Nevada Doctor Charged with $95M Wound Care Fraud on Medicare

National Fraud Enforcement Division’s first announced charges in Nevada since the formation of the West Coast Health Care Fraud Strike Force A federal grand jury in the District of Nevada returned an indictment yesterday charging Stephen Dubin, M.D., 74, of Henderson, Nevada, with a $95 million scheme to defraud Medicare by billing for medically unnecessary amniotic wound allografts that he and others applied to elderly Medicare patients. According to court documents, Dubin, a medical doctor and sole owner of Dubin Medical Consultants, Inc. (also known as Wound MD) caused Medicare to be billed over $95 million for expensive amniotic allografts that he procured through illegal kickbacks and bribes. Dubin allegedly applied these allografts to elderly patients — including vulnerable patients in hospice care — without medical necessity. Medicare paid over $54 million based on Dubin’s false and fraudulent claims. As alleged in the indictment, Dubin received illegal kickbacks, bribes, and rebates from two different allograft distributors. Some of these illegal payments were falsely structured to appear as legitimate “Rebate Agreements” while concealing their true nature and illegal payments. These purported rebates substantially reduced Dubin’s true net cost of acquiring the allografts. Dubin allegedly submitted claims to Medicare seeking reimbursement for the price listed on sham full-price invoices, instead of the actual price he paid for the allografts. Dubin and others allegedly kept as profit the difference between Medicare’s reimbursement and the price paid for the allografts. The indictment also alleges that Dubin received illegal kickbacks from one allograft distributor through payments from a pass-through bank account held in the name of a shell company in exchange for purchasing allografts from the distributor. Induced by these illegal kickbacks, bribes, and rebates, Dubin and his co-conspirators applied allografts without regard to medical necessity, including by applying allografts to infected wounds; to wounds that were not responding to allograft treatment; without first attempting, completing, or confirming conservative wound care treatment as required by Medicare; and in quantities that far exceeded the size of wounds. Dubin allegedly selected allografts that would maximize his profit, not based on the patient’s need. To conceal the lack of medical necessity, Dubin falsified patient medical records to make it appear as though the application of allografts was medically reasonable and met Medicare requirements. Dubin used the proceeds of his alleged offenses to fund a lavish lifestyle, including having multi-million-dollar yachts built for him. Dubin is charged with conspiracy to commit health care fraud and five counts of health care fraud. If convicted, he faces a maximum penalty of 10 years in prison for each count.