$870,000 Home Healthcare Patient Recruiter Shell Game Cracked

March 15, 2022.  A Florida man orchestrating home healthcare patient recruiting scheme pled responsible to 1 rely of conspiracy to commit healthcare fraud for receiving bribes and kickbacks in trade for Medicare beneficiary referrals.  This fraud scheme garnered $870,000 in false claims from Medicare, of which the affected person recruiter pocketed $630,000.  A whistleblower on the 5 residence healthcare corporations concerned may have noticed this paying-for-patients scheme and reported the fraud towards authorities well being packages.

In keeping with the allegations, the Miami, Florida affected person recruiter and co-conspirators tapped Medicare beneficiaries to use for residence healthcare companies. With a purpose to make sure the beneficiaries obtained companies, the co-conspirators instructed the possible sufferers what to say with a view to receive a prescription. 5 residence healthcare businesses have been concerned on this scheme over a interval of 5 and a half years. The recruiter paid kickbacks to Medicare beneficiaries, whereas additionally receiving kickbacks and bribes from the house healthcare corporations. The house healthcare businesses billed Medicare for companies that have been neither medically obligatory nor really supplied. The recruiter hid their ill-gotten beneficial properties in shell corporations. For pleading responsible to 1 rely of healthcare fraud, the recruiter faces as much as 10 years in jail.

Medicare Elements A (hospital insurance coverage) and B (medical insurance coverage) cowl home healthcare services, supplied that a physician certifies {that a} beneficiary wants these companies and is in truth homebound. Bilking the system to earn funds for companies not rendered diminishes Medicare’s capability to supply these companies for sufferers with precise want.

An worker of the house healthcare corporations may have reported this fraud to the federal government. After reporting Medicare fraud, a whistleblower could obtain 15-25% of funds recovered by the federal government in a profitable qui tam lawsuit. Whistleblowing protects taxpayer funds and the integrity of government-funded healthcare packages similar to Medicare.

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