. Mack has agreed and stipulated to damages in the amount of $773,847 and a civil money penalty of $725,000 as authorized by the False Claims Act, 31 U.S.C. Section 3729(a), for a total $1,498,847.
"These penalties are a clear signal to those who try to steal from the Medicaid program: you will be prosecuted and you will pay the price. With state and federal law enforcement working together, those who attempt to cheat or abuse the Medicaid system will be brought to justice," said Attorney General Cornyn.
"The United States will proceed vigorously against offenders like Dr. Mack, who not only cheated the government, but also endangered children by not performing the tests he was paid to administer," said U. S. Attorney Mervyn Mosbacker.
The Attorney General's Medicaid Fraud Control Unit joined the United States Defense Criminal Investigative Services in reviewing Mack's billing records. The investigation revealed a pattern of billing Medicaid and CHAMPUS (known as Tri-Care) for services not rendered. The bulk of the fraudulent billing related to Dr. Mack's failure to perform periodic blood screening tests mandated by the Texas Health Steps Program. These tests screen children for a variety of medical problems that can be treated if detected early, such as lead poisoning and sickle cell anemia. In addition, Mack systematically billed the Medicaid and CHAMPUS programs for additional services which were not performed such as strep tests, tympanometry screens and allergy exams. Some lab work which was completed and billed for was performed in an unlicensed laboratory.
In most cases, the Attorney General's office will investigate instances of Medicaid fraud and turn over their findings to the district attorneys or U. S. Attorneys with jurisdiction in these cases. They prosecute these cases for prison time, fines, restitution, and civil penalties where appropriate. In 1999, $5.7 million in fines and restitution were ordered against fraudulent providers as a result of the Attorney General's investigations - a tremendous increase from the $32,000 in fines and restitution ordered in 1997.
The investigation was handled by John Hoover and Rodney Boyles of the Texas Attorney General's Medicaid Fraud Control Unit, Special Agent George Fifer of the U. S. Department of Defense Criminal Investigative Service, Linda Evans and Marianne Bailey of the United States Attorney's Office, and Assistant United States Attorney Michelle Zingaro.
To report suspected instances of Medicaid fraud, the Office of the Attorney General's Medicaid Fraud Control Unit may be contacted at (512) 463-2011. Additionally, such instances of fraud may be reported via email at firstname.lastname@example.org. All calls and correspondence are confidential.
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Contact Mark Heckmann, Heather Browne, or Tom Kelley at (512) 463-2050
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