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February 20, 2014 at 6:27 PM

Seattle doctor asks to change plea in Medicare-fraud case

FARGO, N.D. (AP) — A Seattle doctor accused of turning in phony Medicare claims that included reports of nursing-home visits to patients who were dead says he will plead guilty.

John C. Chen is charged in North Dakota federal court with six counts, including health-care fraud and false statements related to health care. The charges carry a combined maximum penalty of 45 years in prison.

The case is being heard in North Dakota because Fargo-based Noridian Healthcare Solutions processes and pays Medicare Part B claims in Washington state. Medicare Part B helps to pay for certain physician and outpatient services.

Chen’s lawyer, Robert Flennaugh II, filed a change of plea notice Wednesday and asked that the plea and sentencing hearings be combined.

“He lives in the state of Washington and prefers to fly out for one hearing,” Flennaugh wrote.

Flennaugh did not immediately respond to requests for comment.

Authorities said Chen submitted 673 claims for medical services in the Seattle-Tacoma area from 2007 through 2010, when he was out of the country. Another 212 claims were filed between April 2007 and July 2012 for nursing-home visits that never took place, according to court documents.

It’s not clear how many claims Chen submitted for services he said he performed on certain dates after patients had died.

Physicians are permitted to bill Medicare for evaluation and management services provided to patients in skilled nursing facilities, but they must be deemed “medically necessary” and the doctor must personally document the need for services in the patient’s medical record. The indictment said Chen failed to keep accurate notes of patient records.

The government is asking Chen to pay back any losses and forfeit all property and proceeds that were gained as a result of the scheme. Those damages have not been specified.

A change of plea and sentencing hearing has not been scheduled.

Comments | More in General news, The Blotter | Topics: John C. Chen


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