Durable Medical Equipment

In Tennessee, a man was sentenced to 23 months in prison and ordered to pay $1.8 million in restitution for his scheme to defraud Medicare. The man controlled a group of durable medical equipment suppliers that billed Medicare for enteral nutrition products for tube-fed patients who were not tube-fed. Enteral supply kits that were not provided were also billed to Medicare to give the appearance that the patients were tube-fed. The man, along with a co-conspirator, recruited friends and family members to open durable medical equipment suppliers in different States in an attempt to avoid detection by Medicare. The nominee owners were paid a percentage of the profits.

In Indiana, a former chiropractor was sentenced to 12 years and 6 months in prison and ordered to pay $1.5 million in restitution for his scheme to defraud the Government. The former chiropractor billed Medicare, Medicaid and private insurers over $1,300 each for medically unnecessary back braces. The braces, which were worth less than $100 each, were distributed to the elderly and the indigent during presentations given at senior centers.

Practitioners

In Michigan, a family practice physician was ordered to pay $194,000 in restitution and fines for mail fraud. The physician prescribed large doses of OxyContin for patients with chronic pain, causing many of the patients to become addicted to the drug. In addition, the physician ignored drug-seeking behavior exhibited by many of his patients. Subsequently, Medicaid and other insurers paid for drugs that were not for a legitimate purpose.

In Ohio, a podiatrist was sentenced to 5 months incarceration, 5 months home detention and ordered to pay $120,000 in restitution for health care fraud. The podiatrist billed Medicare and Medicaid for performing surgical procedures on patients when she actually only provided routine foot care.