Federal Jury Convicts Doctor on Fraud Charges for Approving Medically Unnecessary Tests

CHICAGO — A federal jury in Chicago has convicted a physician on fraud charges for approving medically unnecessary tests that were billed to Medicare.

While working for Chicago-based Grand Medical Clinic Inc., DR. OMAR GARCIA authorized percutaneous allergen tests for numerous Medicare beneficiaries, knowing that the tests were not medically necessary. In most instances, Dr. Garcia issued his approval after the tests had already been completed. Dr. Garcia submitted or caused to be submitted fraudulent claims to Medicare for payment of the unnecessary tests.

The jury in federal court in Chicago on Monday convicted Dr. Garcia, 52, of Ocala, Fla., and formerly of Wilmington, Ill., on all six counts of health care fraud. Each count is punishable by a maximum sentence of ten years in prison. U.S. District Judge Matthew F. Kennelly set sentencing for May 6, 2020.

The conviction was announced by John R. Lausch, Jr., United States Attorney for the Northern District of Illinois; Emmerson Buie, Jr., Special Agent-in-Charge of the Chicago office of the FBI; Lamont Pugh III, Special Agent-in-Charge of the Chicago Region of the U.S. Department of Health and Human Services Office of Inspector General; and Martin J. Dickman, Inspector General of the U.S. Railroad Retirement Board. The U.S. Office of Personnel Management and the U.S. Food and Drug Administration provided valuable assistance. The government is represented by Assistant U.S. Attorneys Kavitha J. Babu and Saurish Appleby-Bhattacharjee.

Evidence at the five-day trial revealed that Dr. Garcia’s fraud scheme began in 2011 and continued until 2015. Dr. Garcia and others submitted the fraudulent bills from Grand Medical and other medical entities in an attempt to reduce the volume of billing by any single company and minimize scrutiny from Medicare. After the entities received payments from Medicare, Dr. Garcia was paid via checks reflecting his percentage of the payments.

Source: Federal Jury Convicts Doctor on Fraud Charges for Approving Medically Unnecessary Tests / Department of Justice Northern District of Illinois

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