Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); Michael B. Steinbach, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; and Mark R. Trouville, Special Agent in Charge, U.S. Drug Enforcement Administration (DEA), Miami Field Division, announce today that Christopher Gregory Wayne, an osteopathic physician residing in Miami, pled guilty before U.S. District Judge Robert N. Scola, Jr., to a criminal information that charges him with health care fraud and conspiracy to violate the narcotics laws of the United States. Sentencing has been scheduled for May 16, 2014.
At sentencing, Wayne faces a maximum sentence of 10 years in prison and a $250,000 fine on the health care fraud charge. The narcotics charge carries a maximum sentence of five years in prison and a $250,000 fine.
In his plea, Wayne admitted to executing a scheme to defraud the Medicare program and attempting to cause a loss in excess of $2,500,000 to Medicare. Wayne agreed to the entry of a forfeiture judgment in the amount of $1,649,042 and the forfeiture of real property and a car, representing proceeds traceable to the health care fraud offense. Wayne also agreed to entry of a money judgment in the amount of $428,300 as proceeds of the narcotics distribution.
Mr. Ferrer commended the investigative efforts of HHS-OIG, FBI, and DEA. The case is being prosecuted by Assistant U.S. Attorneys Eric Morales and Brent Tantillo.
Thursday, February 20, 2014
Monmouth County Doctor Admits Stealing $1.1 Million from Partners
NEWARK—A pain management doctor with a practice based in Red Bank, New Jersey admitted today that he embezzled more than $1.1 million from a medical practice, U.S. Attorney Paul J. Fishman announced.
Robert Muscio, 40, a resident of Colts Neck, New Jersey, pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark federal court to one count of committing mail fraud to embezzle those monies.
According to documents filed in this case and statements made in court:
Between 2007 and 2008, Muscio misused his position as medical director of a practice—with which he is no longer associated—to write checks on the practice’s bank account to pay his personal expenses. To conceal this misconduct from his partners, Muscio falsely described the payments as business expenses of the practice.
The mail fraud count to which Muscio pleaded guilty is punishable by a maximum potential penalty of 20 years in prison and a $250,000 fine. Sentencing is scheduled for May 21, 2014.
U.S. Attorney Fishman credited special agents of the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Thomas O’Donnell, and the FBI, under the direction of Special Agent in Charge Aaron T. Ford, with the investigation leading to today’s guilty plea.
The government is represented by Senior Litigation Counsel Andrew Leven of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $520 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act; the Food, Drug; and Cosmetic Act; and other statutes.
Defense counsel: Joseph J. Benedict Esq., New Brunswick, New Jersey
Robert Muscio, 40, a resident of Colts Neck, New Jersey, pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark federal court to one count of committing mail fraud to embezzle those monies.
According to documents filed in this case and statements made in court:
Between 2007 and 2008, Muscio misused his position as medical director of a practice—with which he is no longer associated—to write checks on the practice’s bank account to pay his personal expenses. To conceal this misconduct from his partners, Muscio falsely described the payments as business expenses of the practice.
The mail fraud count to which Muscio pleaded guilty is punishable by a maximum potential penalty of 20 years in prison and a $250,000 fine. Sentencing is scheduled for May 21, 2014.
U.S. Attorney Fishman credited special agents of the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Thomas O’Donnell, and the FBI, under the direction of Special Agent in Charge Aaron T. Ford, with the investigation leading to today’s guilty plea.
The government is represented by Senior Litigation Counsel Andrew Leven of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $520 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act; the Food, Drug; and Cosmetic Act; and other statutes.
Defense counsel: Joseph J. Benedict Esq., New Brunswick, New Jersey
Wednesday, February 19, 2014
Corpus Christi Doctor Convicted in Connection with Fraudulent Health Care Billing Scheme
CORPUS CHRISTI, TX—Dr. Roque Joel Ramirez, 49, of Robstown, has entered a plea of guilty to mail fraud in connection with his scheme to defraud Medicare and Medicaid through fraudulent billings, announced United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott.
