A recruiter has pleaded guilty for her role in an operation that resulted in more than $25 million in improper Medicare claims. Federal investigators arrested more than a dozen people in connection with the Medicare fraud scheme. The Department of Health and Human Services, along with the Department of Justice and the Federal Bureau of Investigation announced the plea this week as part of their nationwide efforts to target health care providers for improper billing.
Many health care businesses have paid recruiters to put them in touch with patients who qualify for Medicare services. In this case, the recruiter was paid by Florida Home Health Providers, Inc., a Miami company that provides physical therapy and other home therapy services. The government charged that the company was billing for services that were not medically necessary or that were never given at all. The Medicare recipients would be paid kickbacks or bribed by the recruiter for their cooperation in the billing scheme.
This recruiter was alleged to have directly contributed to $195,000 in improper Medicare claims. For this, she was charged with conspiracy to commit health care fraud and solicitation of health care kickbacks. After pleading guilty, she faces a potential punishment of up to 15 years in prison, as well as extensive fines. Her sentencing has been scheduled for January.
Most of the health care fraud cases that have drawn headlines have targeted doctors and health care companies. Recruiters may soon become the focus of significant criminal investigation as prosecutors work to keep their efforts to combat Medicare fraud in the public eye.
Source: FBI.gov, "Miami-Area Patient Recruiter Pleads Guilty in $25 Million Health Care Fraud Scheme," 8 November 201