Fraudsters are always going to continuously find new ways to scheme. But sometimes they need another fraudster to get that scheme to the next level. Many times it takes a fraudster to find the fraudster to get the scheme to the next level, like Kevin Karl Wills, Jr., the middleman to a multimillion dollar Medicare scheme. Wills and a co-conspirator owned and operated a “consulting” company that joined forces with a “marketing” company whose sole focus was to only obtain Medicare beneficiary identifying information illegally. Clearly a group intent on illicit gains!
Wills arranged and facilitated meetings for the marketers with medical service providers. He bridged agreements where the marketers supplied the providers with lists of Medicare beneficiaries and their identifying information, including the Medicare Beneficiary Identification Numbers (BIN). The key number information for Medicare fraud success. The providers then shipped COVID-19 tests to the identified beneficiaries and billed Medicare for the tests. Upon reimbursement by Medicare, the providers would then pay Wills and the marketers a set dollar amount per beneficiary. However, the providers paid this amount only if a claim submitted on behalf of a beneficiary was reimbursed by Medicare. It’s a kickback…generally considered unethical and definitely illegal under federal law.
Wills received a total of approximately $652,312 in kickbacks, small money for such an integral part in stealing from the U.S. taxpayer. Wills’ place as the middleman caused the submission of approximately 152,00 fraudulent claims to Medicare which resulted in reimbursements from Medicare totaling approximately $14,405,700.
Great job by the Health an Human Services-Office of Inspector General in this case.
Today’s Fraud of The Day is based on article “Fort Lauderdale man pleads guilty in Medicare kickback scheme” published by My Florida News on November 28, 2024.
Kevin Karl Wills Jr., a 48-year-old from Fort Lauderdale, has pleaded guilty to conspiring to receive kickbacks for referring Medicare beneficiaries for COVID-19 tests and trading their identification numbers. He faces up to five years in prison, according to the United States Attorney’s Office.
Wills and a co-conspirator ran a company that engaged marketers to illegally obtain Medicare beneficiary information, stated the plea agreement. They formed “consulting” agreements with medical service providers, introducing marketers who supplied lists of Medicare beneficiaries and their identification numbers. Providers shipped COVID-19 tests to these beneficiaries, billed Medicare, and paid kickbacks to Wills’ company and the marketers, contingent on Medicare reimbursement.
