Florida Siblings Face Federal Health Care Fraud Charges in Scheme to Defraud Medicare

Two Florida siblings are facing federal charges related to a scheme to defraud Medicare of millions of dollars. Federal prosecutors say that the siblings owned a Medicare billing company called Grapevine Professional Services, Inc. and used the company to bill Medicare for a reported $25 million in fraudulent claims. According to federal authorities, the pair profited from bogus orders for medical equipment and kickbacks paid by companies they did business with. The two are facing numerous charges including conspiracy to commit healthcare fraud, wire fraud, and conspiracy to violate the Anti-Kickback Statute. If convicted on these charges, they can face up to 20 years in federal prison.

Healthcare fraud is a growing problem in Florida and across the United States. According to the Office of the Inspector General for the U.S. Department of Health and Human Services, federal authorities recovered $3.3 billion in healthcare fraud judgments and settlements. In the same year, the federal government opened 1,000 new cases against defendants accused of healthcare fraud. 800 defendants faced federal charges.

What is healthcare fraud? 

18 U.S. Code Section 1347 defines healthcare fraud as a scheme to knowingly defraud a healthcare benefit program by means of false pretenses, promises, or false representation. Healthcare fraud encompasses a wide range of illegal activities that could be committed by patients, insurers, healthcare providers, and third parties. Examples of healthcare fraud include:

• Billing for services that were never performed
• Falsely diagnosing a patient with a condition, they don’t have to justify surgeries, tests, and other medical procedures
• Falsely representing services performed to obtain payment for services that aren’t covered
• Taking kickbacks for patient referrals
• Billing for more costly services than those that were actually performed
• Waiving copays and deductibles and then over-billing insurers or benefit plans
• Billing patients more than the copay for services that were pre-paid or paid by the insurer
• Offering products that claim to treat or cure a condition when the treatment is not proven safe or effective for those purposes.

Penalties for healthcare fraud in Florida 

A defendant can face a maximum of 10 years in federal prison if they are convicted of healthcare fraud. If a patient suffers a bodily injury due to healthcare fraud, then the sentence is escalated to 20 years. If a patient dies due to healthcare fraud, then the defendant can face a life sentence. In addition, there are other offenses that can be charged along with healthcare fraud. These include:

• Conspiracy to commit healthcare fraud has a potential 20-year sentence
• False Claims Act violations have a maximum 5-year sentence for every violation
• Money laundering has a maximum 10-year sentence
• Wire fraud has a maximum 20-year sentence.

Talk to a Tampa, FL Federal Charges Criminal Defense Attorney Today 

The Matassini Law Firm represents the interests of those facing federal charges in Tampa, FL. Call our Tampa criminal lawyers today to schedule an appointment, and we can begin preparing your defense immediately. Nicholas G. Matassini is Board Certified in Criminal Trial Law by The Florida Bar, the highest recognition of professionalism and trial experience in Florida.

Source:

wptv.com/news/crime/florida-siblings-face-federal-charges-in-multimillion-medicare-scheme