Ramirez, a licensed physician in Texas since 1997 and owner of Health Resolutions Inc., was indicted by a federal grand jury on October 9, 2013, in a scheme to defraud Medicare and Medicaid through fraudulent billings. He was set for trial this morning but opted to enter a guilty plea to one count of mail fraud for using the United States Postal Service (USPS) for the purpose executing his scheme. His medical office in Corpus Christi is now closed.
Ramirez admitted he knowingly and willfully engaged in a scheme to defraud Medicare and Texas Medicaid and submitted false and fraudulent billings for medical services he did not provide. He also admitted he committed mail fraud by using USPS to receive payment on the fraudulent bills.
Court documents indicated that Ramirez knowingly and willfully engaged in the scheme from May 2008 through December 2011 by submitting fraudulent billings for physician services he did not provide. Thousands of false and fraudulent bills were submitted, according to the charges. Ramirez billed for medical services he claimed he personally provided to patients who had actually died prior to the dates of his claimed services. He also submitted bills claiming he personally provided services to patients at his clinic when he was actually overseas or in another state. Some of the bills also indicated he would have personally worked more than 24 hours in a single day. Court documents also alleged that when he provided medical services to Medicare and Medicaid patients in nursing homes, he would send fraudulent bills claiming he had seen the patients in private residences in order to collect the higher fees paid for house calls.
Senior U.S. District Judge Hayden Head, who accepted the guilty plea, has set sentencing for May 15, 2014, at which time Ramirez faces up to 20 years in federal prison and a $250,000 maximum fine. He was permitted to remain on bond pending that hearing.
The investigation was conducted by the FBI, U.S. Department of Health and Human Services-Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit. Assistant United States Attorney (AUSA) Robert D. Thorpe, Jr. and Special AUSA Rex G. Beasley are prosecuting.
Ramirez, a licensed physician in Texas since 1997 and owner of Health Resolutions Inc., was indicted by a federal grand jury on October 9, 2013, in a scheme to defraud Medicare and Medicaid through fraudulent billings. He was set for trial this morning but opted to enter a guilty plea to one count of mail fraud for using the United States Postal Service (USPS) for the purpose executing his scheme. His medical office in Corpus Christi is now closed.
Ramirez admitted he knowingly and willfully engaged in a scheme to defraud Medicare and Texas Medicaid and submitted false and fraudulent billings for medical services he did not provide. He also admitted he committed mail fraud by using USPS to receive payment on the fraudulent bills.
Court documents indicated that Ramirez knowingly and willfully engaged in the scheme from May 2008 through December 2011 by submitting fraudulent billings for physician services he did not provide. Thousands of false and fraudulent bills were submitted, according to the charges. Ramirez billed for medical services he claimed he personally provided to patients who had actually died prior to the dates of his claimed services. He also submitted bills claiming he personally provided services to patients at his clinic when he was actually overseas or in another state. Some of the bills also indicated he would have personally worked more than 24 hours in a single day. Court documents also alleged that when he provided medical services to Medicare and Medicaid patients in nursing homes, he would send fraudulent bills claiming he had seen the patients in private residences in order to collect the higher fees paid for house calls.
Senior U.S. District Judge Hayden Head, who accepted the guilty plea, has set sentencing for May 15, 2014, at which time Ramirez faces up to 20 years in federal prison and a $250,000 maximum fine. He was permitted to remain on bond pending that hearing.
The investigation was conducted by the FBI, U.S. Department of Health and Human Services-Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit. Assistant United States Attorney (AUSA) Robert D. Thorpe, Jr. and Special AUSA Rex G. Beasley are prosecuting.
Friday, February 14, 2014
Local Physician Indicted on Charges of Health Care Fraud
ROCKFORD, IL—A suspended Rockford physician was indicted today by a federal grand jury on charges of healthcare fraud. Charles S. DeHann, 59, of Belvidere, Illinois, was charged with nine counts of engaging in a scheme to defraud Medicare.
