By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On February 28, 2022, ten (10) Florida residents were charged in an indictment in the U.S. District Court for the Southern District of Florida for their alleged roles in a $67 million health care fraud, wire fraud, kickback, and money laundering scheme. Federal prosecutors allege that the individuals billed Medicare for bogus genetic tests and durable medical equipment.
The Alleged Scheme.
The federal indictment alleges that between January 2020 and July 2021, the defendants referred Medicare beneficiaries for unnecessary medical genetic tests and durable medical equipment (DME). Additionally, the alleged conspirators allegedly paid kickbacks and bribes to several telemedicine companies for doctors‘ orders. The indictment further alleges they falsified Medicare enrollment forms in order to submit false claims for various knee and back braces and unnecessary medical equipment for patients.
The Charges.
All ten (10) defendants face various charges, including conspiracy to commit health care fraud and conspiracy to commit money laundering. The crimes are punishable by a maximum 20-year prison sentence. Health care fraud and anti-kickback violations are each punishable by a maximum of 10 years in prison. Conspiracy to pay and receive kickbacks is punishable by five years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Read the press release from the Department of Justice (DOJ) to learn more about the case, and the 10 Florida defendants.
Government Cracking Down On These Types of Scams.
Scams in genetic testing and durable medical equipment (or DME), have become a popular focus for federal prosecutors intent on cracking down on health care fraud. As a result, the Department of Health and Human Services Office of the Inspector General (HHS-OIG), in conjunction with the Centers for Medicare and Medicaid Services (CMS), is taking steps to increase accountability and decrease the presence of fraudulent activity providers.
By knowing that the government is beefing up measures to fight such healthcare fraud, healthcare providers and suppliers can attempt to avoid practices that are likely to lead to audits and possible prosecutions. Additionally, healthcare providers can prepare for potential audits by increasing their documentation and compliance efforts. Click here to read a prior blog on a similar fraud case dealing with DME suppliers.
To learn some helpful tips if you are the target of a Medicare audit or investigation, click here.
Click here to read my recent blog for even more tips to avoid fraud prosecutions.
Contact Health Law Attorneys Experienced in Medicare Fraud and Durable Medical Equipment Supplier Cases.
The attorneys of The Health Law Firm represent physicians and medical groups that are being audited or investigated by Medicare, Medicaid, Tricare, or insurance companies. They also represent nurse practitioners, dentists, podiatrists, and healthcare professionals who order testing or medical equipment. They represent durable medical equipment (DME) suppliers, pharmacists, pharmacies, testing facilities, labs, and other health care providers in Medicare audits, ZPIC audits, MAC audits and RAC audits throughout Florida and across the U.S. They also represent DME suppliers, physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions, termination from the Medicare or Medicaid Program and administrative hearings.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or Toll-Free (888) 331-6620.
Sources:
Health Law Weekly. “Ten Defendants Indicted in $67 Million Fraud Scheme.” AHLA. (March 11, 2022) Web.
Musgrave, Jane. “Health care fraud case swells to $67M, prosecutors allege; another 10 men face charges.” Palm Beach Post. (March 1, 2022). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.
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