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Doctors Going to Jail for Medicare Scams

Handcuffs & StethoscopeThe month of June has been flush with medical professionals heading to jail for Medicare fraud.

Most recently, a Miami-Dade county doctor, Dr. Rene de los Rios was given a lengthy 20 year sentence for his participation in a Medicare fraud scheme.  Dr. de los Rios falsified hundreds of patient records to the tune of $46.2 million for HIV therapy.  Many of his patients received kickbacks.  While, Dr. del los Rios' attorney argued for a shorter sentence (given his client's 72-years of age), the U.S. District Judge refused and instead chastised Dr. del los Rios for violating his medical oath, stealing from the vulnerable government program, and disgracing himself.

In Brooklyn, New York, three employees from one of the largest Medicare fraud busts ever recently pled guilty to charges of conspiracy to commit health care fraud.  The three employees worked at Solstice Wellness Center (a clinic that purported to specialize in physical therapy and diagnostic testing), and were involved in a scheme where Medicare recipients were paid cash kickbacks for medically unnecessary services.  The employees face a maximum sentence of 10 years in prison.

Even in Michigan, a physician was sentenced to prison for her roll in a Medicare fraud scam.  Maria Harber, the owner of CompleteHealth, LLC, a metro Detroit clinic, was sentenced to 15 months in prison and ordered to pay restitution of $1,000,000 for her role in a Medicare fraud scheme.  Harber admitted to billing Medicare for medically unnecessary tests and services.  Specifically, Harber obtained patients by paying kickbacks to driver recruiters and even directly to Medicare beneficiaries. CompleteHealth, LLC typically paid patient recruiters $100 to $150 per patient, with $50 to $75 going to the patients in exchange for visiting CompleteHealth and subjecting themselves to medically unnecessary tests.

While the above cases appear to be blatant "bad actors," all health care professionals should be alert of the increased resources being allocated to finding and fighting Medicare fraud.

Categories: Fraud & Abuse, Physicians

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