Where would America be without Medicare? The government national health insurance program, which was founded back in 1965, provides health insurance for nearly 60 million Americans per year. The majority of beneficiaries are aged 65 and older. However, there are some younger people with disability status as well as those with certain diseases who also benefit from Medicare.
As the Allegiant Blog has well documented over the years, Medicare is also the victim of many counts of fraud. Countless medical practitioners, among others in the health industry, have manipulated their billing practices in order to illegally bilk the insurance program out of millions. Our beautiful home state of Florida is no stranger to such fraudsters. Among them is 34 year-old, Nathan LaParl.
LaParl pleaded guilty to his role in a kickback scheme.
As reported by the District of Massachusetts branch of the United States Department of Justice last week, the Boca Raton resident was recently sentenced in a multi-million dollar Medicare fraud scheme. As the DoJ, reveals, LaParl pleaded guilty to one count of receiving kickbacks in connection with a federal health care program last month. He also pleaded guilty to one count of violating the HIPAA statute.
Last week, LaParl was sentenced to three years of probation. The first year is to be served subject to a curfew and forfeiture in the amount of $220,671. To pull off his scheme, the defendant worked in tandem with Talia Alexandre. Together, they sold Medicare patients’ personal and medical data to Juan Camilo Perez Buitrago.
“LaParl and Alexandre worked with foreign call centers to contact Medicare patients to ask if they were interested in durable medical equipment (DME) such as arm, back, knee and shoulder braces ‘at little to no cost,’” explains the DoJ report, “The call centers collected demographic and insurance information from Medicare patients, which LaParl and Alexandre sold to Perez Buitrago.”
In total, the pair received more than $1.6 million from Perez Buitrago for the patient data.
Perez Buitrago used that patient data to submit more than $109 million in false and fraudulent claims. He submitted claims for DME that was not prescribed and not necessary. In fact, in many cases, the equipment was neither requested nor received.
“To perpetuate the scheme, LaParl checked Medicare patients’ insurance eligibility by improperly accessing a patient eligibility tool provided by co-defendant Stefanie Hirsch,” details the report, “Hirsch owned EI Medical, Inc., a Medicare-enrolled wheelchair and scooter repair company that qualified for access to a health care clearinghouse that contains Medicare patients’ personal, medical and insurance information.”
Hirsch also pleaded guilty to violating the HIPAA statute.
She improperly gave LaParl access to the clearinghouse. As well, she charged him about 25 cents per patient eligibility check. Using Hirsch’s credentials, LaParl accessed the personal and medical data of over 350,000 patients. Hirsh was sentenced to three years of probation back in September. She was also ordered to pay a fine of $2,500.
“Alexandre pleaded guilty to one count of receiving kickbacks in connection with a federal health care program and was sentenced on Dec. 8, 2021, to three years of probation with the first year spent in home detention,” the DoJ reports, “Alexandre was also ordered to pay a fine of $5,000 and restitution in the amount of $1.47 million.”
Are you an attorney working on a fraud case?
Allegiant Experts can help you! Contact us today to schedule a complimentary consultation. Please don’t hesitate to give us a call at 407-217-5831. You may also email us at firstname.lastname@example.org.