U.S. authorities are searching for a licensed physical therapist wanted in a Medicare and Medicaid fraud case tied to a Brooklyn rehabilitation clinic.
Conrado Dizon Lopez Jr., 51, owned Total Rehab in Brooklyn, according to the U.S. Department of Health and Human Services Office of Inspector General.
The alleged scheme involved reimbursement claims submitted between March 2009 and November 2011. The public fugitive notice does not say Lopez has been arrested or convicted in the case.
Lopez Was Linked to Total Rehab in Brooklyn
HHS-OIG identifies Lopez as a licensed physical therapist and the owner of Total Rehab.
The federal fugitive notice says the case comes from the Eastern District of New York and involves claims submitted to Medicare and Medicaid through the clinic.
Authorities say Lopez is wanted on charges including health care fraud, conspiracy to commit health care fraud, false claims, false statements related to health care matters, and falsification of records.
Investigators Say the Services Did Not Meet Medicare Rules
HHS-OIG says the claims included services that were not rendered, not medically necessary, not appropriately supervised, or performed by unlicensed people.
HHS-OIG says he was identified as the rendering provider on approximately $2.8 million in fraudulent claims. Federal investigators say Lopez and others submitted or caused the submission of approximately $18.4 million in fraudulent reimbursement claims to Medicare and Medicaid.
Backdated Treatment Records Became Part of the Case
HHS-OIG says Lopez confessed to investigators that he knowingly participated in the scheme.
The agency says he admitted signing backdated medical records, described as superbills, after returning from trips outside the United States.
According to the fugitive notice, some of the records covered dates when Lopez was on vacation and not in the country. Investigators say those records were still used to support claims submitted for reimbursement.
Authorities Are Asking for Information
The Filipino Times reported that U.S. authorities are seeking Lopez in connection with the case.
The outlet cited the HHS-OIG notice, which lists his possible whereabouts as Manila or the United Arab Emirates.
HHS-OIG has released Lopez’s photo and asks anyone with information to report a fugitive sighting or contact its fugitive hotline at 888-476-4453.
Therapy Claims Should Match Real Visits and Providers
Patients and caregivers can review Medicare summary notices, Medicaid statements, insurer portals, and explanation-of-benefits notices for therapy visits they do not recognize, dates when no appointment happened, providers they never saw, repeated services, or charges for treatment that was not supervised by a licensed professional.
Suspected Medicare or Medicaid fraud can be reported to the U.S. Department of Health and Human Services Office of Inspector General at oig.hhs.gov/fraud/report-fraud. Medicare beneficiaries can also report suspicious claims to 1-800-633-4227 or contact their state Senior Medicare Patrol program for help reviewing statements.