Linh Cao Nguyen, M.D., of Peoria, pleaded guilty March 19 to health care fraud.

Nguyen’s sentencing is scheduled for May 28 before United States District Judge John C. Hinderaker.

Nguyen admitted that for years, he engaged in a scheme to defraud various health care benefit programs, including Medicare, TRICARE, AHCCCS, Blue Cross Blue Shield, and UnitedHealthcare. As part of his scheme, Nguyen knowingly caused to be submitted thousands of false billing claims.
Nguyen also falsely created patient records to conceal and avoid detection of his fraudulent billing scheme.

Generally, the fraudulent claims identified a medical doctor as the treating provider when, in fact, another provider such as a nurse practitioner, social worker, unlicensed psychology intern, or wound care nurse provided the service independently. By billing the medical service as if it were provided by a physician, Nguyen falsely inflated the amount his company was to be paid for the service.

Nguyen admitted the loss he caused was at least $3.7 million. Nguyen agreed to pay restitution to the private insurance companies totaling over $1 million.

A conviction for health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine.

The United States Department of Health and Human Services, Office of Inspector General, the Federal Bureau of Investigation, and the Department of Defense Office of Inspector General, Defense Criminal Investigative Service conducted the investigation in this case. The United States Attorney’s Office, District of Arizona, Tucson, is handling the prosecution.