News roundup: Physician assistant impersonators tangled up in fraud

Physician assistants and unlicensed people posing as them have captured headlines recently for perpetrating or witnessing alleged and proven healthcare fraud.   

In Houston, for example, a jury convicted Dennis B. Barson, Jr., D.O., and his clinic administrator Dario Juarez of conspiracy and healthcare fraud after they billed Medicare a whopping $2.1 million on behalf of 429 beneficiaries in two months, the Austin American-Statesman reported. On one date in 2009, they filed claims on behalf of 156 patients. Prosecutors said the pair filed claims for urinary, bowel and sexual dysfunction tests not performed. Though Barson was the only physician working at the clinic, it was Juarez who saw patients and represented himself as a physician's assistant or a doctor, the American-Statesman noted.

And in Maryland, Shawna Michelle Gunter pleaded guilty to wire fraud and aggravated identity theft after posing as a physician's assistant in a pediatric practice, according to WJLA-TV. Gunter lied on her resume, presented a practitioner's profile that belonged to someone else as her own and provided a fake Howard University diploma.

She diagnosed and treated more than 200 children without supervision and wrote more than 400 prescriptions for controlled substances. As a result, the practice filed hundreds of false Medicaid claims and collected nearly $20,000 inappropriately, the station noted.    

Meanwhile, in Illinois, Albert Young--a legitimate physician assistant--filed a civil lawsuit against his former employer, Skyline Physicians, after they reportedly fired him for refusing to participate in alleged Medicare and Medicaid fraud, The Cook County Record stated.

Young provided in-home patient care. He reportedly lost his job after telling superiors that the company was committing fraud by falsifying medical histories, ordering unnecessary tests, editing documentation with white-out and reassigning patients to other providers after determining the patients weren't homebound. Young also accuses Skyline Physicians of violating the Illinois Whistleblower Act for terminating his employment as a result of fraud allegations brought forward, The Record reported.    

For more:
- see the Austin American-Statesman article
- here's the WJLA-TV piece
- read The Cook County Record article

Fraud on the home front: Case lessons for payers and providers
Blowing the whistle on fraud may be hazardous to your career
Feds continue to crack down on healthcare fraud

 

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