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Healthcare Fraud

Highland Park Resident and Physicians Indicted in $70 Million University Athletic and Healthcare Fraud Case

The alleged conspirators billed insurers for treatment that was often being administered by athletic trainers hundreds of miles from the physicians of record.
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Courtesy: iStock

Two physicians and two other individuals were indicted in federal court for submitting false claims to private insurers saying that physicians provided medical services to student-athletes at universities around the country and for fraudulently obtaining government funds meant for COVID-19 testing of uninsured Americans. The defendants allegedly obtained $70 million through the schemes.

Highland Park resident Mouzon Bass III and Lance West Wilson of Allen worked with Dr. Robert Brent Scott of California and Dr. Kyle Kelly Carter of Keller, who was charged in a separate indictment in October 2023, according to the U.S. Attorney’s Office in the Eastern District of Texas. Prosecutors charged them with conspiring to commit wire fraud, healthcare fraud, and money laundering.

Between 2014 and 2023, the defendants used Bass and Wilson’s practice management software company Vivature to provide medical billing services to educational institutions and then proceeded to submit false claims to students’ insurers that said Scott and Carter were providing services to student athletes around the country when they had not seen or treated these athletes. According to Texas Medical Board records, Carter is a family medicine physician at Precision Family Medicine in Carrollton and has been practicing for 31 years. He has no previous TMB discipline.

Dallas-based Vivature has more than 400 collegiate partners and says it helps college and university sports medicine departments comply with federal and state medical regulations by recording student-athlete injuries and treatments. Bass is the company’s CEO, and Wilson is an executive vice president, though the “Meet the Team” page online is now blank.

Here is how the scheme would work, according to the indictment. The athletic trainer performing the work would enter their services into Vivature’s software. Vivatrure would use that information, student demographics, and insurance information to bill the student’s insurance company. Insurance would pay the claim to Vivature, which would share the reimbursement with the institution, per their contract. The indictment lists LeTourneau University, Auburn University, and Arkansas Tech University as Vivature clients with this type of contract.

The physicians were often hundreds of miles from the alleged patients being treated. The services were actually performed by athletic trainers in the schools’ athletic departments, who were usually excluded from the insurance companies’ reimbursement policies. Bass and Wilson submitted thousands of false claims to insurance carriers and named Scott, Carter, and other physicians as the providers of record in exchange for kickbacks to the physicians.

At times, Bass and Wilson used physicians’ names and information without the doctors’ consent to obtain reimbursements from insurance companies. Bass and Wilson agreed to pay physicians for using their physician information in other cases, according to the indictment. Scott received $10,000 per month from Vivature, court documents say.

Scott was listed as the supervising physician on $230,000 worth of work provided to ATU student-athletes, but ATU’s head athletic trainer confirmed that Scott never visited campus, treated the students, or met with the trainer.

The indictment includes a second scheme involved Bass, Wilson, and Scott obtaining Health Resources and Services Administration government funds meant for COVID-19 testing provided to uninsured Americans. The defendants worked with international resorts with American travelers and offered to manage the billing and claims for the COVID-19 testing given to the travelers, even though they were not eligible for the HRSA funds because they had private insurance. The defendants made over $70 million from the alleged schemes, setting up 200 bank accounts between 2014 and 2023 to receive the funds.

The indictment says that Bass used funds from the scheme to make payments on a multi-million dollar yacht, a $7 million home in Highland Park, an $11 million residence in Mexico, and a lake house in Oklahoma.

In 2023, Luxe Interiors and Design published a story about the Bass’ home. The story says the home “exudes innate elegance, its limestone façade flanked by towering trees that filter warm light through French-style windows. In turn, the interiors unfold gracefully with marble fireplaces, crown molding and espresso-dark floors boasting herringbone detailing.”

As this is an indictment, not a verdict, the defendants are presumed innocent until proven guilty.

Author

Will Maddox

Will Maddox

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Will is the senior editor for D CEO magazine and the editor of D CEO Healthcare. He's written about healthcare…

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