Doctor Sentenced for $54M Medicare Fraud Scheme

A Texas doctor was sentenced today to 10 years and one month in prison and ordered to pay over $34 million in restitution for his role in a scheme to defraud Medicare by prescribing durable medical equipment and cancer genetic testing without seeing, speaking to, or otherwise treating patients.

According to court documents, Daniel R. Canchola M.D., 54, of Flower Mound, agreed to electronically sign doctor's orders for durable medical equipment (DME) and cancer genetic testing that he knew were used to submit false and fraudulent claims to Medicare. From August 2018 through April 2019, Canchola received approximately $30 in exchange for each doctor's order he signed authorizing DME and cancer genetic test orders that were not legitimately prescribed, not needed, or not used - totaling more than $466,000 in kickbacks. The doctor's orders Canchola signed were used to submit more than $54 million in false and fraudulent claims to Medicare. According to court filings, the Medicare beneficiaries for whom Canchola prescribed DME and cancer genetic testing were targeted by telemarketing campaigns and at health fairs, and they were induced to submit to the cancer genetic testing and to receive the DME regardless of medical necessity.

In October 2022, Canchola pleaded guilty to a conspiracy to commit wire fraud.

Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department's Criminal Division; Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General (HHS-OIG) Dallas Regional Office; and Chief William Marlowe of the Texas Attorney General's Medicaid Fraud Control Unit (MFCU) made the announcement.

HHS-OIG and MFCU investigated the case.

Assistant Chief Brynn Schiess and Trial Attorney Ethan Womble of the Criminal Division's Fraud Section prosecuted the case.

The Fraud Section leads the Criminal Division's efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.