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Health Insurance Fraud Getting A Lot Harder To Get Away With

Over the past several weeks, we have happily utilized our blog to report on the various cases of health insurance fraud that have resulted in stiff penalties for perpetrators. Needless to say, it’s on unconscionable crime to steal money from policies that are meant to protect the health and well-being of American citizens. There are far too many instances of people bilking Medicare out of money that deserves to go towards much-needed medication and treatment for the sick and injured.

As mentioned, however, there seems to be a growing number of instances when such fraud does not go unpunished. On August 11th, Richard Rainey reported on one such instance. On, he reveals that 46 year-old Tracy Richardson Brown of New Orleans was sentenced to over six and a half years in prison for attempting to rob Medicaid of no less than $3.3 million. She was also ordered pay more than $2 million in restitution.

U.S. District Judge Stanwood Duval Jr., who delivered the sentence, called Brown’s actions “reprehensible”. The owner of a New Orleans medical supply company was found guilty of 18 counts of healthcare fraud, conspiracy and other charges. They include billing Medicaid for equipment such as wheelchairs, knee and back braces and other medical devices that were neither wanted nor needed. Rainey notes that Brown’s victims were elderly people.

Of course Brown’s company is not the only one guilty of bilking insurance companies out of millions of dollars for fraudulent claims. On the same day as Rainey’s report, Tom Haydon of revealed that a network including dozens of medical care companies was ordered to repay insurance companies $20 million for fraudulent claims and an additional $3.5 million in fines.

47 year-old Gregorio Lajara of Perth Amboy, New Jersey was the alleged leader of the network. With his business, Medico Management, he worked with over 60 people and companies in a scheme to run up medical bills for people they purported were injured. To perpetuate their fraudulent plans, the group recruited car accident victims and sent them to chiropractors, physicians and MRI clinics for unnecessary treatments in order to collect on their insurance payments.

Richard Badolato is the New Jersey state Banking and Finance Commissioner. He revealed that Lajara paid “runners” to recruit car accident victims in order to create unnecessary treatment plans that would bilk insurance companies out of as much money as possible. “This case will act as a strong deterrent to potential fraudsters in New Jersey,” Badolato is quoted as saying, “We will come after you, no matter how complex the case or how long it takes to resolve.”

Judge James Hely, who handed down the decision, was unimpressed with Lajara’s actions as well. “Hely, in his decision, noted that 41 patients were sent for brain MRIs, but were not sent to a neurologist for treatment of a suspected brain injury,” writes Haydon. “The outrage here is that if a patient truly had a head injury and (the physician) was concerned about that, there should have been an immediate referral to a medical doctor,” he quotes Hely as saying.

At Allegiant Experts, we continue to support harsh sentences for health insurance fraudsters while working diligently to do our part in putting a stop to them. If you’re an attorney who could use some assistance in a health insurance fraud case, please don’t hesitate to contact us to learn more about how our team of clinical experts can help you. We can be reached at 407-217-5831.

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