7 Charged in Florida DME Fraud
Submitted by Robin Mathias on Sun, 09/05/2004 - 2:31pm. Fraud Cases | Medicaid Fraud Cases | Medical Equipment Fraud Cases
A 79-count Indictment charged Lazaro Betancourt, Carlos Marx Mesa, Kenia Mesa, Osvaldo Piedra, Viridiana Negrin, Gilberto Herrera, and Guillermo Carnet with healthcare fraud against Medicare, as well as money laundering and check cashing schemes. According to an August 5, 2004 press release by the United States Attorney for the Southern District of Florida, the people indicted created durable medical equipment (DME) companies that billed Medicare for services which were not delivered to Medicare beneficiaries. The defendents allegedly laundered the money they received from Medicare. A money laudering conviction could result in a maximum sentence of 20 years in prison. Financial penalties could amount to $21 million (treble the $7 million identified as Medicare fraud.). Durable Medical Equipment fraud is very common in Medicare and Medicaid, because no licensing is required to become a DME supplier. State Medicaid programs and Medicare are starting to crack down on this type of fraud by requiring onsite visits of DME providers. However, during a speech at the NASO Conference in August, Leslie Aronovitz of the GAO mentioned that DME providers are often able to trick scheduled site visits. If the providers know they have to show proof of a storefront once every three to five years, they’ll make sure they have a convincing operation for their site visits. Random site visits are much more effective in making sure providers are running legitimate businesses.