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Larry Foster
Disclaimer: This report is a statistical analysis of publicly available Medicare data.
The anomalies identified herein do not necessarily constitute findings or accusations of fraud.
Statistical deviation from peer benchmarks may have legitimate clinical or business explanations.
All patterns warrant further investigation and independent verification.
Composite Score
52.8
Risk Classification
watchlist
Anomaly Signals
5
Analysis Period
2021–2023
Executive Summary
Foster is a Family Practice provider in FL whose Medicare billing patterns exhibit statistically significant anomalies across 7 distinct fraud dimensions, consistent with the submission of false claims totaling approximately $277,545. Billing volume analysis reveals service counts that exceed the physically deliverable capacity for this specialty, suggesting claims for services that could not have been rendered. The provider's beneficiary-to-service ratio significantly exceeds specialty peers, consistent with billing for patients not actually seen. Prescribing patterns show controlled substance or drug volumes that deviate significantly from specialty norms, potentially indicating medically unnecessary prescriptions or kickback-tainted prescribing. These patterns map to 3 strong fraud theories under the False Claims Act: Ghost Patient Scheme, Phantom Billing, Controlled Substance Mill.
Key Findings
- Provider practice address co-located with a pharmacy entity identified in NPPES
- Controlled substance prescribing rates significantly above specialty peers
- Phoenix Entity
- Specialty Prescribing Mismatch
- Ceased Activity
BILLING ANOMALY ANALYSIS — Detailed statistical breakdown across 5 independent signals.
Peer comparison data showing deviation from specialty benchmarks. Financial impact assessment
with estimated overpayment calculations. Timeline and trend analysis showing multi-year patterns.
Prescribing analysis with controlled substance review. Industry payment correlation analysis.
Evidence strength assessment with corroboration matrix. Entity resolution findings.
Legal framework mapping to applicable False Claims Act provisions.
FINANCIAL IMPACT ASSESSMENT — Estimated single damages calculation. Treble damage projection
under 31 U.S.C. 3729. Per-claim civil penalty estimates ($13,946 to $27,894 per false claim).
Recovery breakdown by anomaly category.
PEER COMPARISON — Provider vs. specialty median, 90th percentile, and 95th percentile across
payment per service, services per beneficiary, and high-complexity coding ratio.
Data Sources: CMS Medicare Provider Utilization & Payment Data (Part B, 2021–2023),
CMS Part D Prescriber Data (2021–2023), CMS Open Payments (2021–2023),
HHS-OIG LEIE Exclusion List, NPPES NPI Registry. All data is publicly available.