The indictment alleges that DeHaan, a physician licensed in Illinois, and president of Housecall Physicians Group of Rockford, South Carolina, treated numerous patients at Rockford-area assisted living facilities and, as a physician, had access to patients and patient records. The indictment alleges that, from January 2013 through January 24, 2014, in order to enrich himself, DeHaan submitted false claims to Medicare for reimbursement for medical services that DeHaan provided to patients in their homes. As part of the scheme, DeHaan allegedly obtained patient information of Medicare beneficiaries through his affiliation with and privileges granted to him at various Rockford-area assisted living facilities, without the knowledge or consent of the patients. It is also alleged that DeHaan billed for medical services purportedly provided to patients whom DeHaan never actually treated and billed routine visits with Medicare patients at the highest levels of in-home care when he knew that his visits with these patients typically did not qualify for such billing.
In addition, DeHaan allegedly billed for medical services provided to patients when he knew he did not provide any reimbursable medical service. For instance, on multiple occasions, DeHaan billed Medicare for medical services purportedly provided to patients, when DeHaan’s visit with the patient involved no medical care and instead involved DeHaan’s having sexual contact and attempting to have sexual contact with a patient and making sexual advances toward a patient, according to the indictment.
DeHaan was initially charged with federal health care fraud last month when he was arrested on a criminal complaint. He was released on bond and will appear for arraignment on February 12, 2014, at 10:00 a.m. in federal court in Rockford, before U.S. Magistrate Iain D. Johnston.
Each count of health care fraud carries a maximum potential penalty of up to 10 years in prison, a fine of up to $250,000, and full restitution. If convicted, the court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
The charges were announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Robert J. Holley, Special Agent in Charge of the Chicago Office of Federal Bureau of Investigation; and Lamont Pugh, III, Special Agent in Charge of the Chicago Regional Office of the U.S. Department of Health and Human Services Office of Inspector General.
The federal case was investigated by the FBI and HHS-OIG, with the assistance of the Illinois Department of Financial and Professional Regulation. The government is being represented by Assistant U.S. Attorney Scott R. Paccagnini.
The public is reminded that an indictment is only a charge and is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving his guilt beyond a reasonable doubt.
The indictment alleges that DeHaan, a physician licensed in Illinois, and president of Housecall Physicians Group of Rockford, South Carolina, treated numerous patients at Rockford-area assisted living facilities and, as a physician, had access to patients and patient records. The indictment alleges that, from January 2013 through January 24, 2014, in order to enrich himself, DeHaan submitted false claims to Medicare for reimbursement for medical services that DeHaan provided to patients in their homes. As part of the scheme, DeHaan allegedly obtained patient information of Medicare beneficiaries through his affiliation with and privileges granted to him at various Rockford-area assisted living facilities, without the knowledge or consent of the patients. It is also alleged that DeHaan billed for medical services purportedly provided to patients whom DeHaan never actually treated and billed routine visits with Medicare patients at the highest levels of in-home care when he knew that his visits with these patients typically did not qualify for such billing.
In addition, DeHaan allegedly billed for medical services provided to patients when he knew he did not provide any reimbursable medical service. For instance, on multiple occasions, DeHaan billed Medicare for medical services purportedly provided to patients, when DeHaan’s visit with the patient involved no medical care and instead involved DeHaan’s having sexual contact and attempting to have sexual contact with a patient and making sexual advances toward a patient, according to the indictment.
DeHaan was initially charged with federal health care fraud last month when he was arrested on a criminal complaint. He was released on bond and will appear for arraignment on February 12, 2014, at 10:00 a.m. in federal court in Rockford, before U.S. Magistrate Iain D. Johnston.
Each count of health care fraud carries a maximum potential penalty of up to 10 years in prison, a fine of up to $250,000, and full restitution. If convicted, the court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
The charges were announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Robert J. Holley, Special Agent in Charge of the Chicago Office of Federal Bureau of Investigation; and Lamont Pugh, III, Special Agent in Charge of the Chicago Regional Office of the U.S. Department of Health and Human Services Office of Inspector General.
