A Florida man has been convicted in a Medicare and Medicaid fraud case for allegedly billing over $1.3 billion in false claims to the government-run health care programs. The 50-year-old man’s trial ran for eight weeks and included extensive testimony on the nature of the allegations in the case. He was accused of billing both programs for services that were never provided to patients, were not medically needed or which were provided through kickback payments. The man has not yet been sentenced.
According to the Department of Justice, the case represents the largest single health care fraud scheme it has prosecuted. The man owned multiple assisted living and skilled nursing facilities. Between 1998 and 2016, prosecutors charged that he paid doctors to admit patients to his facilities rather than competing institutions. However, prosecutors say that after the patients were admitted, they often failed to receive necessary care. Many received unnecessary treatments solely for the purposes of billing Medicare and Medicaid, they alleged. The man reportedly made more than $37 million from the false billings and bought personal items, such as luxury cars and expensive watches, with the proceeds of the funds.
Two other people were charged along with the man, but both pleaded guilty. One pleaded guilty to conspiracy to commit health care fraud while the other pleaded guilty to conspiring to violate the anti-kickback law. The man accused of running the scheme was convicted on multiple charges, including conspiracy to defraud the U.S., money laundering and obstruction of justice.
Medicare and Medicaid fraud cases can often entangle many people working at a targeted facility, even if they had little role to play in decision-making. Someone facing investigation or charges for health care fraud can turn to a white-collar crimes defense lawyer to present a strong defense before trial and in court.