Medical Equipment Fraud Cases
Florida Businessman Sentenced in Health Care Fraud Scheme - Leonardo Pita, the owner of a durable medical equipment company based in Miami-Dade County, Florida, was sentenced to 42 months in prison, followed by three years of supervised release, and ordered to pay over $519,000 in restitution following his convictions for Medicare fraud and money laundering. [Google Reader]
Businessman guilty in wheelchair fraud case - abc13.com -
Businessman guilty in wheelchair fraud case
abc13.com, TX - 8 hours ago
… 24th for a San Antonio businessman convicted in a Medicare and Medicaid billing scheme. … He was convicted Friday on six counts of federal health care fraud. …
After string of successful fraud prosecutions, Sullivan takes on medical device makers
BY JEREMY OLSON
A watchdog of the pharmaceutical industry is turning his attention to the marketing practices of the medical device industry.
Michael Sullivan, the U.S. attorney for the Massachusetts district, has earned more than $3.3 billion for the federal government through health care fraud lawsuits. His biggest cases challenged whether drug makers used kickbacks or other improper methods to sell their products.
The settlement resolves civil liabilities from alleged kickbacks paid to physicians, false statements made to obtain payment for unnecessary services, and payments made to Gambro Supply, a sham DME company.
In Washington last week, deputies arrested Sally Hansen after they caught her selling medical supplies on eBay. The supplies were allegedly paid for by Washington state for Hansen’s disabled child. The Seattle Post-Intelligencer reported thta the state Department of Social and Health Services paid $15,100 for diapers, fruit drinks, PediaSure and a state employee health insurance program paid about $23,000 for medical supplies for Hansen’s daughter.
The investigation reportedly started after Wanda DeGolier bought PediaSure from Hansen on eBay. Ms. DeGolier contacted the medical supply company after she noticed that a label on the box that said the supplies were intended for Hansen’s daughter. Read the Seattle Post-Intelligencer article
On June 22, 2004 Dr. Romulo Valdez, a San Diego physician, pleaded guilty to conspiracy to defraud Medicare and Medi-Cal of more than $725,000. He admitted that he signed Certificates of Medical Necessity for motorized wheelchairs for patients who did not need them. In doing so, he helped Benison Medical Supply defraud Medicare and Medi-Cal. Dr. Valdez faces a maximum penalty of five years in prison and a $250,000 fine.
Motorized wheelchair fraud is a problem across the US. Expect to see more about this type of fraud. See also: 2 Brothers Plead Guilty
Wheelchair fraud is in the news again, as two men in Texas pleaded guilty to submitting fraudulent claims to Medicare for power wheelchairs. In the past year, the Federal government has taken many steps to crack-down on power wheelchair fraud. In February 2004, the Deptartment of Justice announced 11 arrests in Texas as the result of Operation Roll Over. In September 2003, the Centers for Medicare and Medicaid Services (CMS) announced Operation Wheeler Dealer, a ten point plan to curb wheelchair fraud in the Medicare program. At the end of April 2004, CMS announced new payment guidelines to make sure that people who need wheelchairs get them and people who don’t, don’t.