The CEO of a healthcare software company has been found guilty in a scheme to defraud Medicare and other health programs of more than $1 billion. Gary Cox, 79, of Maricopa County, Arizona, led Power Mobility Doctor Rx, LLC (DMERx), and used false advertising and foreign call centers to obtain personal information from beneficiaries. This information was then used to create fraudulent doctors’ orders for unnecessary medical supplies.
According to the U.S. Attorney's Office release, federal jury delivered the verdict yesterday after reviewing court documents and evidence detailing the fraud. Cox and his co-conspirators worked with pharmacies, durable medical equipment suppliers, marketers, and telemedicine companies. These companies were paid kickbacks in exchange for signing off on medical orders with minimal or no patient interaction. The orders were routed through the DMERx platform, leading to over $1 billion in claims submitted to Medicare, of which more than $360 million was paid out.
Cox concealed the scheme using sham contracts and altered medical documents to avoid detection. The physicians involved signed off on orders based on little or no patient contact.
Cox was convicted of multiple charges: conspiracy to commit health care fraud and wire fraud (up to 20 years in prison), three counts of health care fraud (each carrying up to 10 years), conspiracy to pay and receive health care kickbacks (up to 5 years), and conspiracy to defraud the United States and make false statements related to health care (up to 5 years). A sentencing date has not yet been scheduled. A federal judge will determine the final sentence based on legal guidelines.
The case was investigated by multiple federal agencies, including HHS-OIG, FBI, VA-OIG, and DCIS. It was prosecuted by Trial Attorneys Darren C. Halverson and Jennifer E. Burns from the DOJ’s Fraud Section.
