A 51-year-old doctor from Peoria, Linh Cao Nguyen M.D., has been sentenced to 24 months in prison after pleading guilty to Health Care Fraud.
According to the Department of Justice, over the course of several years, Nguyen engaged in a scheme to defraud various health care benefit programs, including Medicare, TRICARE, AHCCCS, Blue Cross Blue Shield, and UnitedHealthcare. As part of his scheme, Nguyen knowingly caused the submission of thousands of false billing claims. Nguyen also falsely created patient records to conceal and avoid detection of his fraudulent scheme. The fraudulent claims identified a medical doctor as the treating provider when, in fact, another provider such as a nurse practitioner, social worker, unlicensed psychology intern, or wound care nurse provided the service independently. By billing the medical service as if it were provided by a physician, Nguyen falsely inflated the amount his company was to be paid for the service.
The total loss to the insurance companies from Nguyen’s scheme was approximately $3.7 million. As part of his sentence, Nguyen was ordered to pay over $1.1 million in restitution to the private insurance companies.
Nguyen also was required to pay over $2.5 million to the government in a separate civil agreement.