The federal case was investigated by the FBI and HHS-OIG, with the assistance of the Illinois Department of Financial and Professional Regulation. The government is being represented by Assistant U.S. Attorney Scott R. Paccagnini.
The public is reminded that an indictment is only a charge and is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving his guilt beyond a reasonable doubt.
Tuesday, February 4, 2014
Queens Doctor Sentenced for His Role in $15 Million Medicare Fraud Scheme
A Queens, New York medical doctor was sentenced today to serve 12 months and a day in prison for his role in a scheme that fraudulently billed Medicare more than $15 million for, among other things, physical therapy and lesion removal services that were medically unnecessary and never provided.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta E. Lynch of the Eastern District of New York, Assistant Director in Charge George Venizelos of the FBI’s New York Field Office, and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
Hoi Yat Kam, 59, was sentenced by U.S. District Judge Edward R. Korman in the Eastern District of New York. In addition to his prison term, Kam was sentenced to serve three years of supervised release and to pay $2,217,656 in restitution.
Kam pleaded guilty on January 9, 2013, to conspiracy to commit health care fraud. According to court documents, Kam conspired with others to execute a fraudulent scheme in which he and others provided a variety of spa services, such as massages and facials, as well as free meals and social activities to Medicare beneficiaries at URI Medical Service PC and Sarang Medical PC to induce those beneficiaries to allow their Medicare numbers to be billed for medical services that were never provided and were not medically necessary. URI and Sarang were two clinics in Queens that purportedly provided physical therapy and lesion removals. In total, Kam and his co-conspirators submitted approximately $15.1 million in false and fraudulent claims to Medicare.
The case was investigated by HHS-OIG and the FBI and brought as part of the Medicare Fraud Strike Force, under the supervision by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case was prosecuted by Senior Trial Attorney Nicholas Acker and Trial Attorney Bryan D. Fields of the Fraud Section. Trial Attorney Katherine Houston formerly prosecuted the case.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta E. Lynch of the Eastern District of New York, Assistant Director in Charge George Venizelos of the FBI’s New York Field Office, and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
Hoi Yat Kam, 59, was sentenced by U.S. District Judge Edward R. Korman in the Eastern District of New York. In addition to his prison term, Kam was sentenced to serve three years of supervised release and to pay $2,217,656 in restitution.
Kam pleaded guilty on January 9, 2013, to conspiracy to commit health care fraud. According to court documents, Kam conspired with others to execute a fraudulent scheme in which he and others provided a variety of spa services, such as massages and facials, as well as free meals and social activities to Medicare beneficiaries at URI Medical Service PC and Sarang Medical PC to induce those beneficiaries to allow their Medicare numbers to be billed for medical services that were never provided and were not medically necessary. URI and Sarang were two clinics in Queens that purportedly provided physical therapy and lesion removals. In total, Kam and his co-conspirators submitted approximately $15.1 million in false and fraudulent claims to Medicare.
The case was investigated by HHS-OIG and the FBI and brought as part of the Medicare Fraud Strike Force, under the supervision by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case was prosecuted by Senior Trial Attorney Nicholas Acker and Trial Attorney Bryan D. Fields of the Fraud Section. Trial Attorney Katherine Houston formerly prosecuted the case.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Friday, January 31, 2014
Three Miami Residents Indicted for Alleged Roles in $190 Million Medicare Fraud Scheme
Three Miami residents have been indicted for their alleged participation in a $190 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office made the announcement after the indictment was unsealed.
On January 28, 2014, a federal grand jury in Miami returned a 10-count indictment charging Nelson Rojas, 43; Roger Bergman, 64; and Rodolfo Santaya, 54, for allegedly participating in a scheme to defraud Medicare by submitting false and fraudulent claims from approximately December 2002 to October 2010.
Rojas was charged with conspiracy to pay and receive bribes and kickbacks in connection with a federal health care program, conspiracy to commit money laundering, two counts of money laundering, and one count of aggravated identity theft. Bergman and Santaya were each charged with conspiracy to commit health care fraud and wire fraud. In addition, Bergman was charged with conspiracy to make false statements relating to health care matters. Santaya was also charged with conspiracy to pay and receive bribes and kickbacks in connection with a federal health care program, as well as two counts of receiving bribes and kickbacks in connection with a federal health care benefit program.
