Fraudulent Healthcare Billing Scheme Uncovered in Virginia
RICHMOND, Va. – In a shocking revelation, Bon Secours Health System, Inc. and one of its surgical oncologists, Dr. Eugene Y. Chang, M.D., have been found guilty of falsifying documents and engaging in a fraudulent scheme to bill Medicare and other federal healthcare payors for non-covered breast examinations and ultrasounds. The scheme, which lasted from June 1, 2010, through Dec. 31, 2014, resulted in the duo agreeing to pay $400,000 to settle civil fraud allegations.
According to the investigation, Dr. Chang would falsify documents with diagnosis codes, such as ‘lump or mass in breast,’ where none existed, in order to induce federal healthcare payors to pay for non-covered ‘screening’ breast examinations in connection with routine screening mammograms. The examination was billed as ‘diagnostic,’ while patient charts maintained by Dr. Chang indicated that the patient had no complaint.
The settlement resolves allegations that Dr. Chang arranged for certain patients to receive screening breast examinations and screening breast ultrasounds at approximately six-month intervals following screening mammograms, and improperly billed these services as ‘diagnostic,’ resulting in federal healthcare programs paying for non-covered screening examinations and ultrasounds.
The settlement was reached after a lawsuit was filed in the U.S. District Court for the Eastern District of Virginia by a former Bon Secours practice manager and a former colleague of Dr. Chang under the qui tam, or whistleblower provisions of the False Claims Act. The relator share in this settlement is $108,000.
Bon Secours Health System and Dr. Eugene Y. Chang have been charged with engaging in a scheme to defraud the United States by falsely billing Medicare and other federal healthcare payors for non-covered breast examinations and ultrasounds. The case was investigated by Assistant U.S. Attorney Robert McIntosh.
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney’s Office for the Eastern District of Virginia, the Department of Health and Human Services, the Office of Inspector General, the Defense Criminal Investigative Service, and the U.S. Office of Personnel Management, Office of the Inspector General.
Defendant: Bon Secours Health System and Dr. Eugene Y. Chang
Criminal Charges: Engaging in a scheme to defraud the United States by falsely billing Medicare and other federal healthcare payors for non-covered breast examinations and ultrasounds
City and State: Marriottsville, Maryland, and Suffolk, Virginia
Exact Date: June 1, 2010, through Dec. 31, 2014
Sentence or Outcome: Agreed to pay $400,000 to settle civil fraud allegations
Dollar Amounts: $400,000 (settlement amount) and $108,000 (relator share)
Defendant Status: Currently under investigation and awaiting further action
Related Federal Cases
- Airbus Defense and Space Inc., False Claims Act Violation, West Virginia 2016 · Virginia
- Jackie G. Woodson Jr., Conspiracy to Commit False Claims, Virginia 2022 · North Carolina
- Cindy Shearer, Wire Fraud and Filing False Income Tax Return, West Virginia 2013 · Washington
- Jacquelyn Farrish, Health Care Fraud, Virginia 2025 · Maryland
- Lara Coleman, Mail and Wire Fraud, Virginia 2023 · Florida
Key Facts
- State: Virginia
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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