Earlier this year, a Miami couple pleaded guilty to Medicare fraud in a deal with prosecutors. Based on the plea deal, a federal judge sentenced the couple to prison last week. Prosecutors accused the couple of committing health care fraud by submitting $45 million in false claims.
The couple apparently launched a health care company to provide home-based nursing services for diabetes patients. However, a government investigation revealed that the company did not actually provide those services. Instead, the couple allegedly paid both recruiters and patients for their cooperation.
By sharing profits with the patients in exchange for their complicity, the couple was able to submit millions of dollars worth of false claims. The company made as much as $30 million between 2006 and 2009. Federal prosecutors have already secured 25 other convictions related to this business and may indict even more defendants.
Kickback schemes are a common form of health care fraud. Federal investigators frequently discover health companies who pay recruiters to solicit patients with access to Medicare or Medicaid funds. This case is slightly unusual in that the couple did not merely pay the recruiters-they also roped the patients into the deal with further kickbacks. Those patients could likely face fraud charges for their cooperation in the scheme.
Pursuant to the plea deal, the couple will complete hefty prison sentences. The husband faces a ten year sentence while the wife serves nine years. The couple has an 8-year-old daughter.
Source: CBS Miami, “Medicare Fraudsters Sentenced to Prison After $45M Scheme,” Sept. 15, 2012