June 19, 2018

Workers’ Comp Fraud Conviction Against TX Physician Affirmed

Austin, TX – The Third Court of Appeals in Austin has affirmed an Austin trial court’s 2014 conviction of Howard Douglas, III, M.D., of Frisco on felony fraud charges. Douglas was convicted and sentenced to five years’ imprisonment for overbilling Texas Mutual Insurance Company for medical evaluations performed on injured workers.

Before the 2014 conviction, Texas Mutual had investigated Douglas and Western Medical Evaluators, a company he co-owned with his daughter Barbara Douglas, on allegations that Texas Mutual was overbilled for the time taken to perform patient evaluations. Texas Mutual uncovered evidence that Douglas created three additional companies: North Texas Medical Evaluators, Marconi Physical Performance Testing and Nolan Physical Performance & Neurodiagnostics. These companies were used to perpetuate the fraudulent overbilling scheme.

Douglas’s attorneys appealed the 2014 conviction, claiming that additional evidence existed but had been wrongly excluded from the trial. In this week’s decision, the appeals court agreed with the trial court’s ruling that the evidence was irrelevant and could have distracted the jury.

“We are pleased with the court’s ruling on this important issue,” Mary Nichols, senior vice president and general counsel for Texas Mutual, said. “Unchecked, overbilling and other workers’ compensation health care fraud schemes can increase premiums for all Texas employers.”

Source: Texas Mutual

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