VALDOSTA – A Valdosta doctor has been sentenced to more than eight years in federal prison for defrauding Medicare and Medicaid of more than $2.2 million.
Dr. Douglas Moss, 58, of Valdosta was sentenced Friday to 97 months in prison; U.S. District Judge Hugh Lawson imposed an additional three years of supervised release, according to U.S. Attorney for the Middle District of Georgia court records.
Shawn Tywon, 50, of Valdosta, a physician's assistant in Moss' office, was sentenced Friday to two years in prison and two years of supervised release, according to the U.S. Attorney's office.
Moss and Tywon were ordered to pay $2,256,861.32 in restitution to Medicare and Georgia Medicaid.
"There is no parole in the federal system," according to the U.S. Attorney's office.
Moss and Tywon were accused of trying to defraud Medicare and Medicaid programs by submitting false claims for services they never provided at local nursing homes.
In 2011, Moss accepted positions as medical director for Holly Hill Nursing Home, Valdosta Nursing Home, Lakehaven Nursing Home and Crestwood Nursing Home, court documents state.
According to the Georgia Composite Medical Board's website, Moss' specialty is emergency medicine and he received his Georgia medical license in 1995. Moss practiced medicine in Valdosta since 2002, according to court records.
From January 2012 through December 2014, Moss, Tywon and "co-conspirators, both known and unknown to the Grand Jury" submitted more than 31,000 claims for nursing home care to Medicare and Georgia Medicaid, according to the indictment.
Both defendants knew many of these services were not rendered by Moss and were not medically necessary, according to court records.
"The evidence showed that Dr. Moss routinely did not render the services he billed under his name, and even visited Las Vegas casinos during at least two periods of time when he submitted bills for services in Valdosta," according to court records.
On May 14, Moss' case was heard in a seven-day trial in federal court. A jury found Moss guilty of one count of conspiracy to commit health-care fraud and six counts of health-care fraud.
A month earlier, Tywon pleaded guilty to conspiracy to commit health-care fraud.
“Stealing from Medicare and Medicaid programs undermines our government’s mission to assist providing health care to senior citizens and vulnerable members of our society. Enriching oneself on the backs of law-abiding, taxpaying citizens will not be tolerated, and the punishment is prison time,” Charlie Peeler, U.S. attorney for the Middle District of Georgia, said in a statement. “Dr. Moss stole more than $2.2 million by billing the government for work he did not perform. We will continue to work closely with our law-enforcement partners to end government fraud.”
“The ability to combine resources with our federal partners is critically important as we work together to prosecute those who break the law and take advantage of government programs for their own personal gain,” Georgia Attorney General Chris Carr said in a statement. “We remain committed to protecting the integrity of the Georgia Medicaid program, its members and the taxpayer dollars used to provide this service, and, as identified by today’s action, we will remain vigilant in our efforts to recover any and all funds spent illegally.”
“Today’s sentencing demonstrates that when medical professionals choose to break the law and corrupt the system to line their pockets with taxpayer dollars, we will work relentlessly to bring those individuals to justice,” Derrick L. Jackson, special agent in Charge of the Office of the Inspector General of the U.S. Department of Health and Human Services, said in a statement. “Protecting precious Medicare and Medicaid funds remains a top priority for the Inspector General and our law-enforcement partners.”
“When health-care professionals choose to defraud federally funded programs like Medicare and Medicaid there are many victims, including American taxpayers and the people who are rightly entitled to those funds,” Chris Hacker, special agent in charge of FBI Atlanta, said in a statement. “Health-care costs are driven up when doctors and staff bill for unnecessary and unfulfilled services and the FBI and our partners will continue to use every resource in our power to stop it.”