High Priority

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The government places a high priority on preventing the loss of Medicare health care dollars, particularly in the area of durable medical equipment (DME) where services and supplies offered are vulnerable to fraud. An article published by the Daily Breeze tells about a registered nurse and former owner of a medical supply company who managed to bilk more than $8.3 million through his business.

The story states that for more than six-and-a-half years, the former owner of the DME supply company paid cash kickbacks to patient recruiters in exchange for patient referrals. He also paid kickbacks to physicians for fraudulent prescriptions for medically unnecessary services and supplies, such as power wheelchairs. (Unfortunately, the love of cold, hard cash can persuade physicians even though they know that the fraudulent prescriptions are a no-no.)

The man used the bogus prescriptions to submit $8.3 million in claims to Medicare for durable medical equipment that was not medically necessary. (Medicare paid nearly $4.3 million for the fake claims.)

Court reports state that the 42-year-old man was convicted by jury for conspiracy to commit health care fraud, seven counts of health care fraud and one count of money laundering. He was sentenced to four years in federal prison and ordered to pay back more than $4.3 million in restitution, jointly and severally with a co-defendant.

Congratulations to the Medicare Fraud Strike Force once again. The organization, which was set up by the government to increase the accountability and decrease the presence of fraudulent providers, has clearly indicated that stopping fraud is a high priority.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Carson Woman Sentenced to Prison for $8.3 Medicare Fraud Scheme,” published by the Daily Breeze on May 11, 2015.

A registered nurse from Carson who owned a medical supply company was sentenced Wednesday to four years in federal prison for her role in an $8.3 million Medicare fraud scheme.

In addition to the prison term, U.S. District Judge Christina A. Snyder ordered Olufunke Fadojutimi to pay nearly $4.3 million in restitution, according to the U.S. Department of Justice.

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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.