Former Michigan Doctor Charged with Healthcare Fraud and False Statements

A federal grand jury in Grand Rapids returned an indictment charging a Texas doctor with defrauding healthcare insurers and creating false medical records. According to court documents, Dr. Daniel Castro, age 70, currently of McKinney, Texas, was employed by Bronson Hospital in Battle Creek from February 2015 until May 2017, where he practiced as an otolaryngologist (an ear, nose, and throat physician). The indictment alleges that Dr. Castro performed functional endoscopic sinus surgeries on patients whose symptoms, history, and computed tomography scans (CT scans) did not support the medical necessity of such procedures. Additionally, the indictment alleges that Dr. Castro routinely billed for removing diseased tissue from inside his patient’s sinuses when diseased tissue did not truly exist and billed for performing surgery on sinus cavities that did not exist, to increase his compensation.

The grand jury also alleged that Dr. Castro routinely billed for performing complex neck dissection surgeries designed to treat confirmed cancer of the head and neck when his patients did not have cancer and he actually performed much simpler surgical neck procedures not associated with cancer treatment. Finally, the indictment alleges that Dr. Castro created false entries in his office consultation notes and operative reports in order to justify the medical necessity of his sinus surgeries or to make it appear as if he had actually performed the higher paying neck dissections or sinus procedures that he did not actually perform.

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