This month, a Florida grand jury in the Southern District indicted three south Florida residents on a 16-count superseding indictment.
The three men are charged with conspiracy to receive and pay healthcare kickbacks and receipt of kickbacks. Two were also indicted on charges of conspiring to launder money, while one of the two faces four counts of money laundering. Other charges facing the Miami men are conspiracy to possess with an intent to distribute a controlled substance and conspiring to commit healthcare fraud.
These violations are rooted in a fraudulent scheme that allegedly defrauded the federal Medicare program of $23 million. Two of the three face trafficking charges because they are accused of submitting forged prescriptions for drugs like oxycodone to drug stores.
According to the superseding indictment, a 57-year-old man was a co-owner of two pharmacies in the state. During the six-year period between March 2006 and September 2012, he allegedly paid out kickbacks to a pair of brothers and a third man for information about Medicare beneficiaries. Armed with that personal information, the pharmacy co-owner bilked the government out of over $23 million in fraudulent Medicaid and Medicare claims. The brothers reportedly concealed their kickbacks by passing them off as legitimate payments for medical services that were allegedly provided by shell companies they controlled.
According to the indictment, one of the brothers and the third, unrelated, man are accused of delivering or causing fraudulent prescriptions for opiates like oxymorphone and oxycodone to be delivered to the two pharmacies where the kickbacks were being paid out. The pharmacist filled the phony prescriptions, then submitted fraudulent claims to Medicare for reimbursement while his co-conspirators arranged for their resale on the Miami black market.
In December of 2012, the pharmacist entered a guilty plea to a count of of conspiracy to defraud the government by paying illegal health care kickbacks and a single count of conspiracy to commit healthcare fraud. Last year, he was sentenced to a 14-year prison term.
Medicaid and Medicare fraud are taken very seriously by the federal government, and the penalties are steep. Those facing similar charges may wish to retain defense counsel as soon as possible after an arrest.
Source: Federal Bureau of Investigations, "Three Florida Residents are Charged with Health Care Fraud, Money Laundering, and Drug Trafficking" Oct. 12, 2014