The September 18 blog detailed the case against a Miami executive who was accused of making $205 million in false Medicare claims as co-owner of American Therapeutic Corp. He was convicted and sentenced to 50 years in federal prison for Medicare fraud. Prosecutors are drawing attention to a new wrinkle that drew their attention in the case against the man and his company. He is said to have undertaken significant lobbying efforts in Washington to make it easier to obtain money through fraud.
The man helped to create an advocacy group known as the National Association for Behavioral Health. Prosecutors allege that, through this group, he helped others learn to defraud the government of millions of dollars in false health care claims. His lobbying efforts included holding fundraisers for elected officials and teaching fellow health care executives how to obtain approval for Medicare claims that would otherwise be denied.
Now, the health care professionals who rely on valid Medicare claims fear they may be implicated in his fraudulent scheme. Many health care companies that operate in the field of mental-health issues, as American Therapeutic Corp. did, are non-profit organizations whose work is dependent upon lobbying efforts and public support. They fear that investigators and voters will regard the field as suspect and remove the funding their patients rely on.
For now, legitimate health care providers should be wary of attention from federal prosecutors. The massive attention being paid to Medicare fraud may place them in the unfortunate position of having to explain why they billed Medicare for valid services.
Source: The Washington Post, "Health-care executive's Medicare fraud scheme included lobbying Washington," Dan Eggen, 5 October 2011