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Always Be Closing

Healthcare-8
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

The ABC of business success – Always Be Closing. A strategy that emphasizes the importance of fully focusing on the deal. Covering all bases to ensure that no time or effort is wasted on activities that won’t lead to success. It is a strategy that Jeffrey Brooks took to heart in his $30 million Medicare claim scheme. Brooks covered all his bases.

A successful Medical Equipment (DME) Supplier needs two things, besides a brace, in order to process a claim with Medicare. Medicare information from the patient and a DME order from the doctor. Brooks owned and operated eight DME companies and was ready to fraud. And he knew how to get the patients and the doctors’ orders. Brooks was the master of Always Be Closing. Beginning around May of 2019, Brooks started submitting fraudulent claims to Medicare for DME orders using Medicare beneficiaries that were obtained from third party call centers. These third-party call centers obtained and sold personal identifying information about Medicare recipients. It is a business which Brooks happened to own.

Brooks didn’t own the doctors’ practices or telehealth business that would provide the DNE orders. Technically he didn’t own them. He just paid illegal kickbacks and bribes to the doctors for the orders. Brooks billed more than $29 million fraudulent claims to Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs. An amount that seems insignificant to the hardship for those whose Medicare information was compromised. Medical identity theft not only wastes taxpayer dollars. It will disrupt the victim’s medical care.

Great by the Health and Human Services Department.

Today’s Fraud of The Day is based on article “The owner of a Greenville, South Carolina, company created bogus doctors’ orders using medical information bought from call centers to bilk Medicare for millions, officials said” published by WYFF News on January 18, 2024

The office of Adair Ford Boroughs, the U.S. Attorney for South Carolina, said Thursday that Jeffrey Brooks, 40, of New York, was sentenced to more than seven years in federal prison after pleading guilty to one count of conspiracy to commit health care fraud.

Brooks also paid $850,000 last year in a civil settlement to resolve allegations that he provided kickbacks and caused false claims to be submitted in violation of the federal False Claims Act.

Officials said during the conspiracy, Brooks was the owner of a call center in Greenville, South Carolina, that purchased personally identifiable information of Medicare patients.

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