Bullied by Fraud

6

Bullies are tyrants and will do just about anything to get their way. They are adept at using their influence to intimidate anyone who doesn’t agree with them. (We tend to think of bullies as mean kids who torment other children, but bullying also exists in the adult world.) An article published in The MetroWest Daily News covers the trial of a man who bullied his employees and patients of his home health care company in order to steal $27 million from Medicare.

The article states that for nearly seven years, the home health care company owner and his partner worked with several conspirators to defraud the government benefits program. (Where there is one fraudster, another one is usually lurking nearby.) The duo ordered their company nurses to run ”wellness clinics” at senior housing centers and assisted-living facilities so they could recruit Medicare beneficiaries. (Well now, isn’t that convenient.)

At the company owner’s direction, the new patients received home health care services funded by Medicare, even though they were not homebound. (Medicare pays for home health care if homebound patients are qualified.) The partners also falsified nursing visit reports claiming that the patients received skilled nursing services when they did not.

Here’s where the bullying comes in. If the company nurses recommended discharging a patient from the program, the owner would discourage the practice and retaliate by transferring the patient to another nurse. This also happened when the patient requested that the services end. (Bullies don’t get that ”no” means ”no.”)

The 65-year-old man was found guilty by a jury on a total of 18 counts including health care fraud, money laundering and conspiracy to commit health care fraud. The jury also allowed the government to seize $45,000 in cash from two bank accounts and his home, valued at $840,000. (He used $700,000 of the illegally collected Medicare payments to buy his house and pay off his mortgage. That’s definitely not the way to go about obtaining housing paid for by the government.) He could face up to 10 years in prison, a fine of $250,000 plus restitution to Medicare.

The article states that the man’s business partner is scheduled for trial. In addition, the company medical director, who also pleaded guilty to health care fraud for signing fraudulent home health care orders, is scheduled to be sentenced.

People often bully others to achieve a better social status. Bullies irrationally think that their place in society will improve by putting others down. (Perhaps this man’s desire was to live a more privileged life, even though it was at the expense of his patients and other deserving beneficiaries who could not receive medical assistance because of his illegal acts.) Kudos goes to the jury for punishing this bully. He definitely deserves to lose a few privileges to make up for stealing what he did not deserve.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Natick Man Convicted in $27M Medicare Fraud,” written by Norman Miller and published by The MetroWest Daily News on December 3, 2014.

A federal jury convicted a Natick man on Wednesday after a 15-day trial for his role in scamming $27 million from Medicare.

After deliberating four hours, the jury found Michael J. Galatis, 63, guilty on 10 counts of health care fraud, seven counts of money laundering and one count of conspiracy to commit health care fraud.

Read More

SHARE
Previous articleGuest Writer: Greg Desmarais
Next articleLucrative Fraud
Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.