Healthcare fraud is a family affair

A Des Moines doctor and his brother are accused of health care fraud for allegedly seeking reimbursement on medical procedures that were unnecessary or not performed. Dr. Peter Boesen, 45, and his brother, James Boesen, 48, are charged in a 57-count federal indictment relating to their practices at a Des Moines ear, throat and nose clinic.

James Boesen, who’s job at the clinic included billing insurance companies, is accused of conspiring with his brother to seek inflated reimbursements from Medicare, Medicaid and Wellmark Blue Cross and Blue Shield of Iowa.

The lawsuit alleges the Boesens falsified patient notes and submitted inaccurate claims to receive more money.

If convicted, the brothers may forfeit $373,000 the amount they’re accused of receiving through fraudulent activity. Their conspiracy charge could get them up to a five-year prison sentence and $250,000 in fines. The other charges are punishable by up to 10 years in prison.

The lawsuit alleges the brothers conducted illegal activity between 1997 and 2002.

According to the indictment, Dr. Boesen scheduled patients for repeated appointments that were medically unnecessary. He also allegedly fabricated patient notes to justify procedures he performed.

The lawsuit alleges the doctor instructed nurses to contact pathology laboratories and instruct them to have his patients’ tissue samples be labeled “cholesteatoma” which is an ear infection that sometimes requires surgical treatment.