Wednesday, August 28, 2013

Yakima Doctor convicted of Medicare fraud to forfeit $129K

YAKIMA, Wash. — A sentencing hearing has again been postponed in the case of Dr. Curtis Holden, who late last year was convicted of Medicare and Medicaid fraud. However, under a recent settlement, Holden agreed to pay $129,000, far less than what a jury found he stole from the U.S. government.
Holden, formerly of Advanced Podiatry Specialists of Yakima, was convicted in early December on 32 counts of health care fraud for routinely “upcoding” patient visits billed to Medicare and Medicaid, effectively changing patient records to exaggerate what services he had performed in order to get higher reimbursement from the government.
Prosecutors in the case said his fraudulent billing practices lasted for several years in the 2000s, though the counts on which he was found guilty are from 2006 and 2007.
In the forfeiture document, filed Friday, Holden agreed to turn over his 2004 BMW X5 along with $129,675.84 seized by the FBI from various bank accounts.
The document also noted that Medicare is still holding $54,157.32 in payments that Holden had billed but the government suspended when it discovered he had misrepresented the services billed.
The forfeited funds will go directly toward restitution to the government health plans. The document says that figure “settles all criminal and civil claims” filed last June and “the Complaint for Violations of Federal False Claims Act” filed in June 2010.
The government previously contended that Holden owes Medicare and Medicaid about $630,000 more than the settlement amount. But the defendant disputed the sum, and at a hearing on the matter, “the amount was compromised,” according to court documents.
Assistant U.S. attorney Joe Harrington said the settlement was determined to be appropriate by both parties, and that the decision to accept the figure was made by U.S. attorneys after consulting with Medicare. Part of the reason for settling was the “litigation risk” attorneys would carry if they tried to further pursue the full amount in court.
“We have an adversarial criminal justice system; there’s two sides to every story ... There’s always litigation risk that your position wouldn’t be accepted by the court,” Harrington said.
The court has scheduled Holden’s sentencing hearing for Oct. 22. It was originally scheduled for July 9, then was pushed back by a postponement of the forfeiture hearing, which was canceled this week as the two parties came to an agreement on forfeiture motions.
It’s possible Holden could receive a prison sentence, but Harrington said it would be impossible to speculate on that likelihood.

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