Infusion therapy and criminal charges for Medicare fraud

On Behalf of | Mar 18, 2022 | Medicare and Medicaid Fraud

Medicare fraud costs the U.S. government $65 billion each year and fraudsters use a number of ways to commit this kind of crime.

One source of Medicare fraud is infusion therapy as evidenced by an Orlando, FL, physician and an infusion clinic owner.

About infusion therapy

Some patients cannot take oral antibiotics for serious infections and diseases. Examples are some cancers, Crohn’s disease, gastrointestinal issues and AIDS. Fusion therapy is an alternative treatment whereby patients receive medication through a sterile catheter inserted into a vein. People can access the treatment through infusion therapy centers.

About Medicare fraud charges

Medicare fraud charges related to infusion therapy treatment include altering or falsifying patient records, money laundering, providing unnecessary treatment with drugs and paying illegal kickbacks to obtain patient referrals.

About the Orlando arrests

In 2017, an Orlando, FL, infusion clinic owner and a local physician collaborated on a scheme to defraud Medicare by submitting false claims to the government program. At the time, the doctor was the medical director for four infusion clinics. He and the owner of the clinics submitted claims for expensive medications that included anticancer chemotherapeutic drugs—medications patients never received. Over a period of three years, Medicare paid $9.8 million and private insurance companies paid an additional $3.5 million for the fraudulent claims. When caught, the men pleaded guilty to one count of conspiracy to commit healthcare fraud. The doctor received a prison sentence of 64 months and the clinic owner 90 months. The court also ordered the men to pay $9.8 million in restitution.

About the investigation

Timing is critical. Those facing Medicare fraud charges often sense an impending investigation. This is the time to seek legal guidance to begin building a strong defense.

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