A West Jordan doctor, barred in 1987 from filing Medicaid and Medicare claims for 10 years because of fraud, is again the subject of federal investigations in connection with suspected fraud, the Deseret News has learned.
Medical records of Robert Charles Davis, president of the Family Medical Center Corp., now located at 1519 West and 9000 South, were obtained through a federal search warrant. U.S. Magistrate Ronald N. Boyce authorized the search warrant, which was requested on Jan. 3 by U.S. Postal Inspector Gary R. Jones.Numerous Medicaid and Medicare claims filed by Davis' clinic allegedly contained "false and fictitious representations," according to an affidavit signed by Jones. Davis used other physicians' names on the billings "as a means to circumvent his suspension," the affidavit says.
The Deseret News filed an application in federal court to remove restrictions on the information received when the search warrant was executed, as the warrant was marked secret. Boyce signed the order unsealing the court documents.
According to affidavits attached to the warrant, the Postal Inspection Service and the U.S. Department of Health and Human Services are conducting separate, ongoing investigations of the medical center, concerning suspected violations of federal statutes prohibiting false, fictitious or fraudulent medical claims and mail fraud.
Another agency, the U.S. Department of Labor, is also investigating the Family Medical Center, based on allegations of fraud against the Office of Workers Compensation Program, according to the affidavit signed by Jones. Because of the earlier Medicaid suspension, Davis was also barred from filing workers' compensation claims.
After his federal suspension in 1987 prohibiting him from treating both Medicaid and Medicare patients, Davis hired other doctors to treat patients under the government programs. But an "investigation by the Bureau of Medicaid Fraud has disclosed, however, that many of these same patients were in fact treated by Robert Charles Davis, M.D., and not by the attending physicians whose names appeared on the claim form," the affidavit said.
Two doctors, who are former employees of Davis, said claims were submitted under their names and resulting payments were deposited into Family Medical Center bank accounts. Some of the claims were submitted for treatments allegedly performed "for periods of time when they were no longer employed at Family Medical Center," the affidavit said.
Court records list 21 patients whose claims submitted to the Utah Medicaid Program by the Family Medical Center "contain false and fictitious representations," based on comparing information from patient interviews regarding treatment with billing forms, according to the affidavit. In addition, 19 more false patient claims were submitted to the Medicare Program.
In a separate matter, Davis has been the subject of a three-year investigation by state medical licensing officials and is scheduled for a disciplinary hearing on March 14 in front of the Utah Physicians Licensing board.
The Utah Division of Professional and Occupational Licensing scheduled the hearing, which could lead to revocation of Davis' license to practice medicine in Utah. The state's 155-charge petition accuses Davis of willfully making false statements on hospital records and medical rec-ords, overcharging government agencies and insurance companies and acting in a sexually inappropriate manner with patients and staff members.
Davis was arrested, handcuffed and led from his clinic to the Salt Lake County Jail on June 24, 1986, where he was booked into jail on fraud charges. He was charged with three counts of filing false Medicaid claims, a second-degree felony. Davis pleaded "no contest" to one charge, while the other two were dropped. Through a plea bargain, the felony was reduced to a Class A misdemeanor.
Documents filed as part of the state criminal case indicate Davis received the Medicaid and Medicare suspensions, beginning June 13, 1987, based on evidence of $86.25 in overcharges. But a total of 2,095 fraudulent line items, which resulted in overpayments of $43,369.48, were identified.
In another matter, Davis was acquitted last week by a West Jordan City Justice Court judge of criminal assault. Judge JoAnn Rigby ruled there was not enough evidence to support the assault complaint, brought by a former employee.