False claims related to Medicare continue to be prevalent in the health care industry. Consider the recent case of three business owners – two from Texas and the other from Florida – who face prison on federal charges stemming from allegations that they sought to defraud Medicare of $14.5 million.
Two of the defendants – owners of medical equipment companies and pharmacies – allegedly conspired with the third defendant, a Texas owner of telemarketing firms. The first two men allegedly paid kickbacks to the telemarketing owner in exchange for signed medical orders for back, knee and hip braces that were medically unnecessary for Medicare beneficiaries.
Health care fraud, identity theft and kickbacks
The trio face a future trial after a federal grand jury indicted them in December in U.S. District Court for the Western District of Texas. Between them, they face 22 counts of federal charges related to health care fraud, identity theft and kickbacks.
The alleged scheme occurred from August 2020 through November 2021. Medicare wound up paying the $7 million of the $14.5 million in claims.
The pharmacy companies owned by defendants Kuba Zarobkiewicz of San Antonio and Anthony Fermin of Boca Raton, Florida, were registered Medicare providers. The two business owners agreed to provide kickbacks to defendant Farrukh Mirza of Richmond, Texas, and his telemarketing companies for providing physician-signed prescriptions for orthotics products.
Accepting unnecessary medical products
Under the scheme, telemarketing employees called Medicare beneficiaries, attempting to obtain their benefits identification number, while encouraging them to receive a “free” brace product. After that, the telemarketers tried to link up the Medicare beneficiary with a physician.
The doctors would talk to each beneficiary and later write prescriptions for a brace product even though in many cases the braces were unnecessary. Some beneficiaries even received braces without having spoken with a physician.
Fraud taints the health care industry
Health care executives and professionals must continue to focus on integrity to build strong relationships with patients and communities. Medicare fraud taints these professionals and the health care industry.