Acting United States Attorney April M. Leon announced on March 10, 2025, that a 35-year-old Louisiana man had pleaded guilty to making false statements related to healthcare, including posing as a licensed medical doctor and gaining unauthorized access to healthcare facilities and prescriptions.
According to his guilty plea, the defendant, a licensed paramedic working for an ambulance service, admitted that he had never attended or graduated from medical school. While employed by the ambulance company, he falsely represented himself as a licensed medical doctor to co-workers and friends. To perpetuate the deception, he fabricated a fake medical degree, created a fake residency match letter, and even attended a celebration for his supposed medical school graduation.
By posing as a doctor, the defendant gained physician access privileges at several hospitals, where he interacted with patients, including in the intensive care unit. He wore “MD” and “Flight Surgeon” insignia on his clothing and was issued badges from hospitals and his ambulance company identifying him as a physician.
From May 2019 through November 2022, the defendant also called in prescriptions to various pharmacies for both himself and others. He fraudulently claimed to be two different doctors with the authority to write prescriptions, causing pharmacies to submit reimbursement claims to healthcare benefit programs, including Medicaid and private insurance.
For example, on October 3, 2022, he wrote a prescription for Ondansetron-ODT, 4mg tablets, for a cancer patient. The defendant forged a doctor’s signature on the prescription and failed to consult with the patient’s oncologist before issuing it. Not only did he lack the medical training and certification required to write prescriptions, but he also lacked authorization from the actual doctor to do so.
The defendant’s conviction is punishable by up to five years in prison, a fine of up to $250,000 (or twice the gross gain or loss, whichever is greater), and a term of supervised release for up to three years.
Compliance Perspective
Issue
Healthcare facilities receiving government funds are required to conduct comprehensive background checks on all employees to ensure they are qualified and legally permitted to work. These checks must include criminal background checks, sex offender registry searches, identification verification, past employment history, education verification, and a search of the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE). Additionally, for positions requiring certifications or licenses, verification of these credentials must be documented in the individual’s personnel file. Before hiring, these checks must be completed and cleared, and after an employee is hired, it is essential to continue routine monitoring of databases to ensure the employee has not been added to an exclusion list or had their credentials suspended or revoked. This ongoing monitoring ensures that employees remain legally authorized to practice healthcare in the facility, helping to prevent the illegal practice of healthcare by unlicensed individuals or the misuse of someone else’s credentials.
Discussion Points
- Regularly review and update policies for verifying professional licenses and monitoring the OIG’s LEIE to ensure they meet current legal standards. Ensure policies include verifying employee credentials at the time of hire and on an ongoing basis, as well as confirming that employees are not listed on exclusion lists. Update procedures as necessary to stay compliant with legal requirements.
- Train relevant staff on protocols for verifying licenses and certifications during hiring and ongoing employment. Licensed personnel should be informed of their responsibility to maintain an active license and promptly notify administration if their license expires, is suspended, or if they are added to the OIG’s LEIE or a state exclusion list.
- Conduct periodic audits to verify that employee licenses and certifications are valid and up to date, and that OIG LEIE checks are routinely performed. Audit procedures should also include identifying signs of fraud, such as altered documents, mismatched information, or discrepancies in employee records. Immediately address any discrepancies or negative findings to ensure compliance.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*
