A Nevada doctor has been indicted in connection with a $95 million scheme to defraud Medicare.
Dr. Stephen Dubin, of Henderson, Nevada, is accused of bilking the system by charging the health insurance program for elderly Americans over “medically unnecessary amniotic wound allografts,” according to a Department of Justice news release.
Dubin has been charged with conspiracy to commit health care fraud and five counts of health care fraud. Each count carries a 10-year maximum prison sentence.
“This indictment exposes a scheme driven by greed, not medicine. As alleged, this provider exploited elderly patients by pushing costly and unnecessary medical procedures, then lied to Medicare to pocket millions of taxpayer dollars,” Assistant Attorney General Colin McDonald of the Justice Department’s National Fraud Enforcement Division said.
“Healthcare fraud is not a victimless crime; it steals vital resources from elderly and vulnerable citizens who truly need life-saving treatments,” First Assistant U.S. Attorney Sigal Chattah for the District of Nevada said.
“These defendants prioritized personal greed over patient care by weaponizing complex billing codes for advanced wound care products. As part of the West Coast Health Care Strike Force, our office, alongside our federal law enforcement partners, will continue to aggressively dismantle predatory schemes that target public healthcare programs.”
Special Agent in Charge Christopher Delzotto of the FBI Las Vegas Field Office called the scheme a “betrayal of trust and exploitation of his healthcare position for personal financial gain” that was “both cruel and premeditated.”
Dubin, owner of Dubin Medical Consultants, Inc. — also called Wound MD — “caused Medicare to be billed over $95 million for expensive amniotic allografts that he procured through illegal kickbacks and bribes,” the release said, noting Medicare paid out $54 million worth of the claims.
As noted by LifeLink Tissue Bank, an allograft is “tissue (i.e. bone, ligaments, heart valves) recovered from a human donor for transplantation into another person.”
The indictment said Dubin received illegal kickbacks, bribes, and rebates from two allograft distributors.
Dubin billed Medicare for the full amount on a fake bill, while he and his co-conspirators split the difference between what he actually paid and what Medicare gave him.
The indictment further said the allografts were applied when there was no reason to do so.
It also alleged that Dubin received illegal kickbacks from one allograft distributor through payments from a pass-through bank account held in the name of a shell company in return for buying allografts from the distributor.
The indictment said allografts were applied to “infected wounds; to wounds that were not responding to allograft treatment; without first attempting, completing, or confirming conservative wound care treatment as required by Medicare; and in quantities that far exceeded the size of wounds,” according to the release.
The indictment added that allografts were picked based on profit maximization, not any rational medical need.
As noted by the White House, the anti-fraud efforts coordinated by Vice President J.D. Vance have focused on millions in healthcare-related fraud.
Last month alone, the anti-fraud efforts “stopped $220 million in fraudulent skin substitute claims and suspended billing privileges for over 800 providers complicit in Durable Medical Equipment fraud,” the White House said, while six New Jersey residents were charged in a $20 million healthcare fraud kickback operation.
Also last month, an individual wanted in connection with a $547 million Medicare fraud scheme was arrested.
This month, 1,076 hospices in California were removed from Medicare due to fraud.
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