Danville doctor sentenced to prison, ordered to pay nearly $2 million
Morning Star Family Medicine doctor billed patients without performing services
DANVILLE, Va. – Dr. Edwin L. Fuentes of Danville will spend two years in prison, pay $1,739,194 as well as repay $125,789 in investigative costs after pleading guilty to one count of health care fraud and one count of willfully evading taxes.
Fuentes was sentenced Tuesday.
“Doctors who overcharge insurance plans for their services, place false notes in patient files, then hide the stolen money will be held responsible for their crimes,” said Special Agent in Charge Nick DiGiulio of the U.S. Department of Health and Human Services Office of the Inspector General. “We will continue to work with our law enforcement partners to bring justice to those who steal our health care dollars.”
"Fraud against healthcare benefit programs and the federal government must be severely punished,” U.S. Attorney Rock Mountcastle said Tuesday. “I commend the Virginia Attorney General's Medicaid Fraud Control Unit, the Department of Health and Human Services Office of the Inspector General, the Internal Revenue Service-Criminal Investigations, the Danville Police Department, and the Virginia Department of Motor Vehicles-Law Enforcement Division for working together to bring the defendant to justice.”
Evidence presented in court showed from at least January 2012 through December 2014, the medical practice billed covered patients to various insurers. Fuentes supervised all billing decisions at Morning Star, and he was the only one authorized to complete the superbill, which listed services the health care benefit programs provided.
During the two-year span, Fuentes had directed and ordered other Morning Star employees to bill the health care benefit programs without providing the services to the patients.
Through Morning Star, Fuentes was able to defraud the health care benefit programs, resulting in overpaying Fuentes $999,228.
Some of the funds were diverted to a Wells Fargo bank account by Fuentes for day trading. He hadn't been reporting the extra income to the IRS for the tax years of 2011 through 2014.
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