Articles Posted in Medicaid and Medicare Fraud

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A Florida man plead guilty in early 2014 to attempting to defraud Medicare of more than $28 million after buying several rehabilitation clinics, including one in Venice.

The U.S. Department of Justice claims the man bought up the clinics so he could gain access to the clinics’ Medicare provider numbers.

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A Florida man faces up to 15 years in prison for attempting to defraud Medicare of more than $28 million after buying several rehabilitation clinics.

The 53-year-old man, formerly of Southwest Florida, pleaded guilty to conspiracy to commit healthcare fraud and making a false statement relating to healthcare matters.

He faces up to 15 years in prison.

According to a Department of Justice statement, the man was the head of a Delaware holding company that he allegedly used to buy several comprehensive outpatient rehabilitation facilities and outpatient physical therapy providers throughout Florida in the mid-2000s.

Those offices included clinics in Venice, Fort Myers, Lake Wales and Port St. Lucie.

Once they owned the clinics, the man and other company executives apparently obtained identifying information of both Medicare beneficiaries and physicians, which they then used to create and submit false claims for therapy services that were not prescribed and not provided.

DOJ officials claim the man and his co-conspirators forged patient records in order to hide the services they billed Medicare for that had not actually been provided.

The man and his co-conspirators are accused of filing $28.35 million in fraudulent claims with Medicare from 2005 through 2009. Medicare paid approximately $14.4 million on those claims, according to reports.

Authorities allege that once the man received enough Medicare money out of clinics, he sold the storefronts to “straw owners,” who were all recent immigrants to the United States and had no experience working in the healthcare industry.

The DOJ unsealed a 30-count indictment against the man and one of his co-conspirators, a 57-year-old disbarred attorney, in April 2012.

The 53-year-old man has pleaded guilty to two of those charges – conspiracy to commit health care fraud and making a false statement relating to health care matters.

Healthcare fraud cases cost the government millions of dollars each year. The government often makes mistakes and accuses innocent medical professionals and clinic owners of committing federal crimes in order to try and recover their losses from fraudulent claims. Unfortunately, when you are accused of committing Medicare or any other type of healthcare fraud, your family, career and reputation are at risk.

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Med-Care Diabetic and Medical Supplies Inc., based in Boca Raton, FL has fallen under intense scrutiny after a recent investigation into medical equipment suppliers has indicated signs of Medicare fraud.

The federal government is concerned that loopholes in the law and a lapse in management has allowed the Boca Raton company, and others like it, to exploit Medicare, resulting in tax payers footing the bill.

Democratic Missouri U.S. Sen. Claire McCaskill, who has opened a congressional investigation into the company, claims that these medical supply companies are harassing the elderly and their doctors through phone calls and unsolicited faxes for everything from diabetic testing materials to power scooters, even though the patients do not need these items. This is apparently a problem that has cost Medicare – and taxpayers – $27 billion over the past four years.

735910_old_people.jpgFrom 2009 to 2012, Medicare apparently paid $43 billion for medical equipment supplies such as back braces, sleep apnea monitors and power scooters. However, according to research by staffers of a Senate subcommittee on financial oversight lead by McCaskill, more than 60 percent of those payments – $27 billion to be exact – may have been improper. According to reports, the federal government has only been able to recover around 3 percent of overpayments.

The Boca Raton company was asked by McCaskill to testify before her subcommittee on April 24, but reports indicate that no one showed up. At this time, the senator is considering compelling testimony by subpoena on the grounds that because the company makes a profit on taxpayer money they are obligated to provide that information to the government.

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Authorities in Palm Beach County filed charges against 22 individuals Wednesday, alleging they stole nearly $1 million.

“Operation Leap Fraud,” apparently one of the biggest public assistance fraud roundups ever in Palm Beach County netted suspects from across Palm Beach County Jupiter to Delray Beach, and from Pahokee to West Palm Beach on charges ranging from mortgage and insurance fraud to public assistance fraud.

According to the Palm Beach County State Attorney’s Office, only 15 of those charged have been arrested at this time; seven others remained at large Wednesday evening.

Authorities claim the 22 individuals racked up $967,647.37 in fraud.

Authorities did not mention how long the operation took place, but the investigation, which included the U.S. Department of Housing and Urban Development and U.S. Department of Agriculture, apparently targeted people suspected of defrauding housing and other agencies.

At a press conference Wednesday afternoon, the State Attorney’s Office and the Sheriff’s Office said more arrests will follow and there will be no tolerance for even minor cases.

One of the men arrested in the sting, allegedly only defrauded $817.14. Authorities claim the man bilked an elderly woman out of her government-issued Electronic Benefit Transfer card, leaving her without the means to buy food.

It will definitely be interesting to see how the State Attorney’s Office will prosecute these cases. The government and insurance companies do not look fondly on those that attempt to defraud various benefits meant to assist qualifying individuals with their day-to-day needs. There are many ways to defraud the government, and the Florida White Collar Crime Lawyers at Whittel & Melton can assist those facing various fraud charges, including:

• Health Insurance Fraud
Petty Theft & Grand Theft

• Organized Fraud
• Identity Theft
Insurance Fraud

• Welfare Fraud
Medicare/Medicaid Fraud

• Public Assistance Fraud
Florida public assistance fraud can be charged as a misdemeanor or felony depending on the amounts wrongfully obtained. The fraud charge can be classified as a felony if the amount of the assistance illegally gained is worth more than $200 over a 12-month period. Misdemeanor charges can be filed if the value of the assistance is less than $200. If convicted of public assistance or insurance fraud you will be required to pay back the amount of wrongfully obtained benefits and may be perpetually prohibited from receiving future benefits. You may also face jail or prison time, community service or a variety of other criminal punishments.

If you have been arrested for any public assistance fraud in Florida, it is crucial to your defense to consult with the Florida White Collar Crime Lawyers at Whittel & Melton as soon as possible. We will do everything in our power to protect your Constitutional rights. At Whittel & Melton, we can provide you with the aggressive legal representation you need for every stage of your criminal case up to and including trial.

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