By Hayley Fowler
The medical director for more than a dozen hospice providers in Mississippi supplied them with a steady stream of patients over the course of a decade, federal prosecutors said.
There was just one problem: Many of those patients weren’t dying.
Dr. Scott Nelson, a licensed physician from Cleveland, Mississippi, is accused of funneling patients to various hospices to help the owners defraud Medicare and Medicaid out of at least $15 million. A federal jury found him guilty of health care fraud after a two-week trial in the Northern District of Mississippi, the U.S. Attorney’s Office said in a news release on Tuesday, April 5.
Defense attorneys representing Nelson did not immediately respond to McClatchy News’ request for comment on April 6.
Defense attorneys representing Nelson did not immediately respond to McClatchy News’ request for comment on April 6.
“Just to enrich himself, Dr. Nelson fraudulently prescribed hospice care for a steady stream of Medicare and Medicaid beneficiaries who he knew were not dying, ignoring the fact that under this end-of-life status they would not be eligible for curative services,” Special Agent in Charge Tamala E. Miles said in the release.
Mississippi Attorney General Lynn Fitch said the alleged scheme violated patients’ trust, adding they shouldn’t “have to worry about being pawns in a get-rich-quick scheme.”
Mississippi Attorney General Lynn Fitch said the alleged scheme violated patients’ trust, adding they shouldn’t “have to worry about being pawns in a get-rich-quick scheme.”
Nelson was indicted in 2017 alongside three owners of the hospices for which he was the medical director. The four of them were accused of concocting and executing the alleged fraud scheme from at least 2005 until 2015.
According to the indictment, Nelson’s job was to certify patients for hospice at one of several facilities in the Mississippi Delta. The owners of those facilities are then accused of submitting fraudulent claims for reimbursement of services to Medicare and Medicaid on behalf of those patients.
Prosecutors said the hospice owners often brought three or four patients at a time to Nelson’s office in Cleveland, located about 120 miles northwest of Jackson, Mississippi.
“In almost all cases, the patients had no idea they were being placed on hospice and multiple patients testified at trial that Dr. Nelson did not explain hospice to them and did not tell them he was referring them to hospice care,” the U.S. Attorney’s Office said.
Nelson signed medical records on their behalf that allowed the hospice owners to bill Medicare and Medicaid for unnecessary medical care, prosecutors said.
Nelson signed medical records on their behalf that allowed the hospice owners to bill Medicare and Medicaid for unnecessary medical care, prosecutors said.
The hospice owners received more than $15 million from the government based on his bogus patient referrals, according to the Justice Department. Prosecutors said Nelson was paid $442,000 in medical director fees from at least 14 hospice providers between 2009 and 2014.
All three of the hospice owners named with Nelson in the indictment pleaded guilty before his case went to trial on March 21.
Court filings show Nelson submitted a plea deal in 2019 that a judge later rejected.
According to the Mississippi State Board of Medical Licensure, Nelson’s medical license is still active. He is scheduled to be sentenced on July 27.
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