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Tipsheet

CEO of Health Care Software Company Convicted in $1 Billion Medicare Fraud Scheme

AP Photo/Andrew Harnik

A federal jury convicted the CEO of Power Mobility Doctor Rx, LLC, of deliberately exploiting the federal health care system by focusing on self-serving financial gain over the medical needs of patients. 

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Gary Cox for his role in operating a platform that generated false doctors’ orders to defraud Medicare and other federal health care benefit programs of more than $1 billion. According to court documents, Cox, along with his co-conspirators, exploited hundreds of thousands of Medicare beneficiaries by misleading them into accepting unnecessary medical items like orthotic braces and pain creams. They used an online platform, DMERx, to generate fake doctors’ orders and facilitate illegal kickbacks and bribes between telemedicine providers, pharmacies, and marketers. In return, Cox and his team profited by coordinating these fraudulent transactions and selling the bogus orders. 

The scheme falsely claimed that Medicare patients had been properly examined and treated. However, doctors were paid by telemedicine companies to sign off on orders without confirming patients' medical needs. This would often happen after only a brief phone call, and sometimes, the doctors would have no contact with the patient at all. 

Cox was convicted of conspiracy to commit health care fraud and wire fraud, along with three counts of health care fraud and conspiracy to pay and receive health care kickbacks. He was also charged with conspiracy to defraud the United States and making false statements concerning health care matters. He faces a maximum penalty of 20 years in prison. 

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Head of the Justice Department’s Criminal Division, Matthew Galeotti, stated that Cox led a massive healthcare fraud scheme involving fake doctors’ orders to bill over $1 billion, exploiting seniors and government programs, and emphasized the Justice Department’s commitment to prosecuting such crimes.

“The defendant orchestrated a scheme to defraud government health care benefit programs on a massive scale, creating fraudulent doctors’ orders used to bill insurers over $1 billion,” Galeotti said. "Americans are all too familiar with junk mail and spam calls that target seniors to steal their personal information and promote waste, fraud, and abuse in our economy. The Criminal Division will continue to aggressively prosecute health care fraud schemes to hold criminals accountable, protect the vulnerable, and recover financial losses.”

Deputy Inspector General Christian Schrank criticized Cox for violating public trust by billing the government for unnecessary medical equipment. 

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