Dozens charged in elaborate multi-state Medicare fraud scheme

On Behalf of | Apr 16, 2019 | Firm News

Medicare fraud is a serious crime. According to the Centers for Medicare & Medicaid Fraud, such fraudulent activity often involves the intentional submission of false claims to obtain payment and knowingly bribing others to refer or prescribe items qualified for reimbursement.

In early April, federal prosecutors revealed they had unearthed and exposed an elaborate health care fraud scheme. The FBI charged 24 individuals after obtaining 80 search warrants across the United States for various medical supply companies. At the core of the massive scheme was the intent to defraud the Medicare program by prescribing and distributing unnecessary orthopedic braces to elderly and disabled patients.

A detailed scheme to exploit the Medicare system

The medical device scam involved call centers, medical supply companies, doctors and more to take advantage of the Medicare system and prey on elderly or disabled beneficiaries of the program. The Justice Department detailed that call centers located in the Philippines and Latin America identified vulnerable patients. Then, the medical supply companies shipped out unnecessary braces to patients as doctors signed the fake prescriptions. In many cases, doctors did not even see the patients first.

After doctors signed the prescriptions, Medicare would reimburse the medical supply companies for the braces. In turn, all involved in the elaborate scam received kickbacks for their involvement. The Associated Press reported that a single brace could result in kickbacks of $300 due to the inflated cost of the unnecessary braces. Participants of the scheme used their money to purchase luxurious items both in the U.S. and abroad.

Florida played a key role in the scheme

While prosecutors charged people across seven states, Florida played an influential role in the complex operation. FBI agents and local law enforcement officers raided an office building just outside of Tampa on April 9th where several medical supply companies operated out of. Many of the companies operated out of the building for under 18 months and were registered by the same individual.

Overall, authorities stated that the scheme cheated taxpayers across the country out of nearly $1 billion. Those involved could face considerable penalties, including steep fines, jail time, and more.

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