Florida Health Clinic Owner Arrested on Charges of $300,000 in Medicaid Fraud

Monday, July 8, 2013
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The owner of a Lake County, Florida, medical center was arrested by the Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) on June 27, 2013, for allegedly committing $300,000 in Medicaid fraud. According to the AG, the clinic owner allegedly billed Florida Medicaid for services never rendered and used the Medicaid provider number of a physician who was no longer employed at his facility. The AG stated that for three years the health clinic owner supposedly submitted more than 2,500 fraudulent claims to the Medicaid program.

To read the press release from the AG, click here.


Clinic Owner Caught After Ex-Employee Reported Fraud.

The MFCU began its investigation of the owner after a complaint was filed by a former employee. A physician, who used to work at the health clinic, accused the owner of using her Medicaid provider number to bill and receive payments from the Medicaid program for services when she did not work at the clinic, according to the Orlando Sentinel.

Click here to read the article from the Orlando Sentinel.

The health clinic owner now faces two counts of Medicaid fraud and one count of criminal use of a personal identification number. The owner is also charged with one count of operation of an unlicensed health care clinic, because his clinic allegedly did not have a valid license from the Agency for Health Care Administration (AHCA) during the time the Medicaid claims were made, according to the Orlando Sentinel.


Responding to a Medicaid Fraud Control Unit Investigative Subpoena.

The MFCU is in charge of investigating and prosecuting health care providers suspected of defrauding the state's Medicaid program.  When the unit opens a case against a provider, the first step is usually the issuance of an investigative subpoena, requesting specific patient records. It is important to remember that the MFCU would not be involved unless criminal fraud was suspected. This is not a routine audit. Click here to read practice tips on how to properly respond to a subpoena.


Fraud Charges Are a Very Serious Matter.

We have been consulted by many individuals similar to the subject of this story, both before and after criminal convictions for fraud or related offenses. In many instances, we are convinced that the person is actually not guilty of fraud. However, in many cases those subject to Medicaid or Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter or they decide not to spend the money required for a top quality attorney to defend them.

If you are accused of Medicare or Medicaid fraud, realize that you are in the fight of your life. Your liberty, life and profession are at stake. You need to sell everything you own, borrow everything you can and hire the absolute best criminal defense attorney available who has experience in defending such cases to represent you.

If you win and are acquitted, at least you still have a professional license and can start over. However, if you lose, you will most probably be in prison for years. You will lose your license. You will be excluded from Medicare. You will be a convicted felon. You will have nothing and will have no way of starting over successfully.

Do not delude yourself. This is extremely serious. Be prepared to give up whatever you have if you can avoid a conviction.


Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.


Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Comments?

As a health care professional, how do you keep your Medicaid number safe from fraud? Please leave any thoughtful comments below.


Sources:

Meale, Jenn. “Attorney General Bondi’s Office Arrests Lake County Resident for More Than $300,000 in Medicaid Fraud.” My Florida Legal. (June 27, 2013). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/7AD84D3084CCE3A885257B97005FF497

Lelis, Ludmilla. “Tavares Health Clinic Owner Arrested on Charges of Medicaid Fraud.” Orlando Sentinel. (June 27, 2013). From: http://articles.orlandosentinel.com/2013-06-27/news/os-medicaid-fraud-arrest-randall-ritch-20130627_1_medicaid-fraud-medical-clinic-medicaid-provider-number


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
 

Tag Words: Medicaid, Medicaid fraud, Medicaid investigation, physician, doctor, medical clinic, Florida Medicaid, Florida Medicaid Program, Medicaid audit, services never rendered, Medicaid provider number, Medicaid claims, fraudulent claims, Attorney General (AG), Agency for Healthcare Administration (AHCA), Medicaid Fraud Control Unit, defense attorney, defense lawyer, Medicaid fraud defense attorney, Medicaid fraud defense lawyer, Florida attorney, Florida lawyer, The Health Law Firm


"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
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7/8/2013

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