According to the indictment, Rojas, Bergman, and Santaya allegedly participated in a scheme orchestrated by the owners and operators of American Therapeutic Corporation (ATC) and its management company, Medlink Professional Management Group Inc. ATC and Medlink were Florida corporations headquartered in Miami. ATC operated purported partial hospitalization programs (PHPs), a form of intensive treatment for severe mental illness, in seven different locations throughout South Florida. Both corporations have been defunct since October 2010.
The indictment alleges that Bergman was a licensed physician’s assistant who participated in the scheme by, among other things, admitting Medicare beneficiaries to ATC facilities for PHP treatment even though they did not quality for such treatment and falsifying patient records to make it appear as though patients needed, qualified for and actually received legitimate PHP treatment when they did not. The indictment alleges that Santaya served as a patient recruiter who provided ineligible patients to ATC in exchange for kickbacks. The indictment alleges that Rojas was the co-owner of a check cashing business and that he facilitated the payments of bribes and kickbacks from ATC to various patient recruiters.
ATC, Medlink, and various owners, managers, doctors, therapists, patient brokers, and marketers of ATC and Medlink have pleaded guilty or have been convicted at trial. In September 2011, ATC owner Lawrence Duran was sentenced to 50 years in prison for his role in orchestrating and executing the scheme to defraud Medicare.
The charges and allegations contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.
The case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. The case is being prosecuted by Assistant Chief Robert A. Zink and Trial Attorney Nicholas E. Surmacz.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,700 defendants who collectively have falsely billed the Medicare program for more than $5.5 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office made the announcement after the indictment was unsealed.
On January 28, 2014, a federal grand jury in Miami returned a 10-count indictment charging Nelson Rojas, 43; Roger Bergman, 64; and Rodolfo Santaya, 54, for allegedly participating in a scheme to defraud Medicare by submitting false and fraudulent claims from approximately December 2002 to October 2010.
Rojas was charged with conspiracy to pay and receive bribes and kickbacks in connection with a federal health care program, conspiracy to commit money laundering, two counts of money laundering, and one count of aggravated identity theft. Bergman and Santaya were each charged with conspiracy to commit health care fraud and wire fraud. In addition, Bergman was charged with conspiracy to make false statements relating to health care matters. Santaya was also charged with conspiracy to pay and receive bribes and kickbacks in connection with a federal health care program, as well as two counts of receiving bribes and kickbacks in connection with a federal health care benefit program.
According to the indictment, Rojas, Bergman, and Santaya allegedly participated in a scheme orchestrated by the owners and operators of American Therapeutic Corporation (ATC) and its management company, Medlink Professional Management Group Inc. ATC and Medlink were Florida corporations headquartered in Miami. ATC operated purported partial hospitalization programs (PHPs), a form of intensive treatment for severe mental illness, in seven different locations throughout South Florida. Both corporations have been defunct since October 2010.
The indictment alleges that Bergman was a licensed physician’s assistant who participated in the scheme by, among other things, admitting Medicare beneficiaries to ATC facilities for PHP treatment even though they did not quality for such treatment and falsifying patient records to make it appear as though patients needed, qualified for and actually received legitimate PHP treatment when they did not. The indictment alleges that Santaya served as a patient recruiter who provided ineligible patients to ATC in exchange for kickbacks. The indictment alleges that Rojas was the co-owner of a check cashing business and that he facilitated the payments of bribes and kickbacks from ATC to various patient recruiters.
ATC, Medlink, and various owners, managers, doctors, therapists, patient brokers, and marketers of ATC and Medlink have pleaded guilty or have been convicted at trial. In September 2011, ATC owner Lawrence Duran was sentenced to 50 years in prison for his role in orchestrating and executing the scheme to defraud Medicare.
The charges and allegations contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.
