A New Jersey doctor has received a three-year prison sentence for defrauding the government in a $3 million Medicare billing fraud scheme.

The doctor, Anthony Enrico, billed Medicare for 150,000 physical therapy sessions that were not actually conducted by licensed and qualified personnel, said U.S. Attorney Craig Carpenito in a statement.

Court documents showed that the Medicare billing fraud scheme was a years-long endeavor, lasting from January 2007 through May 2016. Enrico billed a number of other health insurance providers along with Medicare.

In order to qualify for reimbursement by Medicare and private insurers, physical therapy services must be provided by those with the proper training and certifications. Enrico himself is qualified to perform these physical therapy services, but he has admitted that he regularly directed those who were unqualified to perform physical therapy in his stead. He then would bill Medicare and other insurers for the services as if they had been performed by qualified personnel.

Enrico pleaded guilty to health care fraud, admitting that he had billed health insurers deceitfully in more than 150,000 instances.

On top of the prison time itself, Enrico has also been ordered to pay $3 million in restitution—the same amount incurred by his Medicare billing fraud scheme.

New Jersey has become stricter at handling Medicare billing fraud, creating a Health Care and Government Fraud Unit to address these issues in 2010. In the years since, the New Jersey U.S. Attorney’s Office has recovered more than $1.38 billion in health care fraud and government fraud judgments, fines, and settlements.

Filing a Medicare Billing Fraud Lawsuit

Medicare billing fraud lawsuits like this one often originate from whistleblower lawsuits. By filing a Medicare billing fraud lawsuit like this, a plaintiff employee alerts the government to possible fraud, and the government is then able to intervene, filing a lawsuit itself.

Whistleblower lawsuits are filed by employees or former employees who have found evidence of Medicare billing fraud or other illegal activities against the government. Many of these employees choose to come forward, acting as whistleblowers, because they feel that their employer’s actions are wrong—even if they are worried about retaliation.

A person considering becoming a whistleblower on behalf of the government may worry about being fired or otherwise retaliated against at work. However, there are regulations in place to protect whistleblowers.

Whistleblowers may earn a substantial reward for calling attention to the suit. A whistleblower award is usually between 15 and 30 percent of the money recovered in a government fraud whistleblower lawsuit. Many whistleblower lawsuits end up bringing in millions in settlement money, so a whistleblower monetary reward can be significant.

If you believe you have witnessed some kind of fraud against the government by your current or former employer, you may be able to file a whistleblower lawsuit (also known as a qui tam lawsuit) against the company on behalf of the government. These kinds of lawsuits have been filed over Medicare billing fraud, fraud against other insurers, physician/hospital kickbacks, and many other types of government financial fraud.