A patient recruiter for a Florida health agency has pleaded guilty in connection with a health care fraud scheme that reportedly defrauded the Medicare program. The defendant, age 45, entered the guilty plea on June 27. She was charged with a single count of conspiracy to solicit and receive health care kickbacks, effectively committing Medicare fraud, according to news outlets. The woman pleaded guilty to violating federal laws, which makes the potential consequences of the case far more serious.
The defendant was accused of receiving financial benefits from the owner of a home health care agency in exchange for soliciting patients. The woman allegedly booked therapy and home care services for patients who did not need them; however; in many cases, those treatments were not only medically unnecessary, but they were actually never provided. The services were billed to Medicare, and the woman received more than $6 million in claims reimbursements from Medicare before the alleged fraud came to light.
The woman was investigated through a special task force known as the Medicare Fraud Strike Task Force. This group operates in nine cities and has so far charged almost 2,000 defendants for fraudulent Medicare claims totaling more than $6 billion. This case is being prosecuted with information obtained through that initiative and the Federal Bureau of Investigation.
The woman in this case has pleaded guilty to the federal charges she faces. Although guilty pleas are useful in some scenarios, they are not appropriate for every criminal trial. Criminal defendants in federal fraud cases should carefully consider their plea options before making such a critical decision, as a plea can have significant implications when it comes to the defendant’s future.
Source: eNews Park Forest, “Patient Recruiter Pleads Guilty for Role in $6.5 Million Health Care Fraud Scheme”, June 27, 2014