ST. LOUIS – U.S. District Judge Stephen R. Clark on Thursday sentenced a Moberly doctor to 22 months in prison for falsely using his father’s name to bill Medicare and Medicaid for medical services.
Justin G. LaMonda was also ordered to repay $537,332.
LaMonda’s crimes originated after the Missouri Board of Registration for the Healing Arts suspended his medical license for 30 days in 2017 after he was accused of engaging in sexual activity with his office manager and prescribing her controlled substances “without sufficient examination and outside of the usual course of professional practice,” LaMonda’s plea agreement says.
On Dec. 20, 2018, a Medicare administrative contractor revoked LaMonda’s Medicare Part B privileges after determining that he submitted reimbursement claims for services performed when he was suspended.
LaMonda and his father, who was also a doctor, agreed to bill Medicare for services performed by LaMonda as if his father had performed them.
On Sept. 12, 2019, the Missouri Medicaid Audit and Compliance Unit terminated Dr. LaMonda’s Medicare provider number. LaMonda and his father then expanded their scheme to include Medicaid claims.
LaMonda instructed his billing personnel to use his father’s unique billing provider number on claims for payment, on referrals to other health care providers and on orders for durable medical equipment, falsely claiming that the father had performed the medical services or ordered additional equipment or treatment, his plea agreement says.
When LaMonda’s father received payments from Medicare and Medicaid for services purportedly performed by him, he would transfer the funds to his son.
LaMonda admitted causing total losses of $537,322 to Medicare and Missouri Medicaid.
LaMonda “flagrantly violated” the revocation of his Medicare and Medicaid billing privileges by fraudulently billing those programs, Assistant U.S. Attorney Amy Sestric wrote in a sentencing memorandum.
“Health care professionals who intentionally submit such blatant fraudulent information can adversely affect individuals who depend on Medicare and Medicaid for access to safe and effective health care services. The laws are meant to ensure both the integrity of program funds and the provision of appropriate, quality services to patients,” stated Special Agent in Charge Curt L. Muller with the U.S. Department of Health and Human Services Office of Inspector General. “Our agency collaborates frequently with our law enforcement partners to investigate providers who undermine our federal health care programs and the well-being of patients by submitting fraudulent claims.”
LaMonda, 42, pleaded guilty in March to two counts of making false statements related to health care matters. His medical license has been revoked. LaMonda’s father, Dr. Gary LaMonda, died in September 2021.
The U.S. Department of Health and Human Services Office of Inspector General, the FBI and the Missouri’s Attorney General’s Medicaid Fraud Control Unit investigated this case. Assistant U.S. Attorney Amy Sestric prosecuted the case.