An Orange County man has pleaded guilty to orchestrating a massive Medi-Cal fraud scheme that submitted nearly $270 million in bogus claims over an 11-month span for expensive prescription drugs containing generic ingredients that were not medically necessary and, in many instances, not provided to the purported recipients.
William T. Huish, 36, of Orange County, Texas, pleaded guilty to one count of conspiracy to commit health care fraud, announced the Department of Justice’s U.S. Attorney’s Office for the Southern District of Texas. The scheme, which ran from January 2022 to December 2022, involved Huish submitting false claims to Medi-Cal for expensive prescription drugs that contained generic ingredients, which were not medically necessary and, in many cases, not provided to the purported recipients.
According to the plea agreement, Huish and his co-conspirators used various schemes to defraud Medi-Cal, including submitting claims for prescription drugs that were not prescribed by a licensed physician and were not actually provided to the recipients. The scheme also involved Huish and his co-conspirators paying kickbacks to individuals who referred patients to their pharmacies, in exchange for a share of the profits.
The investigation into Huish’s scheme was conducted by the Health Care Fraud Unit of the U.S. Attorney’s Office for the Southern District of Texas, in partnership with the Texas Attorney General’s Medicaid Fraud Control Unit and the Federal Bureau of Investigation. The case was prosecuted by Assistant U.S. Attorney Andrew M. Reardon of the U.S. Attorney’s Office for the Southern District of Texas.
Huish faces up to 10 years in prison and a fine of up to $250,000, as well as restitution and forfeiture of any proceeds obtained as a result of the scheme. Sentencing for Huish is scheduled for June 2024.
The investigation into Huish’s scheme is ongoing, and authorities are urging anyone with information about the scheme to come forward. The public can report suspected healthcare fraud to the Department of Health and Human Services’ Office of Inspector General at 1-800-HHS-TIPS (1-800-447-8477) or online at oig.hhs.gov.
As the investigation continues, authorities are working to uncover the full extent of Huish’s scheme and hold him and his co-conspirators accountable for their actions. The case serves as a reminder of the importance of protecting taxpayer dollars and ensuring that those who commit healthcare fraud are brought to justice.
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- William Johnson, Murder and RICO Conspiracy, Minneapolis MN, 2023 · Tennessee
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- John McClure, Contractor Fraud Scheme, NY, 2023 · Texas
Key Facts
- State: Texas
- Agency: DOJ USAO
- Category: Healthcare Fraud|White Collar Crime|Financial Crimes
- Source: Official Source â†â€â€ÂÂ
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