A written employee “protocol” for handling no-show patients has prompted a federal grand jury to indict James and Dennis Froeschner the owners of Healthnet Regional Center of Cuba, Missouri (HRCC), according to a joint report by HHS and DoJ. HRCC is one of many rural health centers which provide “services in medically under served areas and are reimbursed for visits, called encounters” — defined by Missouri Dept. of Health and Human Services as “a face to face encounter between the patient and either a physician, nurse practitioner, nurse midwife, physician assistant, licensed clinical social worker, or clinical psychologist.” According to the indictment, the Froeshner’s protocal instructed employees “not to indicate on daily schedules and patient records that patients did not keep their appointments.” Says, DoJ and HHS:

“It was part of the fraud scheme that Dennis Froeschner billed for all patients on a list he had compiled of patients who were scheduled to be seen on a regular basis, although he knew some of the patients had not kept their appointments.”

Likewise Dennis Froeshner billed for nonexistent, unnecessary, or ancillary services to patients’ relatives, says DoJ:

“Dennis Froeschner also billed for health services to relatives accompanying a patient to HRCC although the relatives received no services, for chart reviews where the records do not indicate a  physician reviewed the charts, and for encounters  when  the only service provided was arranging transportation or authorizing a prescription refill. James Froeschner had instructed his staff to complete encounter forms for these activities.”

The fraud allegedly became so bold that bills were submitted for government reimbursement for services even when the clinic was closed, such as weekends and holidays. Both Froeshners are presumed innocent and await trial.

FRAUDBLAWG UPDATE: READ FROESCHNER INDICTMENT IN ITS ENTIRETY.

To report healthcare fraud, contact Frohsin & Barger.