A federal jury found the owner of a Tampa Bay area medical marketing company guilty on Thursday for his role in a $2.2 million-plus Medicare fraud scheme involving the payment of kickbacks and bribes to medical clinics in Miami in exchange for the referral of DNA swabs that were obtained from Medicare beneficiaries.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Maria Chapa Lopez of the Middle District of Florida, Special Agent in Charge Michael McPherson of the FBI’s Tampa Field Office and Assistant Inspector General Shimon Richmond of the U.S. Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.
After a four-day trial, the 49-year-old Land o’ Lakes man and owner of DBL Management LLC was found guilty of one count of conspiracy to pay health care kickbacks and one count of structuring currency transactions to avoid reporting requirements.
The man is expected to be sentenced Oct. 2 by U.S. District Judge Susan C. Bucklew of the Middle District of Florida, who presided over the trial.
According to the evidence presented at trial, the man was paid by Clinical Laboratory Company A for each DNA swab that he arranged to be referred to the laboratory. In order to obtain DNA swabs, the man paid cash kickbacks and bribes to medical clinics in Miami in exchange for the referral of DNA swabs that were obtained from Medicare beneficiaries. The man directed the owners of the medical clinics to collect the DNA of all of the patients at the clinics, regardless of medical necessity.
In the first phase of the scheme, from November 2013 to May 2014, the evidence at trial showed that the man paid these cash kickbacks directly. In the second phase of the scheme, from May 2014 to November 2014, after his arrest on other charges, the man established shell companies, including Healthcare Marketing Florida of Melbourne, and conspired with nominee owners to facilitate the payment of kickbacks, receipt of fraud proceeds, and transfer of unlawfully obtained DNA samples for medically unnecessary testing. Over the course of the entire conspiracy, Clinical Laboratory Company A submitted more than $2.2 million in genetic testing claims and paid the man a percentage of the Medicare reimbursements that it received.
The evidence at trial showed that, in order to conceal his payment of illegal cash kickbacks, the man would travel to different ATMs and bank branches throughout southern Florida and make separate withdrawals of thousands of dollars in cash in order to avoid the filing of U.S. Department of Treasury “currency transaction reports” for an individual withdrawal of more than $10,000.
The man was previously found guilty by a jury in December 2015 of various health care fraud, money laundering and identity theft charges in a case handled by the Criminal Division’s Fraud Section.
He is currently serving 14 years in prison.
The state of Florida, along with every other state, is constantly looking for ways to bring in additional revenue and to cut the rapidly growing costs of Medicare and Medicaid programs, which is why they are going to such great lengths to uncover potential Medicaid and Medicare fraud and abuse cases.
In the majority of cases, Medicare fraud involves using false information to obtain unauthorized benefits, and can take a variety of forms, but it typically involves defrauding the Medicare system through billing for services that were not provided or that were not provided as described. Medicare beneficiaries are sometimes involved in fraud schemes where they split the Medicare or Medicaid funds with another party for care that was not provided.
A number of programs exist at both the state and federal level to uncover and prosecute cases of Medicare fraud by patients, providers, insurers, or owners of a company in the healthcare industry.
Medicare and Medicaid costs the federal government between $80 and $100 billion each year, so government investigators make it their top priority to constantly be on the lookout for any red flags. The Anti-Kickback Statute (AKS) is one tool that the government uses to prosecute actions of fraud. The AKC makes it a crime to give or receive bribes or kickbacks in exchange for patient referrals.
The penalties for violating the AKS are very serious. The AKS is a criminal statute, and a conviction equates to a felony. A conviction under the AKS can lead to five years in prison and fines of $25,000 per violation. The government can also seek hefty financial penalties of $50,000 for each violation of the AKS.