Grand jury: Kentucky doctor billed for unnecessary tests and created false records
An Eastern Kentucky doctor has been charged with writing improper prescriptions, billing taxpayer-funded health programs for unnecessary tests and creating false records to try to cover the scheme.
A federal grand jury indicted Dr. Loey Kousa Thursday on charges of improperly distributing opioid pain drugs through prescriptions not written for a legitimate medical purpose, health fraud and making false statements.
Kousa operated East KY Clinic PLLC in Paintsville. The Appalachian News-Express reported that federal agents searched the clinic in January.
Kousa could not be reached for comment Friday morning.
The grand jury charged that Kousa wrote prescriptions for painkillers – such as hydrocodone – to patients who had no legitimate need for the drugs in order to keep them as patients. Kousa billed Medicare and Medicaid for seeing the patients, the indictment said.
Kousa sometimes saw patients for only a few minutes — or a few seconds in some cases — and these visits “included minimal or no substantive medical evaluation of the patient,” the indictment charged.
Kousa also allegedly required patients to undergo unnecessary tests such as electrocardiograms, and billed Medicare and Medicaid for providing services that were not medically necessary or not even provided.
The indictment also charged that he “upcoded” bills, meaning he billed for a higher level of service than he provided, in order to get more money from healthcare programs.
The charges also cited two instances in which Kousa allegedly put information in a patient’s records about seeing and evaluating the patient when the office visits hadn’t actually occurred.
The most serious charges against Kousa are punishable by up to 20 years in prison. If he is convicted, the government wants to take away his medical license and right to prescribe controlled substances and force him to repay the money he received through alleged illegal conduct.
Kousa finished medical school in Syria in 1987 and was licensed to practice in Kentucky in 1993, according to the Kentucky Board of Medical Licensure.
