The CEO of a healthcare software company was convicted by a federal jury for his role in operating a platform that generated fraudulent physicians’ orders to defraud Medicare and other payers out of more than $1 billion.
What happened?
Gary Cox, 79, of Maricopa County, Ariz., was the CEO of Power Mobility Doctor Rx (DMERx), an internet-based platform that generated fraudulent orders for unnecessary orthotic braces, pain creams and other items, according to a June 3 Justice Department news release.
Mr. Cox and his co-conspirators targeted hundreds of thousands of Medicare beneficiaries who provided their personally identifiable information and agreed to accept the medically unnecessary items through misleading mailers, television advertisements and calls from offshore call centers.
He connected pharmacies, durable medical equipment suppliers and marketers with telemedicine companies that would accept kickbacks and bribes in exchange for signed orders transmitted using the DMERx platform. He and his co-conspirators received payments for coordinating these kickback transactions and referring completed physicians’ orders.
The durable medical equipment suppliers and pharmacies that paid kickbacks billed Medicare and other payers more than $1 billion, of which more than $360 million was paid out.
Who else is involved?
The co-conspirators — unnamed in the release — owned, controlled and operated DMERx.
What’s next
Mr. Cox was convicted of conspiracy to commit health care fraud and wire fraud, three counts of health care fraud, conspiracy to pay and receive health care kickbacks, and conspiracy to defraud the U.S. and make false statements in connection with health care matters.
He faces up to 60 years in prison. A sentencing date has not yet been set.
