Mid-State Physician James L. Crabb, M.D Charged In $7 Million Healthcare Fraud Conspiracy

(STL.News) – James L. Crabb, M.D., 78, of Loretto, Tennessee, is facing federal charges for his role in a $7 million healthcare fraud conspiracy, announced U.S. Attorney Don Cochran for the Middle District of Tennessee.  Crabb was charged in a criminal Information on December 20, 2019, and appeared before a U.S. Magistrate Judge yesterday.

According to the charging document, Crabb is a medical doctor, licensed to practice in the states of Tennessee and Mississippi, and operated as a consulting provider to a Florida-based telehealth and marketing company and a physician staffing company located in Georgia.  As an enrolled and participating provider in Medicare, Crabb obtained access to Medicare patients through these companies, which recruited patients through advertising and telemarketing, regardless of medical necessity.

Part of the conspiracy involved unsigned orders and prescriptions for Durable Medical Equipment, which Crabb received from these companies and others.  Crabb signed the orders and prescriptions in the absence of any pre-existing doctor-patient relationship and without a physical examination as required by Medicare.  The charges also allege that Crabb frequently signed orders and prescriptions based only on a brief telephonic conversation or no conversation at all with the Medicare beneficiary.  In other instances, Crabb assigned the signing of his name to an unlicensed assistant and paid this individual cash for each prescription signed – also impermissible under Medicare regulations.  Crabb also signed orders and prescriptions for patients located in states where he was not licensed.

The Information alleges that during the period of February 2015 through August 2019, James Crabb and others caused the submission of approximately $7 million in false and fraudulent claims to Medicare.  The prescribed DME was not medically necessary, was not provided as represented and not eligible for reimbursement, including because the orders and prescriptions were procured through the payment of kickbacks and bribes.  The Information also contains a forfeiture allegation in the amount of $493,780.00 – the amount Crabb received in kickbacks resulting from the scheme.

Crabb made his initial appearance before a U.S. Magistrate Judge in Nashville yesterday and was released with certain conditions, including that he not be allowed to practice medicine.

If convicted, Crabb faces up to 10 years in prison and a $250,000 fine.

This case is being investigated by the U.S. Department of Health & Human Services-Office of Inspector General.  Assistant U.S. Attorney Sarah K. Bogni is prosecuting the case.

The charge is merely an accusation.  The defendant is presumed innocent until proven guilty in a court of law.

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