A federal grand jury in Memphis, Tennessee, returned an indictment charging a podiatrist with a scheme to defraud Medicare and TennCare by prescribing and dispensing medically unnecessary foot bath medications.
According to the indictment, Nathan Lucas, D.P.M., 56, of Memphis, owned and operated a podiatry clinic, Advanced Foot & Ankle Care of Memphis LLC, as well as multiple in-house pharmacies. The indictment alleges that Lucas regularly prescribed antibiotic and antifungal drugs to be mixed into a tub of warm water for patients to soak their feet. These drug cocktails included capsules, creams, and powders that were not indicated to be dissolved in water and some of which were not water soluble. The indictment alleges that Lucas chose these medications to prescribe and dispense based on their anticipated reimbursement amount, rather than medical necessity. For example, in 2019, Lucas wrote a prescription to a patient for 1,080 capsules of vancomycin, 7,650 grams of econazole cream, and 180 grams of lidocaine, all to be dissolved in a foot bath, and caused Medicare to reimburse his pharmacy over $18,000 for dispensing these drugs. From in or around October 2018 to the present, Lucas allegedly caused his pharmacies to submit nearly $4 million in claims to Medicare and TennCare for dispensing expensive foot bath medications that were not medically necessary and would not have been eligible for reimbursement.
Lucas is charged with five counts of health care fraud. If convicted, he faces a maximum penalty of 10 years in prison per count. A federal district court judge in the Western District of Tennessee will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division; Acting U.S. Attorney Joseph C. Murphy Jr. for the Western District of Tennessee; and Special Agent in Charge Derrick L. Jackson of the Department of Health and Human Services–Office of Inspector General (HHS-OIG) made the announcement.
HHS-OIG and the Tennessee Bureau of Investigation are investigating the case.
Trial Attorneys Justin M. Woodard and Sara E. Porter of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Chris Cotten of the U.S. Attorney’s Office for the Western District of Tennessee are prosecuting the case.
The Fraud Section leads the Health Care Fraud Strike Force. Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 federal districts, has charged more than 4,600 defendants who have collectively billed federal health care programs and private insurers for approximately $23 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
An indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
Tags: Healthcare Fraud Insurance Fraud Medically Unnecessary New Drug Trends Provider Arrest Rx Fraud