The case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. The case is being prosecuted by Assistant Chief Robert A. Zink and Trial Attorney Nicholas E. Surmacz.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,700 defendants who collectively have falsely billed the Medicare program for more than $5.5 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Thursday, January 30, 2014
U.S. Attorney Joseph Hogsett Announces Charges Against Indianapolis Man for Health Care Fraud
INDIANAPOLIS—Joseph H. Hogsett, the United States Attorney, announced today that Ronald Reed, age 46, has been charged with conspiring to commit health care fraud in a scheme that involved the sale of electric wheelchairs and scooters and the potential loss of hundreds of thousands in taxpayer dollars. This comes as Hogsett’s office has continued an effort to crack down on white-collar fraud in Indiana’s business community.
“This alleged scheme not only defrauded taxpayers but also victimized some of the most vulnerable in this community,” Hogsett said. “This case embodies a culture of corruption that is unacceptable, and together with our law enforcement partners, we’re going to put a stop to it.”
According to a federal indictment announced today, Reed was the controlling owner of the Indianapolis-based business Benchmark Mobility Corporation, which sold medical equipment including powered wheelchairs, scooters, lift chairs, and hospital beds. As part of these sales, Benchmark would often bill various state and federal health care programs for reimbursement, including Medicare and Indiana Medicaid.
The indictment alleges that beginning in March 2007, Benchmark began having difficulty obtaining operating capital. In response, Reed allegedly began submitting claims to Medicare and Medicaid for used equipment that he had purchased online and refurbished and was selling as “new.” These used pieces of equipment were often purchased on websites such as eBay and Craigslist, and employees were allegedly directed to change serial numbers and take other actions to hide the fraud.
All told, it is alleged that between March 2007 and March 2011, Reed submitted and was reimbursed for $388,872 in claims to Indiana’s Medicaid program and $53,816 in claims to Medicare. Reed is also charged with 13 counts of aggravated identity theft for allegedly using a Medicaid recipient’s identification without permission as part of the scheme.
According to Assistant U.S. Attorney Bradley P. Shepard, who is prosecuting the case for the government, this case was the result of a joint investigation by the Department of Health and Human Services and the Federal Bureau of Investigation. Reed faces up to 10 years in federal prison if convicted, as well as significant fines.
An indictment is only a charge and is not evidence of guilt. A defendant is presumed innocent and is entitled to a fair trial at which the government must prove guilt beyond a reasonable doubt.
“This alleged scheme not only defrauded taxpayers but also victimized some of the most vulnerable in this community,” Hogsett said. “This case embodies a culture of corruption that is unacceptable, and together with our law enforcement partners, we’re going to put a stop to it.”
According to a federal indictment announced today, Reed was the controlling owner of the Indianapolis-based business Benchmark Mobility Corporation, which sold medical equipment including powered wheelchairs, scooters, lift chairs, and hospital beds. As part of these sales, Benchmark would often bill various state and federal health care programs for reimbursement, including Medicare and Indiana Medicaid.
The indictment alleges that beginning in March 2007, Benchmark began having difficulty obtaining operating capital. In response, Reed allegedly began submitting claims to Medicare and Medicaid for used equipment that he had purchased online and refurbished and was selling as “new.” These used pieces of equipment were often purchased on websites such as eBay and Craigslist, and employees were allegedly directed to change serial numbers and take other actions to hide the fraud.
All told, it is alleged that between March 2007 and March 2011, Reed submitted and was reimbursed for $388,872 in claims to Indiana’s Medicaid program and $53,816 in claims to Medicare. Reed is also charged with 13 counts of aggravated identity theft for allegedly using a Medicaid recipient’s identification without permission as part of the scheme.
According to Assistant U.S. Attorney Bradley P. Shepard, who is prosecuting the case for the government, this case was the result of a joint investigation by the Department of Health and Human Services and the Federal Bureau of Investigation. Reed faces up to 10 years in federal prison if convicted, as well as significant fines.
An indictment is only a charge and is not evidence of guilt. A defendant is presumed innocent and is entitled to a fair trial at which the government must prove guilt beyond a reasonable doubt.
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