$30 Orders, $6.6M Fraud
A telemedicine-driven scheme turned chart sign-offs into millions in false Medicare claims.
A Louisiana physician signed off on more than $6.6 million in medically unnecessary cancer genetic tests for patients he never evaluated or spoke with.
Between February and September 2019, Robert Tassin, MD, approved orders through telemedicine companies for Medicare beneficiaries he neither saw nor spoke to, generating over $6.6 million in claims and more than $2 million in reimbursements. He was paid about $30 per order, reflecting a volume-driven scheme with minimal clinical input.
Prosecutors described a model built on signing off on testing without patient interaction, supported by documentation that misrepresented medical necessity, contributing to large volumes of Medicare claims. The key issue was how little direct clinical involvement was required—physician decision-making reduced to high-volume review rather than patient care.
The penalty highlights a persistent gap: large-scale fraudulent billing resulted in probation, home confinement, and restitution. The disconnect between the volume of claims and the consequences keeps the question of deterrence unresolved.
Arrangements that separate physician sign-off from direct patient care warrant closer examination. Documentation of medical necessity—and the role of physicians in approving it—remains a clear point of vulnerability.
“This case is a part of the National Fraud Enforcement Division, with the mission to zealously investigate and prosecute those who steal or fraudulently misuse taxpayer dollars,” according to the US Attorney’s Office for the Eastern District of Louisiana.
Source: US Department of Justice, Eastern District of Louisiana
Unlicensed Hands, $3.2M Fraud
A podiatrist allowed a sales representative to perform procedures typically reserved for licensed clinicians.
A California podiatrist allowed an unlicensed sales representative to perform wound procedures on patients while billing federal programs as if physicians provided the care.
From 2021 to 2024, Felipe Ruiz, MD, worked with pharmaceutical sales representative Jose Gabriel Aguirre to perform and bill for skin graft procedures on patients with severe wounds, including those recovering from amputations. Aguirre, who had no medical license, performed procedures such as sharp debridement—cutting into wounds with a scalpel—often without physician supervision. Claims submitted to Medicare, Medicaid, and Medi-Cal falsely indicated that Ruiz or other physicians performed the services, generating more than $3.2 million in fraudulent billing. In one instance, procedures were billed under a physician who was out of the country.
Beyond billing fraud, the case reflects a breakdown in clinical boundaries—patients treated by someone they believed to be a physician, in settings where supervision was absent and concerns raised by staff went unaddressed.
The more revealing detail is the failure to act. Despite repeated warnings from staff and auditors, the conduct continued over several years, raising questions about how long such practices can persist before intervention—and what signals are missed along the way.
Clinical oversight cannot be assumed. When nonphysicians are involved in procedural care, supervision and documentation become the point of risk—not just for billing compliance, but for patient safety.
“We trust licensed medical professionals to safeguard their patients and not hand them over to unqualified individuals,” said US Attorney Eric Grant.
Source: US Department of Justice, Eastern District of California
Inflated Claims, $572K Paid
A behavioral therapist billed for care that didn’t match what patients received.
A Georgia therapist pleaded guilty after submitting false claims for services that were not provided or misrepresented.
From 2020 to 2023, Mira Stallings, a licensed behavioral therapist and owner of ABAscape LLC, billed TRICARE for individual and group therapy services that were not delivered as claimed. The fraudulent billing exceeded $650,000 and resulted in more than $570,000 in payments. The scheme came to light after a parent reported discrepancies in billing, triggering an investigation that identified repeated misrepresentation of services submitted for reimbursement.
The case underscores how the fraud surfaced—through a parent noticing inconsistencies between care and billing.
The friction is scope. Beyond health care claims, the case extended into misuse of federal pandemic relief funds.
Billing accuracy cannot be treated as administrative detail. When reimbursement depends on how services are documented, even small discrepancies—if repeated—can scale into systemic misuse.
“With our law enforcement partners, we will aggressively pursue those who fraudulently access those funds for their own personal gain,” said US Attorney Margaret E. “Meg” Heap.
Source: US Department of Justice, Southern District of Georgia
Opioids, Kickbacks, $4.7M Fraud
A chiropractor helped facilitate prescriptions with no legitimate medical purpose—and billed the system for it.
A Missouri chiropractor was sentenced after orchestrating schemes involving fraudulent prescriptions, kickbacks, and billing tied to prescriptions for controlled substances.
Jerry Dale Leech, 53, was sentenced to 100 months in prison after pleading guilty to conspiracy, health care fraud, illegal kickbacks, and obtaining controlled substances through fraud. Prosecutors said he worked with physicians who prescribed oxycodone and other drugs without legitimate medical purpose, often without examining patients or reviewing charts. Leech encouraged continued prescribing despite abnormal drug test results and was linked to nearly 95,000 oxycodone pills distributed improperly. The group also routed urine drug testing through a lab in exchange for kickbacks, generating hundreds of thousands of dollars in reimbursements from federal programs.
The issue is the structure: prescribing, testing, and billing were aligned to reinforce one another, allowing prescriptions without legitimate medical purpose to move through the system.
The scale is equally concerning. The conduct spanned multiple physicians, nearly 100,000 pills, and years of activity, raising questions about how such patterns persist across clinical and billing systems before intervention.
Financial and prescribing oversight cannot operate in isolation. When prescribing, testing, and reimbursement are tied together, the risk is not just fraud—it is sustained clinical harm driven by misaligned incentives.
“Jerry Leech and his co-conspirators exploited Medicare and Medicaid and put patients at risk solely for their own financial gain,” said Special Agent in Charge Linda T. Hanley of the US Department of Health and Human Services Office of Inspector General.
Source: US Department of Justice, Eastern District of Missouri
Braces Shipped, $11.4M Billed
A durable medical equipment scheme pushed unnecessary braces to patients nationwide.
A Florida nursing assistant was sentenced after orchestrating a scheme that billed Medicare for braces patients neither requested nor needed.
Christian “Chris” Cruz, 45, owned a durable medical equipment supplier that submitted more than $11 million in claims for orthotic braces, many of which were shipped to Medicare beneficiaries without medical need. Prosecutors said Cruz and a co-conspirator paid kickbacks to obtain signed physicians’ orders, then used those orders to justify billing. The operation sent thousands of braces across the country, including to patients who had not requested the devices. Cruz also concealed shared ownership of the company and moved proceeds through structured cash withdrawals to avoid reporting thresholds.
The scheme relied on paperwork rather than care—signed orders used to legitimize volume, not clinical need.
The reach was substantial. Hundreds of patients and thousands of devices moved through the system before intervention, raising questions about how documentation-driven models scale without early detection.
When reimbursement depends on documentation alone, the vulnerability is not just billing accuracy—it is the ease with which volume can be detached from medical necessity.
“This was a deliberate health care fraud scheme built on lies, bribes, and abuse of the Medicare system,” said US Attorney Jason A. Reding Quiñones for the Southern District of Florida.
