Rolling Away with Fraud

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47310150 - woman doctor with stethoscope and currencies dollar, paying for medical care, corruption or bribe concept

Medicare covers durable medical equipment (DME) for qualified beneficiaries. This benefit can mean a world of difference to someone who is confined to their home and without it would not be able to function normally. The long list of items covered includes equipment, such as canes, oxygen, hospital beds or even motorized wheelchairs. (Note that only a medical doctor can prescribe the equipment.) As an article in the Daily Breeze attests, the DME industry is a frequent target of fraudsters, including one home medical supply company owner who submitted more than $8 million in bogus claims to Medicare.

The story says that the former medical equipment company owner and registered nurse accomplished his scheme with the help of multiple patient recruiters and physicians. For more than 10 years, fraudulent prescriptions allegedly were written by the doctors for power wheelchairs and other medical equipment that was not needed. The owner paid cash kickbacks to his co-conspirators and then used the prescriptions to submit more than $8.3 million in fraudulent claims to Medicare. (That would pay for a whole fleet of power wheelchairs.) Unfortunately, Medicare paid out almost $4.3 million for the fake claims before the scam could be stopped.

The 42-year-old former owner was found guilty of one count of conspiracy to commit health care fraud, seven counts of health care fraud and one count of money laundering. He awaits sentencing.

Congratulations to the Medicare Fraud Strike Force for preventing this man from getting away with additional fraudulent acts. The law enforcement organization’s efforts to prevent and deter fraud and enforce anti-fraud laws nationwide have stopped more than 1,900 defendants who have collectively billed more than $6 billion to the government program meant for deserving beneficiaries. (This criminal will definitely not be rolling away with any more Medicare benefits. The only ride he’s probably going to get is in a paddy wagon.)

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Former Owner of Carson Home Medical Supply Company Found Guilty of Medicare Fraud,” written by Larry Altman and published by the Daily Breeze on August 1, 2014.

The former owner of a home medical supply company in Carson has been found guilty of submitting $8.3 million in phony claims to Medicare for equipment that was not needed, the U.S. Attorney’s Office said.

Olufunke Ibiyemi Fadojutimi, 42, a registered nurse and former owner of Lutemi Medical Supply, was found guilty Thursday in U.S. District Court in Los Angeles of one count of conspiracy to commit health care fraud, seven counts of health care fraud and one count of money laundering, federal prosecutors said.

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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.