Today’s fraud offers a lesson for all the soon-to-be high school and college graduates: Carefully choose your opportunities to prove your worth in the workplace. (In plain language: Don’t let a bad boss turn you into a fraudster.) The Standard-Examiner reports that the owner of a Salt Lake City medical equipment company scammed Medicare into paying false claims on $20 million worth of unneeded wheelchairs by coercing his employees into altering patients’ medical charts.
Medicare only covers the costs for medical equipment it deems a medical necessity for patients, and it puts the burden on doctors and equipment providers to prove a patient’s need before it will pay for equipment such as a wheelchair. Apparently, this Utah medical equipment provider thought he could make a quick buck (well, $4 million bucks for his part of the conspiracy) off of Medicare, by inflating the number of patients who were actually in need of a wheelchair. But he didn’t do the dirty work himself. Instead, he pressured his “young, inexperienced” sales representatives to meet unrealistic quotas, which they did by falsifying or even creating medical records, and used this fraudulent documentation to increase Medicare claims and subsequent reimbursements. (Not exactly good for the resume.)
But federal authorities caught up with the scheme. The equipment company owner pleaded guilty in federal court to three counts of conspiracy to commit health care fraud, a felony, and his sales representatives each pleaded guilty to one count of conspiracy to commit health care fraud. The owner was sentenced to five years in prison, followed by three years of probation and ordered to pay $4 million in restitution—$1 million of which he repaid upon sentencing. (Just $3 million to go!) One sales representative will be imprisoned for six months; another for four months; and the third received 36 months of probation. They were ordered to pay restitution of $957,055, $585,786 and $230,910, respectively. Each of their restitution amounts is equal to the false Medicare reimbursements that resulted from their personal manipulation of medical records. (Perhaps it’s time for a career change?)
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