A Hickory doctor pleaded guilty in federal court Monday to health care fraud for submitting $467,376 in false reimbursement claims to Medicare and Medicaid, Acting U.S. Attorney Jill Westmoreland Rose said.
Dr. Wayne Vincent Wilson, 54, “added and padded” his Medicaid and Medicare reimbursements with fake claims because he believed Medicaid did not pay him enough for his services, court records show.
The false claims resulted in payments of at least $210,100 to Wilson and his Wayne Wilson, MD, Family Practice, according to prosecutors.
Wilson admitted in court Monday to committing the fraud from 2007 to 2014.
Court records show that in some instances, the doctor added nonexistent services to patient office visits, including nerve conduction studies, strep tests and pulmonary stress tests.
Wilson also fabricated entire office visits and submitted fraudulent claims for dates that patients were not even seen at the office.
Beginning in 2005, Wilson contracted with a person identified as “D.D.” to perform nerve conduction studies, and sought reimbursement for those services through his practice.
In 2012, D.D. terminated his relationship with Wilson and the practice, but Wilson continued to submit reimbursement claims to Medicare and Medicaid. He falsely stated that he had performed nerve conduction studies for patients, even though he lacked the equipment and the expertise.
Wilson pleaded guilty to two counts of health care fraud and was released on bail pending his sentencing hearing, which has yet to be scheduled.
Each health care fraud count carries up to 10 years in prison and a $250,000 fine. Wilson agreed to pay restitution – a judge will determine the amount at Wilson’s sentencing.