Investigations Newsletter: DOJ Charges Telemedicine Owner With $784 Million Fraud Scheme

Arent Fox
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A Florida owner of telemedicine companies is charged with orchestrating a health care fraud and illegal kickback scheme that involved the submission of over $784 million in false Medicare claims.

Friday Enforcement Wrap

DOJ Charges Telemedicine Owner With $784 Million Fraud Scheme

A Florida owner of telemedicine companies is charged with orchestrating a health care fraud and illegal kickback scheme that involved the submission of over $784 million in false Medicare claims. According to the superseding indictment, the defendant and his co-conspirators solicited illegal kickbacks and bribes from durable medical equipment suppliers and marketers in exchange for orders of braces and medications. The unnecessary and fraudulent orders for the braces and medications cost Medicare over $784 million.
 
In the superseding indictment, the defendant is charged with one count of conspiracy to commit health care fraud and wire fraud and four counts of income tax evasion. The defendant and co-conspirators were previously charged with one count of conspiracy to defraud the United States and to pay and receive kickbacks, four counts of receipt of kickbacks, and one count of conspiracy to commit money laundering. If found guilty, the defendant may face a maximum penalty of 20 years imprisonment for the conspiracy to commit health care fraud and wire fraud, five years imprisonment on each count of tax evasion, five years imprisonment for the conspiracy to defraud the United States, and pay and receive kickbacks, ten years’ imprisonment for each count of receipt of kickbacks, and 20 years imprisonment on the conspiracy to commit money laundering.
 
Read the DOJ press release here.

Guilty Pleas Trickle in At Start of $3.9 Million Fraud Trial Against Former NFL Players

Former Baltimore Ravens linebacker, Robert McCune, pled guilty to twelve counts of health care fraud, ten counts of wire fraud, three counts of aggravated identity theft, and one count of conspiracy at the start of his trial, along with two other former NFL players, while two of his co-defendants, Clinton Portis and Tamarick Vanover, are proceeding to trial.

McCune is one of ten former NFL players to quickly plead guilty to participating in a scheme to seek fraudulent reimbursements from the Gene Upshaw NFL Health Reimbursement Account Plan for unneeded medical items, such as a $57,000 cryotherapy machine, which allegedly totaled $3.9 million. Former NFL players that have pled guilty and are due to be sentenced in October include John Eubanks, Antwan Odom, James Butler, Anthony Montgomery, Frederick Bennett, Darrell Reid, Etric Pruitt, and Correll Buckhalter.

Charges against the ex-players were initially launched in December 2019 and additional ex-players were added to the case in July 2020. McCune’s trial was originally scheduled for November 2020, but was pushed back due to concerns over the coronavirus.

The case is United States v. McCune, et al., No. 5:19-cr-00206 (E.D.Ky).

New York Attorneys Charged For Trip-and-Fall Schemes

On August 25, 2021, two New York City area lawyers and two doctors, an orthopedic surgeon and pain management doctor, were charged in a six-count indictment for fraud and conspiracy related to trip-and-fall schemes that they allegedly orchestrated. The charges are related to the same series of events from 2018 that already landed three other men in prison.

According to US Attorney Audrey Strauss, the men worked with recruiters to find impoverished people who were willing to stage falls and agree to unnecessary medical procedures in exchange for payouts. The lawyers then filed fraudulent lawsuits while the doctors recommended surgeries and procedures for patients who joined the scam. The trip-and-fall fraud schemes allegedly netted $31 million dollars over a five year period.

The case is United States v. Constantine, et al., No. 21-cr-530 (S.D.N.Y.).

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