The amount of money that the federal government is pouring into health care offers a tempting target for persons inclined to use fraud to steal it. The Congress has created a number of crimes that impose heavy penalties on anyone convicted of such a crime. The acting United States Attorney for the District of New Jersey Rachel Honig has recently used these laws to provide a legal basis for the arrest of eight men alleged to have violated one or more of these statutes.
Two of the men are from Toms River, N.J., and they have been charged with conspiracy to commit health care fraud. Four of the men are alleged to have operated in Florida, and they have also been charged with conspiracy to commit health care fraud. Several of the men have also been charged with a conspiracy to violate the federal Anti-Kickback statute.
The defendants are alleged to have committed health care fraud that caused losses to Medicare, TRICARE and CHAMP/VA of nearly $93,000,000. One of the eight suspects has pleaded guilty to conspiracy to commit health care fraud and violate the Anti-Kickback; a second suspect pleaded guilty to conspiracy to engage in money laundering. The sentencing for both men is set for August 31, 2021.
United States Attorney Honig described the details of the scheme used by the eight men to allegedly embezzle money from the various health care agencies. Each man had a separate role as the suspects are alleged to have offered bribes and received kickbacks in the process of obtaining completed doctors’ orders for durable medical equipment, such as orthotic braces. The doctors’ orders were then submitted to the federal agencies as requests for reimbursement.
The six defendants who have not pleaded guilty to any charges pending against them are facing significant prison terms and fines if they are convicted. Anyone who faces similar charges may wish to consult an attorney with experience in defending federal criminal charges. A capable defense attorney can evaluate the evidence, suggest legal arguments and defense strategies and, when appropriate, negotiate an acceptable plea agreement with the prosecution.