Fraud Schemes Reported by the DOJ

Fraud Schemes Reported by the DOJ

The Department of Justice reports these  two cases of fraud:

Florida Businesswoman Pleads Guilty to Criminal Health Care and Tax Fraud Charges and Agrees to $20.3 Million Civil False Claims Act Settlement

"According to court documents, Wolfe and her conspirators used Regency to establish dozens of DME supply companies — or, rather, DME fronts — using trickery and deception. The scheme involved placing the DME fronts in the names of straw owners. By concealing the true ownership, Wolfe’s conspirators secretly gained control of multiple companies. With such control, they collectively submitted well over $400 million in illegal DME claims to Medicare and the Civilian Health and Medical Program of the VA. The conspirators claimed that the unusually high volume of claims reflected the use of telemedicine procedures, when, in fact, they had simply bribed doctors to approve them. Almost always, the doctors had no telehealth interaction with the beneficiaries."

Two Defendants Plead Guilty to Multi-Million Dollar Medicare Fraud Scheme

"Jones and Putulin helped Perez manufacture and submit false and fraudulent Medicare claims by establishing shell companies in more than a dozen different states, including Massachusetts. Perez directed employees, including Jones and Putulin, to list his mother, wife and yacht captain as corporate directors and to use fictitious names when registering the shell companies as DME providers. At Perez’s request, Jones and Putulin purchased Medicare patient data from foreign and domestic call centers that targeted elderly patients, and instructed call centers to contact the Medicare beneficiaries with an offer of ankle, arm, back, knee and/or shoulder braces “at little to no cost.”  Perez then submitted Medicare claims for those patients without obtaining a prescriber’s order to ensure that the braces were medically necessary."