It isn’t every day that you encounter a Medicare scheme that deceived doctors in twelve different states and drained at least $2.2 million dollars from Medicare over half of a decade, concluding only after an intense two-year investigation by four different government agencies. According to an article by Riverfront Times, this peculiar case centers on a chiropractor who defrauded Medicare, Medicaid and other public and private health insurance companies by submitting false reimbursement claims for “custom” (and as it turned out, shoddy) orthotic boots, which he pushed on elderly nursing home patients at a 1200% surcharge.
According to the report, the chiropractor kicked off his elaborate fraud by altering a medical guide left behind by his deceased business partner. (Thus creating his step-by-step guide to greed.)Thedoctor sold low-quality orthotic boots, worth no more than $200, for as much as $2,600 to nursing homes. In order to avoid attracting attention for submitting too many claims, the physician’s fancy footwork also included filing from multiple companies, aided by his wife, who owned a billing and collections company. Even worse: he solicited doctors in other states, and tricked them into helping him sell the bogus boots.
Still, $2.2 million dollars in stolen government benefits doesn’t go by unnoticed for very long (and the other shoe always drops). This janky jig was up after a joint two-year investigation by the U.S. Department of Health and Human Services, Office of the Inspector General, FBI, and the Missouri Medicaid Fraud Control Unit. According to investigative interviews with nursing home staffers, the boots were so poorly constructed that they caused patients to fall down, and even lacerated their skin. Prosecutors further allege that the couple targeted elderly patients, even though they knew that those lacking supplemental insurance would be stuck footing bills as high as $500. (Yes, kicking them when they’re down.)
Ultimately, the chiropractor pleaded guilty to health care fraud, for which he was sentenced to four years in three months in federal prison, ordered to pay millions of dollars in restitution and lost his medical license. After his wife pleaded guilty to filing false Medicare claims, she was sentenced to five years of probation and ordered to pay $10,571 in restitution.
Shame on this couple for so recklessly exploiting an entire system of people working to improve living standards for the elderly, and bravo to the government for giving this scheme the boot.
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