24 people, 130 durable medical equipment (DME) companies and $1.2 billion. It all adds up to one of the largest health care fraud schemes pulled off in United States history. As Jonathan Stempel of Reuters.com reports, the huge scheme involved doctors, telemarketers and owners of the aforementioned DME companies who all worked to together to sell unnecessary orthotic braces to hundreds of thousands of disabled and elderly patients.
The company owners have been accused of paying kickbacks and bribes to doctors in exchange for their referrals. The doctors were working with fraudulent telemedicine companies to get the back, knee, shoulder and wrist braces that patients did not need.
In total, Medicare was fraudulently billed $1.2 billion for the needless braces.
“The scheme allegedly involved the use of call centers in the Philippines and throughout Latin America, with proceeds laundered through offshore shell companies and used to buy exotic cars, yachts and luxury real estate,” reports Stempel, “Medicare’s anti-fraud unit said it was taking action against 130 medical equipment companies that had submitted more than $1.7 billion of claims, and been paid more than $900 million.”
The various defendants who took part in this health care fraud scheme were scattered all across the U.S.
They were brought in from California, Florida, New Jersey, Pennsylvania, South Carolina and Texas. Florida residents, Creaghan Harry, Lester Stockett and Elliot Loewenstern took the title of having pulled off the largest individual scheme amongst the group. The trio, who consists of the owner, chief executive and marketing vice president of call centers and telemedicine companies, respectively, bilked a grand total of $454 million from Medicare.
New Jersey residents, Neal Williamsky and Nadia Levit owned about 25 DME companies and participated in a scheme that drew $150 million away from Medicare.
The United States Department of Justice report on this case provides further details about the collaborative scheme between all involved parties. “Some of the defendants allegedly controlled an international telemarketing network that lured over hundreds of thousands of elderly and/or disabled patients into a criminal scheme that crossed borders, involving call centers in the Philippines and throughout Latin America,” the DoJ report details.
It goes on to explain that the defendants allegedly paid doctors to prescribe durable medical equipment to patients even if they had no interaction with them at all. In some cases, only brief telephone conversations were conducted before the unnecessary prescriptions were written.
Assistant Attorney General Brian A. Benczkowski was one of the many officials who made the announcement about the huge bust this past Tuesday.
“This Department of Justice will not tolerate medical professionals and executives who look to line their pockets by cheating our health care programs,” he is quoted as saying, “I commend the Criminal Division prosecutors and our partners from U.S. Attorney’s Offices and law enforcement agencies across the country for their unrelenting efforts to stop this alleged fraud before more money was stolen from American taxpayers.”
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