Medical Chain Pleads Guilty to Work Comp Fraud, Repays Texas Mutual $6.5M

Nova Healthcare Management, headquartered in Houston, Texas, entered a plea of guilty to felony workers’ compensation fraud related charges, according to an announcement by Texas Mutual Insurance Co. and the Travis County District Attorney.

According to the court documents, Texas Mutual’s investigation revealed that Nova Healthcare Management, also known as Nova Medical Centers, or Nova, over-billed Texas Mutual for physical therapy by billing services as more expensive one-on-one physical therapy when what it provided was group therapy.

Under the plea agreement, Nova has withdrawn from Texas Mutual’s Texas Star Network, repaid $6.5 million to Texas Mutual and paid a $5,000 fine. Other provisions of the agreement include court costs and mandatory compliance reporting to the Special Prosecution Division of the Travis County District Attorney’s office for the next two years.

Texas Mutual worked closely with the district attorney to ensure a speedy and equitable resolution of the case.

The Nova investigation was a part of the Texas Mutual zero-tolerance-for-fraud policy. Texas Mutual maintains three teams of investigators permanently assigned to investigate every report of suspected fraud.

Source: Texas Mutual Insurance Co.

Topics Texas Fraud Workers' Compensation