Don’t make the mistake of assuming that Medicare fraud only impacts the national health care program itself. The crime can have significant and far-reaching impacts on the American health care system at large. It affects various stakeholders, including healthcare providers, taxpayers and patients.
As it relates to patients, Medicare fraud can harm them directly. For instance, unnecessary medical procedures or treatments may be prescribed. This can lead to potential health risks or complications. As well, patients may receive substandard care or be denied necessary treatments due to fraudulent billing practices. For these reasons and more, Medicare fraud can never be overlooked as something that doesn’t hurt our society as a whole.
Two Florida men have pleaded guilty to Medicare fraud.
As reported by the Office of Public Affairs this week, two men pleaded guilty for their roles in a $67 million Medicare fraud scheme. 36 year-old, Daniel M. Carver of Boca Raton and 32 year-old, Louis “Gino” Carver of Delray Beach submitted false claims for genetic testing and durable medical equipment. The claims were for patients that did not need either. Both Carvers engaged in the scheme in order to obtain kickbacks.
Court documents showed that Daniel Carver owned and managed call centers. He used the businesses to conduct deceptive telemarketing campaigns targeting Medicare beneficiaries. They were being solicited for unnecessary genetic testing and durable medical equipment. Louis Carver worked for these call centers. He acted as a straw owner for a laboratory that submitted false genetic testing claims.
The Carvers and their co-conspirators paid out kickbacks and bribes.
The illegal incentives were given to telemedicine companies in exchange for completed doctors’ orders. The Carvers then sold the doctors’ orders to laboratories and durable medical equipment companies in exchange for kickbacks. To get away with the scheme, the duo forged doctors’ and patients’ signatures. They also tricked medical providers into ordering medically unnecessary genetic testing.
“Between January 2020 and July 2021, the scheme resulted in the submission of over $67 million in false claims to Medicare for medically unnecessary genetic tests and durable medical equipment,” affirms the Office of Public Affairs report.
The Carvers await potentially lengthy prison sentences.
As the report details, Daniel Carver faces a maximum penalty of 25 years in prison. He pleaded guilty to conspiracy to commit health care fraud and wire fraud and conspiracy to defraud the United States and to pay and receive kickbacks. Louis Carver faces a maximum penalty of 10 years in prison. He pleaded guilty to conspiracy to commit health care fraud. Both men are scheduled to be sentenced on December 5, 2023.
“In addition to last week’s guilty pleas, five other defendants in this case have pleaded guilty and are awaiting sentencing,” the report concludes, “Three defendants are scheduled for a trial set to commence on Sept. 26.”
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