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24 Charged in $1.2 Billion Medicare Scam, Federal Officials Say 24 Charged in $1.2 Billion Medicare Scheme, U.S. Says
(about 3 hours later)
Federal officials said Tuesday that they had dismantled a $1.2 billion Medicare scam that spanned continents and ensnared hundreds of thousands of unsuspecting elderly and disabled patients. Federal officials said Tuesday that they had dismantled a $1.2 billion Medicare scheme that spanned continents and ensnared hundreds of thousands of unsuspecting elderly and disabled patients.
The scheme, which the authorities described as one of the largest health care frauds in United States history, centered on the alleged overprescription of medically unnecessary back, shoulder, wrist and knee braces. Twenty-four people were charged, according to the Justice Department. Under the scheme, which the authorities described as one of the largest health care frauds in United States history, doctors prescribed back, shoulder, wrist and knee braces that were not needed, prosecutors said. Twenty-four people were charged, according to the Justice Department.
“These defendants — who range from corporate executives to medical professionals — allegedly participated in an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care,” Brian Benczkowski, the assistant attorney general for the department’s criminal division, said in a statement.“These defendants — who range from corporate executives to medical professionals — allegedly participated in an expansive and sophisticated fraud to exploit telemedicine technology meant for patients otherwise unable to access health care,” Brian Benczkowski, the assistant attorney general for the department’s criminal division, said in a statement.
Some of the accused scammers were owners of durable medical equipment companies that paid kickbacks and bribes to doctors to write prescriptions for braces that were medically unnecessary, according to the authorities. Some of the accused were owners of durable medical equipment companies that paid kickbacks and bribes to doctors to write prescriptions for braces that were medically unnecessary, according to the authorities.
An international telemarketing network with call centers in the Philippines and Latin America would reach out to Medicare beneficiaries, convincing them to get the free or low-cost braces. The doctors would sometimes write prescriptions without speaking to the patient. An international telemarketing network with call centers in the Philippines and Latin America would reach out to Medicare beneficiaries, persuading them to get the free or low-cost braces. The doctors would sometimes write prescriptions without speaking to the patient.
“The defendants took advantage of unwitting patients who were simply trying to get relief from their health concerns,” Craig Carpenito, the United States attorney for New Jersey, said in a statement. “Instead, the defendants preyed upon their weakened state and pushed millions of dollars’ worth of unnecessary medical devices, which Medicare paid for, and then set up an elaborate system for laundering their ill-gotten proceeds.”“The defendants took advantage of unwitting patients who were simply trying to get relief from their health concerns,” Craig Carpenito, the United States attorney for New Jersey, said in a statement. “Instead, the defendants preyed upon their weakened state and pushed millions of dollars’ worth of unnecessary medical devices, which Medicare paid for, and then set up an elaborate system for laundering their ill-gotten proceeds.”
The authorities said the defendants laundered the proceeds through international shell companies and used the money to buy exotic cars, yachts and luxury real estate around the world. The defendants laundered the proceeds through international shell companies and used the money to buy exotic cars, yachts and luxury real estate around the world, the authorities said.
Charges related to the payment of bribes, illegal kickbacks, money laundering and conspiracy to commit health care fraud were brought against people in California, Florida, New Jersey, Pennsylvania, South Carolina and Texas. Prosecutors brought charges related to the payment of bribes, illegal kickbacks, money laundering and conspiracy to commit health care fraud against people in California, Florida, New Jersey, Pennsylvania, South Carolina and Texas.
The individuals charged included the chief executives or employees of five telemedicine companies, the owners of dozens of durable medical equipment companies and three licensed medical professionals, the Justice Department said.The individuals charged included the chief executives or employees of five telemedicine companies, the owners of dozens of durable medical equipment companies and three licensed medical professionals, the Justice Department said.
The scam was investigated by the F.B.I. and the Health and Human Services inspector general, and was prosecuted by the Justice Department. The I.R.S. and 17 United States attorney’s offices also took part in the crackdown. In Florida, Willie McNeal IV, the owner and chief executive of two telemedicine companies, hired health care providers and then paid them to prescribe braces for Medicare beneficiaries regardless of whether it was medically necessary, according to an indictment. Mr. McNeal would then receive illegal kickbacks in exchange for ordering those braces, the indictment said.
Mr. McNeal, 42, facilitated the submission of fraudulent Medicare claims worth nearly $250 million, the government said. If convicted, the government demanded that Mr. McNeal forfeit the profits obtained from the illegal kickbacks and any property that was purchased with those proceeds, including 10 properties in Florida.
John Lauro, a lawyer representing Mr. McNeal, said in a phone interview on Tuesday that he could not comment on the specifics of the allegations but that he was disappointed by the Justice Department’s decision to arrest Mr. McNeal with “no advance warning” or opportunity to explain himself.
“They simply arrested without asking any questions or giving the client the opportunity to talk about the telemedicine business model,” Mr. Lauro said.
In a case out of South Carolina, more than a dozen companies owned by Andrew Chmiel, 43, billed Medicare for more than $200 million as part of a scheme to sell medically unnecessary equipment, according to an indictment. The indictment listed three properties, six cars and nearly two dozen bank accounts as subject to forfeiture if Mr. Chmiel is convicted.
Mr. Chmiel’s lawyer said he was reviewing the indictment, but did not immediately comment on the charges.
The alleged scheme was investigated by the F.B.I. and the Department of Health and Human Services inspector general, and is being prosecuted by the Justice Department. The I.R.S. and 17 United States attorney’s offices also took part in the crackdown.