Good Friends

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Cropped shot of a doctor talking to a senior patient in a clinic

In today’s “Fraud of the Day” article, we take a look at a patient recruiter from South Florida who referred Medicare beneficiaries to a now defunct home health care agency, Good Friends Services. As you might guess, the patient recruiter and the home health agency formed a lucrative friendship that capitalized on trading patients for cash in a healthcare fraud scheme that cost Medicare about $1.6 million.

For about a year-and-a-half, the patient recruiter received kickbacks for every Medicare beneficiary she referred to five different South Florida home health agencies. The Good Friends home health agency alone received more than $600,000 in payments from the government healthcare agency, while the patient recruiter made about $306,800 in kickbacks. The other $1 million paid out by Medicare went to four other home health agencies. In all, the patient recruiter received $710,000 in kickbacks. (That works out to be about $39,444 a month. What a paycheck!)

While it is acceptable in some industries to reward someone who refers business, it is illegal to do so within federal health care programs. After a four-day trial, the 50-year-old from Hialeah was convicted of Medicare fraud and sentenced to more than seven years in prison. Not only can kickbacks cause patients to be referred to a doctor or facility that might not have a patient’s best interest in mind, it can also cause unfair competition. (In the end, fraud causes program costs to increase and the taxpayer has to pick up the tab.)

Some characteristics of a good friend might include honesty, loyalty, transparency, and trustworthiness. Make no mistake, while today’s co-conspirators were friends, they were not honest, transparent or trustworthy, although they were loyal to each other and committed to stealing government benefits they did not deserve. Congratulations to the Medicare Fraud Strike Force for ending this fraudster friendship.

Today’s “Fraud of the Day” is based on a Department of Justice press release, “South Florida Patient Recruiter Sentenced for Role in $1.6 Kickback Scheme,” released on May 8, 2019.

A South Florida patient recruiter was sentenced to 87 months in prison today for her role in a scheme involving approximately $1.6 million in Medicare claims for home health care services that were procured through the payment of kickbacks.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

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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.