HomeConsumer ProtectionsDoctor Convicted of $2.8M Medicare Fraud Scheme

Doctor Convicted of $2.8M Medicare Fraud Scheme

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A federal jury convicted a California man yesterday for his role in a scheme to defraud Medicare by billing $2.8 million for hospice services that patients did not need.

According to court documents and evidence presented at trial, Dr. John Thropay, 74, of Arcadia, was the medical director of several hospice companies, including Blue Sky Hospice Inc. located in Van Nuys, California. From October 2014 to March 2016, Thropay fraudulently certified Medicare patients of Blue Sky as having terminal illnesses that the patients did not have so that Blue Sky Hospice could bill Medicare for hospice services. In 2015, Thropay was listed as attending provider for more hospice claims paid by Medicare than any other provider in the nation.

The jury convicted Thropay of one count of conspiracy to commit health care fraud and four counts of health care fraud. He is scheduled to be sentenced on May 28 and faces a maximum penalty of 10 years in prison on each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, Special Agent in Charge Timothy B. DeFrancesca of the Department of Health and Human Services Office of Inspector General (HHS-OIG), and Acting Assistant Director in Charge Amir Ehsaei of the FBI Los Angeles Field Office made the announcement.

HHS-OIG and the FBI investigated the case.

Assistant Deputy Chief Niall M. O’Donnell and Trial Attorney Eric C. Schmale of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, the program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.

Press Release by DOJ.

Featured image: Clariant International Ltd.

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