A federal district court judge sentenced the owner of a Lauderhill healthcare facility to 30 months in prison for his participation in a Medicare kickback scheme. Receiving payments in exchange for Medicare referrals is a form of healthcare fraud.
The federal government prosecuted the man for referring patients from his Miami-area assisted living facility to other treatment centers. He received cash payments for the referrals. However, the treatment centers to which the man referred his patients submitted false claims to Medicare, apparently defrauding the federal government of $445,025.
At the time that he made the referrals, the man knew about the fraudulent Medicare claims. The government charged him with conspiracy to commit health care fraud because he knowingly referred clients to those facilities in exchange for referral kickbacks.
Kickbacks are just one form of health care fraud. The government also investigates and prosecutes a number of other forms of fraud. Institutions and individuals can commit health care fraud by prescribing and billing for unnecessary services, medical equipment, or treatment procedures. Billing for fake services and submitting false cost reports also constitute fraud.
When the federal government chooses to prosecute a case of health care fraud, it almost always operates on the basis of thorough and extensive investigation. As a result, healthcare fraud charges can often have very serious consequences.
Source: Sun Sentinel, "Medicare fraud lands Lauderhill assisted living facility owner in prison," Tonya Alanez, Aug. 21, 2012