A Texas Doctor has pleaded guilty to playing a role in a $54 million scheme to defraud Medicare. Dr. Daniel R. Canchola, 49, of Flower Mound submitted multiple unnecessary claims to Medicare for cancer screenings genetic tests (CGx).
According to the Flower Mount Leader, Canchola was charged on October 21 with one count of conspiracy to commit healthcare fraud and wire fraud and three counts of healthcare fraud. The bust was linked to 34 other individuals that were involved in this fraudulent ring.
All 35 defendants associated with this fraud are involved with telemedicine companies and cancer genetic testing laboratories. Together, they are suspected of fraudulently billing Medicare $2.1 billion.
A press release from the Department of Justice said Canchola agreed to electronically sign orders for durable medical equipment (DME) and CGx that he knew were used to submit more than $54 million in fraudulent claims to Medicare. Canchola used invoices to track beneficiaries that he signed off for the testing, requesting $30 per order, totaling $466,000.
Those prescribed DME and CGx were targeted by telemarketing campaigns and at health fairs. They were induced to submit to the cancer genetic testing and to receive the DME regardless of medical necessity. This went on from April 2018 to April 2019.
“Daniel Canchola was not treating the beneficiaries for which he signed doctors’ orders for CGx testing for cancer or symptoms of cancer, and he did not use the test results in the treatment of the beneficiaries,” the indictment stated.
Canchola pleaded guilty to conspiracy to commit wire fraud, and he is scheduled to be sentenced on March 15, 2023. For the crimes, he could face a maximum penalty of 20 years in prison. A federal district court judge will determine any sentence after the court process considering the U.S. Sentencing Guidelines and other statutory factors.