Dr. John Thropay Convicted of Medicare Fraud
On February 15, 2024 Dr. John Thropay of Arcadia, California was convicted by a federal jury. The trial was based upon claims that Dr. Thropay defrauded Medicare by billing for unneeded patient hospice services. A loss to the Medicare program of $2.8 million was alleged.
Medical Director Title - A Criminal Investigation Hot Button
In a fairly typical situation, Dr.Thropay held the title of “medical director” for various hospice companies. The “Medical Director” title is a hot button for federal investigators as it often means that referrals are compensated via this title. In Dr. Thropay’s case various hospice companies were allegedly involved including Blue Sky Hospice from Van Nuys, California. The concept alleged what that Dr. Thropay fraudulently certified Medicare patients as having terminal illnesses even if (in some cases), did not. The government claimed that in one of the years affected by these charges, Dr. Thropay was listed as attending provider for more hospice claims paid by Medicare than any other provider in the nation.
Dr. Thropay was convicted of one count of conspiracy to commit health care fraud and four counts of health care fraud.
We do not know whether or not Dr. Thropay was or was not guilty other than the fact that there was a jury verdict. What we know from our experience defending doctors in healthcare fraud cases is that any referrals or large scale review of patients for Durable Medical Devices, hospice care, nursing home or long term care or any gatekeeper function, has dangers. Certainly 99.9% of the physicians performing these tasks are doing a major public service by screening for need and by assessing patients. .01% are deliberately operating a scam and getting kickbacks. However there is also a grey area where the service providers may be using a doctor for their own purposes. A young doctor, an older doctor (and Dr. Thropay was over 70 years old) or doctors with financial problems may be manipulated to participate in conduct that is not deliberately fraudulent but does support a larger fraudulent scheme.
In these cases, there is always a battle between showing that the doctor was truly misled vs. the government arguing “Your client’s a doctor, any smart person would know ...”.
Interestly, there is presently (2/26/2024) no filings against Dr. Thropay on the Medical Board website. This is generally an indication that the Medical Board did not directly participate in the criminal investigation of Dr. Thropay. Dr. Thropay may well appeal his conviction but of course even if he is ultimately found innocent, the cost of going through the process is immeasurably painful.
Daniel Horowitz is a criminal defense specialist certified by the California State Bar Board of Legal Specialization. If you are a physician facing criminal charges anywhere in California, Daniel Horowitz can assist you with the best defense for your case.
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