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4 in Nevada charged for roles in health care fraud

Posted: 11:05 AM, Jun 28, 2018
Updated: 2018-06-29 00:28:11Z

More than 600 medical professionals, including 4 in Nevada, have been charged for their roles in health care fraud schemes. 

It is the U.S. Department of Justice's largest ever health care fraud enforcement action involving 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings.  Of those charged, 162 defendants, including 76 doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. 

In Nevada, four defendants, including three medical professionals were charged with conspiracies to commit health care fraud and distribute controlled substances.

Robert Harvey, a surgical technician, and Alejandro Incera and Leslie Kalyn, both nurse practitioners, were indicted for distribution of prescription opioids and Medicare/Medicaid fraud. A jury trial is set for July 30.

Dr. Horace Guerra is charged for his role in a prescription opioid conspiracy. He allegedly allowed his co-conspirators to write illegal opioid prescriptions, specifically Hydrocodone and Oxycodone, using his pre-signed prescription pad, to patients without a medical purpose. His initial appearance and plea hearing is set for July 25.

The charges announced Thursday aggressively target schemes billing Medicare, Medicaid, TRICARE (a health insurance program for members and veterans of the armed forces and their families), and private insurance companies for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics.   

According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare.  Collectively, the doctors, nurses, licensed medical professionals, health care company owners and others charged are accused of submitting a total of over $2 billion in fraudulent billings.