CORPUS CHRISTI, Texas — Six South Texas doctors and their medical practices have agreed to pay $4,855,844 to resolve allegations they submitted false claims to Medicare, Medicaid and TRICARE for services that were either never provided or not medically necessary, according to a press release from the United States Attorney’s Office - Southern District of Texas.
U.S. Attorney Nicholas J. Ganjei announced the settlement involving Drs. Javier Cabello, 47, of San Benito; Ammar Halloum, 52, of Brownsville; Jamil Madi, 54, of Olmito; Jairo Rodriguez, 62, of Rancho Viejo; Ricardo Schwarcz, 57, of Weslaco; and Stanley Sy, 55, of Pharr. The six doctors owned and operated Benchmark Inpatient Services PLLC, doing business as Beyond Inpatient Services, in Harlingen. Rodriguez also owned and operated Brownsville Pulmonary Center, P.A., doing business as Benchmark Pulmonary Center, in Brownsville.
According to allegations, from Jan. 1, 2020, to May 31, 2023, Beyond Inpatient Services, Benchmark Pulmonary Center and their owners submitted claims for critical care services that patients' medical records did not support, or that were never rendered at all. Benchmark Pulmonary Center and Rodriguez also allegedly submitted claims for pulmonary function testing during that period.
Critical care billing requires complex decision-making and at least 30 minutes of treatment for a critically ill or injured patient. Instead, Beyond Inpatient Services providers allegedly billed critical care for...
Executive Summary What’s new: In recent remarks, a key DOJ official signaled continued aggressive False Claims Act enforcement, with priorities including health care, trade fraud, antidiscrimina...