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A Wolf in Sheep's Clothing

A Wolf in Sheep's Clothing

Healthcare-Medicare-6
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Telehealth has become a very important and viable way for patients to receive medical care and advice, especially in light of the current global pandemic. (And, as you might guess, where there’s a new technology that helps to provide service to government beneficiaries, there’s some fraudster, somewhere, who is eager to take advantage of a platform meant to help citizens.)

A Florida man has been sentenced for his role in a telemedicine fraud scheme that cost Medicare millions of dollars. Patrick Wolfe, 48, of Belleair Beach, Fla., has been sentenced to federal prison for participating in a healthcare bribery conspiracy.

Wolfe owned and operated durable medical equipment (DME) company Wilmington Island Medical Inc., which operated as WI Medical Inc., during the time of the Medicare fraud scheme. He admitted to paying kickbacks in return for DME orders from physicians and nurse practitioners. (It turns out that he was a Wolfe in sheep’s clothing.)

Using WI Medical Inc., Wolfe would bill the fraudulent orders to Medicare Part B and Medicare Part C. This scheme defrauded Medicare out of millions of dollars by fraudulently asserting that his company was truly fulfilling medical equipment orders for Medicare beneficiaries. (He used the ill-gotten gains to fund some joy rides in his Maserati.)

The Medicare beneficiaries, whose identities were illegally used as part of this illegal scheme, were primarily located in the Southern District of Georgia. (Fraudsters are no longer limited to scheming in their own neck of the woods. Now they can scheme virtually anywhere, at any time.) Wolfe’s case is the latest in a series of investigations into fraudulent healthcare practices throughout the Southern District of Georgia.

The prosecution of this case was a result of “Operation Brace Yourself” and “Operation Double Helix” investigations which revealed fraudulent billing and kickback schemes being carried out by similar DME companies. (You have to credit the government for their ingenuity in choosing cool operation names.)

The Southern District of Georgia has now charged 31 individuals and companies as part of the crackdown on fraudulent prescriptions for orthotic braces and pain creams. In the past year, more than $1.5 billion in losses to Medicare and Medicaid for defendants were charged in the Southern District of Georgia alone. (This may make Wolfe’s fraud seem like a penny in the well, but every fraudster caught is money back in the pockets of taxpayers.)

Wolfe was sentenced to two years in prison after pleading guilty to one count of conspiracy and was also ordered to pay $549,476.17 in restitution. He must also serve three years of supervised release after completion of his prison term.

If you are aware of any fraud or kickbacks relating to telemedicine, including COVID-19 fraud, please call the FBI hotline at 1-800-CALL-FBI.

Today’s Fraud of the Day comes from an article, “DOJ: Operator of Wilmington Island medical company pleads guilty in Medicare scheme,” published by MSN on February 12, 2021.

A Wilmington Island business operator who ran a durable medical equipment company has been sentenced to federal prison for participating in a commercial bribery conspiracy that involved a health care program, the U.S. Dept. of Justice said Friday.

According to the DOJ, 48-year-old Patrick Wolfe of Belleair Beach, Fla., the operator of Wilmington Island Medical Inc., which does business as WI Medical Inc., was sentenced to 24 months in prison by U.S. District Court Judge William T. Moore Jr. after pleading guilty to one count of conspiracy.

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