Doctor Pleads Guilty to Role in $54 Million Medicare Fraud Scheme
Department of Justice Press Release Number: 22-1151
A #Texas doctor pleaded guilty today for his role in a $54 million scheme to defraud Medicare by prescribing durable medical equipment and cancer genetic testing without ever seeing, speaking to, or otherwise treating patients.
According to court documents, Daniel R. Canchola, 49, of Flower Mound, agreed to electronically sign orders for durable medical equipment (DME) and cancer genetic testing that he knew were used to submit more than $54 million in false and fraudulent claims to Medicare. From August 2018 through April 2019, Canchola received approximately $30 in exchange for each doctor’s order he signed authorizing DME and cancer genetic test orders that were not legitimately prescribed, not needed, or not used—totaling more than $466,000 in kickbacks. The Medicare beneficiaries for whom Canchola prescribed DME and cancer genetic testing were targeted by telemarketing campaigns and at health fairs and were induced to submit to the cancer genetic testing and to receive the DME regardless of medical necessity.
Canchola pleaded guilty to conspiracy to commit wire fraud. He is scheduled to be sentenced on March 15, 2023, and faces a maximum penalty of 20 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Chad E. Meacham for the Northern District of Texas; Acting Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General (HHS-OIG) Dallas Region; and Chief William Marlowe of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.
The HHS-OIG and MFCU investigated the case.
Acting Assistant Chief Brynn Schiess of the Criminal Division’s Fraud Section is prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in healthcare fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
A Texas doctor pleaded guilty today