Health Care Fraud

January 17th, 2020

Tennessee Physician Charged in $7 Million Medicare Fraud Conspiracy

On January 14th, 2020, Dr. James L. Crabb was charged for his role in a conspiracy to defraud Medicare.  According to the charges, Dr. Crabb, 78 years old, was acting as a Physician Consultant to a Florida based telehealth company and a physician staffing company. Crabb is enrolled as a  Medicare provider and accessed Medicare Patient data to assist in advertising and telemarketing to the patients regardless of medical necessity.

According to the Department of Justice Documents, part of Crabb’s conspiracy included signing orders and prescriptions for Durable Medical Equipment without proper evaluation or exam with the Medicare beneficiary.  Medicare Rules require physical exam with the patient to determine medical necessity.  In some instances Crabb had short telephone conversation or no conversation at all prior to signing the orders and prescription.  Crabb faces up to 10 years in prison and up to $250,000 in fines.

The case is pending Health and Human Services, OIG investigation.