Valdosta Doctor, Physician’s Assistant Sentenced To Prison For Medicare-Medicaid Fraud, Ordered To Repay Millions In Restitution

Valdosta, Ga. — A Valdosta doctor guilty of defrauding the federal and state Medicare and Medicaid health care programs of more than $2.2 million was sentenced to 97 months in prison today, said Charles “Charlie” Peeler, the U.S. Attorney for the Middle District of Georgia. A citizen jury returned a guilty verdict against Dr. Douglas Moss, 58, of Valdosta, on May 14, 2019 following a seven-day trial in federal court. Dr. Moss was found guilty on all seven counts that he was charged with: conspiracy to commit health care fraud (Count 1) and health care fraud (Counts 2-7). U.S. District Judge Hugh Lawson imposed an additional 3 years of supervised release. A co-conspirator, Shawn Tywon, 50, of Valdosta, who worked as a Physician’s Assistant (PA) in Dr. Moss’s practice, entered a guilty plea to conspiracy to commit health care fraud on April 11, 2019 and was sentenced today to 24 months in prison and 2 years of supervised release. Dr. Moss and Mr. Tywon were ordered to pay restitution in the amount of $2,256,861.32 to Medicare and Georgia Medicaid. There is no parole in the federal system.

“Stealing from Medicare and Medicaid programs undermines our government’s mission to assist providing healthcare to senior citizens and vulnerable members of our society. Enriching oneself on the backs of law-abiding, tax-paying citizens will not be tolerated, and the punishment is prison time,” said U.S. Attorney Charlie Peeler. “Dr. Moss stole more than $2.2 million by billing the government for work he did not perform. We will continue to work closely with our law enforcement partners to end government fraud. I want to thank HHS, FBI and the Office of State of Georgia Attorney General Chris Carr for their hard work in this matter.”

“The ability to combine resources with our federal partners is critically important as we work together to prosecute those who break the law and take advantage of government programs for their own personal gain,” said Attorney General Chris Carr. “We remain committed to protecting the integrity of the Georgia Medicaid program, its members and the taxpayer dollars used to provide this service, and, as identified by today’s action, we will remain vigilant in our efforts to recover any and all funds spent illegally.”

“Today’s sentencing demonstrates that when medical professionals choose to break the law and corrupt the system to line their pockets with taxpayer dollars, we will work relentlessly to bring those individuals to justice,” said Derrick L. Jackson, Special Agent in Charge of the Office of the Inspector General of the U.S. Department of Health and Human Services. “Protecting precious Medicare and Medicaid funds remains a top priority for the Inspector General and our law enforcement partners.”

“When health care professionals choose to defraud federally funded programs like Medicare and Medicaid there are many victims, including American taxpayers and the people who are rightly entitled to those funds,” said Special Agent in Charge of FBI Atlanta Chris Hacker. “Health care costs are driven up when doctors and staff bill for unnecessary and unfulfilled services and the FBI and our partners will continue to use every resource in our power to stop it.”

Dr. Moss was a practicing physician at South Georgia Health Group, LLC, (SGHG) in Valdosta, Georgia, since 2002. Dr. Moss was also the Medical Director of four Heritage Health (which became Pruitt Health) facilities (Holly Hill Nursing Home, Valdosta Nursing Home, Lakehaven Nursing Home, and Crestwood Nursing Home) between January 2011 and May 2016, where he served as an attending physician for residents at those facilities. Dr. Moss was also the Medical Director of Grant Medical Clinic in Valdosta, an after-hours clinic. According to testimony and evidence presented at trial, Dr. Moss bilked the U.S. government out of more than $2.2 million dollars by falsifying Medicare and Medicaid claims, either by billing for services he actually did not perform, or by utilizing his PA, Mr. Tywon, as an “extender” (a non-physician practitioner) to render services that were billed as if Dr. Moss had performed them himself, netting a larger reimbursement. The evidence showed that Dr. Moss routinely did not render the services he billed under his name, and even visited Las Vegas casinos during at least two periods of time when he submitted bills for services in Valdosta.    

The case was investigated by the FBI and the U.S. Department of Health and Human Services – OIG. Assistant U.S. Attorneys Sonja Profit and Lyndie Freeman from the U.S. Attorney’s Office for the Middle District of Georgia, and Assistant Director Jim Mooney from the Georgia’s Office of the Attorney General prosecuted the case for the Government. Questions can be directed to Pamela Lightsey, Public Information Officer, United States Attorney’s Office, at (478) 621-2603 or Melissa Hodges, Public Affairs Director (Contractor), United States Attorney’s Office, at (478) 765-2362.