Some people just can never have enough. According to a press release recently issued by the Department of Justice, a high-profile businessman in Tampa was caught leading a group of conspirators through a multi-million dollar scam to defraud Medicare of more than $12 million, by submitting false claims for medical services like radiology, neurology and cardiology. (Arguably, the most expensive services. Go big or go home!)
The group spread the fraudulent claims across three different medical clinics, and used forged or downright false documentation in the clinics’ Medicare enrollment process. They also illegally paid kickbacks to get access to Medicare patients and their personal information. Armed with this data, they submitted claims for patient visits that had never happened or for services that the clinics never actually provided. Finally, they used shell companies and a multitude of cash withdrawals to hide, transfer and share amongst themselves the money that Medicare paid out for the claims. (Fortunately, they did not collect the full $12 million in claims, only a portion had been paid out before they got caught.)
When the federal Medicare Fraud Strike Force did uncover the crime and alerted the Federal Bureau of Investigation and the Department of Health and Human Services Office of the Inspector General, the two agencies commenced an investigation. The probe resulted in federal charges for the ringleader, who was found guilty by a jury of health care fraud, money laundering, wire fraud and aggravated identity theft, as well as conspiracy to commit health care fraud and conspiracy to commit money laundering. In addition to being sentenced to more than fourteen years in federal prison, he was ordered to pay $2,512,460 in restitution.
Anyone who thinks that government officials won’t notice a $12 million dollar increase in claims clearly letting greed get the best of their judgment, especially given the fact that a dedicated task force exists to specifically sniff out such crimes. The Department of Justice cites that the Medicare Fraud Strike Force has filed charges against 2,000 defendants, responsible for $6 billion in fraudulent claims since its inception in 2007.
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