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Passing The Blame

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Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

The U.S. Department of Justice announced on June 27, 2024, that 193 people across the country were facing charges in health care fraud schemes involving a total $2.75 billion in stolen taxpayers’ dollars. And convictions are now starting to happen. On January 14, 2025, Dennis Michael Peyroux, a chiropractor from Slidell, Louisiana, pled guilty to conspiracy to commit healthcare fraud relating to a scheme involving the billing to Medicare for hundreds of thousands of over-the-counter COVID-19 test kits that were either not requested or were ineligible for reimbursement.

The scheme began in November 2022, when Peyroux purchased Medicare beneficiary information that included names and Medicare identification numbers along with fabricated recordings of individuals posing as beneficiaries requesting the test kits. While Medicare does not explicitly mandate written consent, it does allow for verbal consent in certain situations – particularly for telehealth services like virtual check-ins, where the patient must verbally agree to the service and the provider documents this consent in the medical record. Peyroux used this information to bill Medicare through his chiropractic clinic.

In order to pass the blame in the scheme, Peyroux misappropriated the credentials of a former nurse practitioner who had worked for him and falsely listed this nurse as the referring provider on the fraudulent claims. Over approximately six months, Pyroux billed Medicare around $3.3 million in false claims for these test kits, receiving about $3.2 million in reimbursements.

Shout out to the Federal Bureau of Investigation in investigating this case.

Today’s Fraud of The Day is based on article “Slidell Chiropractor Pleads Guilty to $3.2 Million Medicare Fraud Scheme” published by Hoodline New Orleans on January 14, 2025.

A Slidell chiropractor has pled guilty to charges of health care fraud after being accused of a scheme involving over-the-counter COVID-19 test kits. Dennis Michael Peyroux, 57, entered his plea last Wednesday, admitting to conspiracy to commit healthcare fraud. This follows an investigation uncovering that Peyroux and his conspirators purchased Medicare beneficiary information and used them falsely to bill Medicare through his clinic, as reported by the U.S. Attorney’s Office.

According to a release from the U.S. Attorney’s Office on Monday, Peyroux began to purchase Medicare information in November 2022, which included names, Medicare IDs, and even fabricated recordings of individuals purportedly requesting COVID-19 test kits. The scheme led to Peyroux billing Medicare for test kits that were neither requested by beneficiaries nor eligible for reimbursement. He then went on to improperly use the credentials of a former nurse practitioner at his clinic to support the fraudulent claims. Peyroux’s conviction now forces him to pay over to repay $3.2 million to Medicare and face possible incarceration.

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