By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
A Los Angeles medical equipment supplier will spend 30 months in prison for submitting nearly $1 million in false claims to Medicare. The claims were almost all for expensive, high-end power wheelchairs. The man was sentenced on October 5, 2012.
To see the press release from the Department of Justice (DOJ), click here.
Man Used Kickbacks and Illegally Solicited Medicare Beneficiaries in Scheme.
In February 2012, the defendant in this case pleaded guilty to owning and operating a fake durable medical equipment (DME) supply company, which he used to submit false claims to Medicare. He would allegedly pay kickbacks to co-conspirators for prescriptions and other documents needed to pull off the fraud. About ninety-five percent (95%) of all of his claims were for power wheelchairs. The wheelchairs were allegedly supplied to Medicare beneficiaries who were illegally solicited by recruiters.
Feds Try to Put a Stop to Power Wheelchair Medicare Fraud.
In September of 2012, power wheelchair suppliers voiced their concerns over a new government program called the Power Mobility Devices (PMDs) Demonstration. Durable Medical Equipment Suppliers (DMES) protested the program because it requires advanced approval prior to the delivery of a power wheelchair to the consumer.
Federal health officials argue that these changes are necessary because eighty percent (80%) of the power wheelchair claims that were submitted in 2011 to Medicare did not meet program requirements, according to the government. That error rate means more than $492 million of improper payments.
I recently wrote on blog on this hot-button topic, click here to read it.
Stay Away From Patient Recruiters.
We have seen several big cases recently involving prosecution for Medicare fraud in which patient recruiters were involved. It would probably be a good idea, if you are a legitimate Medicare provider, to have nothing to do with patient recruiters. If you are not a legitimate Medicare provider, you don’t care about this anyway.
Don't Wait Until It's Too Late; Consult with a Health Law Attorney Experienced in Medicare Issues Now.
The attorneys of The Health Law Firm represent durable medical equipment (DME) suppliers and health care providers in Medicare audits, ZPIC audits, MAC audits and RAC audits throughout Florida and across the U.S. They also represent DME suppliers, physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions, termination from the Medicare or Medicaid Program and administrative hearings.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
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U.S. Department of Justice. "Los Angeles Medical Equipment Supplier Sentenced to 30 Months in Prison for Medicare Fraud Scheme." FBI. (October 5, 2012). Press Release. From: http://www.justice.gov/opa/pr/2012/October/12-crm-1213.html
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: Medicare, Medicare audit, Medicare fraud Florida, Medicare audits Florida, defense attorney, defense lawyer, legal representation, fraud defense, fraud prevention, Medicare overbilling, Centers for Medicare and Medicaid (CMS), Medical Equipment Supplier, fraud schemes, Durable Medical Equipment Suppliers (DMES), government health programs, Florida Medicare
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