The DOJ just announced that Dr. John Thropay, former radiation oncologist, was convicted of one count of conspiracy to commit health care fraud and four counts of health care fraud. A California federal jury convicted Thropay for his role in a $2.8 million Medicare fraud scheme stemming from the billing of hospice services.

To receive reimbursement for hospice services, Medicare requires a physician to certify that a beneficiary is terminally ill, and the beneficiary must execute an election form choosing hospice care instead of other Medicare benefits. Medicare considers a beneficiary “terminally ill” if they have a life expectancy of 6 months or less.

Thropay was the medical director of several hospice facilities in California. According to trial evidence and court documents, from October 2014 to March 2016, Thropay falsely certified Medicare patients at Blue Sky Hospice Inc., located in Van Nuys, California, as having terminal illnesses so Blue Sky could bill Medicare for hospice services. Thropay, however, was aware that the majority of beneficiaries at Blue Sky did not have terminal illnesses. Moreover, Thropay paid Medicare beneficiaries kickbacks for every month they remained at Blue Sky. Thropay also paid  “marketers” and “cappers” illegal kickbacks in exchange for referring Medicare beneficiaries to Blue Sky.

According to the Government, Thropay was listed as the attending physician for at least $2.8 million in hospice services billed to Medicare and received more than $1.7 million in reimbursements. In 2015, Thropay was listed as the attending physician for more hospice services billed to Medicare than any other provider in the nation. Thropay now faces more than 50 years in prison, and he is scheduled to be sentenced on May 28th. 

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection to health care fraud investigations and litigation. If you need assistance with such a matter, please contact us today.