Everyone who has ever spent time waiting on line in a post office knows that the FBI has a “10 Most Wanted List.” Lots of smaller agencies have their own most wanted list too. So it was only a matter of time before the Inspector General of the U.S. Department of Health and Human Services got in the act. Want to know who is wanted for Medicare fraud? Just visit the OIG’s website.
Short for the Office of Inspector General, the OIG is Medicare’s law enforcement team. We call them the Medicare cops although they generally team up with the FBI when chasing down healthcare bandits.
Medicare fraud has become a serious problem in the United States. Each year the taxpayer funded insurance program loses billions of dollars to fraud. Sometimes patients, such as those seeking to get narcotic painkillers, commit the fraud. The real money, however, lies in the frauds committed by healthcare providers… hospitals, clinics, doctors, ambulance companies, pharmacies and home health agencies. It seems like everyone is doing it.
So who are the most sought after Medicare fraud fugitives? Here is a small sampling:
The feds claim this loser and his wife operated a durable medical equipment company in Hicksville, New York. Allonce and his wife allegedly had employees sneak into nursing homes and steal medical chart information. The company would then bill Medicare under the names of patients whose identity information was stolen.
Allonce’s wife Helene Michel was convicted and sentenced to 12 years in prison but Allonce fled leaving his young daughter behind and homeless (Mom was already in jail).
Taxpayers were left footing a $4.4 million Medicare tab.
SANDY DE LA FE
De La Fe was owner of a discount pharmacy in Miami, the undisputed ground zero for Medicare fraud. Prosecutors say that he devised an elaborate scheme to get Medicare recipients to obtain prescriptions for expensive pharmaceuticals. He then billed Medicare millions for drugs that were never necessary and often not even dispensed.
De La Fe is believed to hiding in Cuba, a country without a U.S. extradition treaty.
Elrington has been wanted since 2013. Prosecutors say that he billed both Medicaid and Medicare for services that were either medically unnecessary or never performed. Worse, he employed an unlicensed “physician” to treat patients at his Detroit area clinic (another Medicare fraud hotspot).
Erlington’s unlicensed doc conducted pelvic exams on female patients earning him a first-degree sexual misconduct charge. Patients are assaulted and the clinic gets paid for it… by taxpayers, of course.
Feds say this coward fled literally hours after being interviewed.
The list goes on and on. The above cases are just a small sample. Sadly in some of the cases, patients were subjected to unnecessary and potentially painful treatment. A so-called doctor not even licensed to practice medicine sexually assaulted at least one patient.
Most Medicare fraud cases come to light through the actions of whistleblowers; ordinary healthcare workers who become heroes and stop fraud. Under the federal False Claims Act, whistleblowers can keep a portion of whatever is collected by the government from wrongdoers. (Most are caught but as this story points out, some cowards try to run and hide.)
Typically whistleblowers earn between 15 and 20% of whatever the government collects. Picking up a phone and dialing the Medicare fraud hotline doesn’t get you an award, however. To be eligible for an award, whistleblowers must have original source (inside) information about a fraud involving government funded healthcare. That information is then condensed into a lawsuit filed under seal (in secret) in a federal court.
Last year whistleblowers received $635 million from the federal government. Much of that was from Medicare fraud cases. Our clients alone received over $100 million.
Think you have what it takes to be a hero? Give us a call. All inquiries protected by the attorney – client privilege and kept strictly confidential. We won’t file a lawsuit until you are ready and comfortable. We also pre-screen our cases with the Justice Department prior to filing so you have a better picture of the merits and probabilities for success.
MahanyLaw – America’s Whistleblower Lawyers