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Brace Yourself

Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

It is not “go big or go home” in the scheming of fraud for Andrew Chmiel. It is “go big AND go to jail.” Because the fraud scheme that Andrew Chmiel was involved in was so large the only alternative to making millions of dollars on behalf of the U.S. taxpayer, inevitably was going to be jail. On March 19, 2024, Chmiel was sentenced to nine years in federal prison for his role in a nearly $100 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary durable medical equipment (DME) orders. There never seems to be a good story about DME’s. Brace yourself. Because Chmiel’s greed is bound to shake up most U.S. taxpayers.

Chmiel controlled and operated ten DME companies. Chmiel used these companies to submit false and fraudulent claims to Medicare for braces that were not medically necessary but also obtained through the payment of kickbacks and bribes. To launch the scheme, Chmiel entered into agreements with an offshore call center to purchase completed doctors’ orders so the DME companies could bill Medicare. This offshore call center solicited through television and internet advertisements. Once a Medicare beneficiary called the 1-800 number that was on the advertisements, that Medicare beneficiary would be screened for eligibility and then convinced that he or she needed a brace, and many times upsold on other braces.

Still didn’t think the brace was necessary? You were going to get it anyway.

With the Medicare beneficiary’s information, the call center would then contact a telemedicine company whose physician or nurse practitioner would issue a prescription without regard to the medical necessity. Any scribble will do to process an order. The signed orders would then be forward to Chmiel who billed Medicare more than $200 million in fraudulent DME claims. Medicare reimbursed Chmiel ‘s companies $98,935,533.00. Which Chmiel is supposed to return as restitution.

Kudos to the F.B.I for this investigation.

Today’s Fraud of The Day is based on article “SC man sentenced to 9 years in prison for massive Medicare fraud” published by Post and Courier on March 19, 2024

A Mount Pleasant man was sentenced March 19 to nine years in federal prison for his role in a massive Medicare fraud scheme and must pay around $95 million in restitution.

Andrew Chmiel was singled out as a central figure in the international telemedicine scam, which drained U.S. taxpayers of more than $1 billion by billing for unnecessary back, shoulder, wrist and knee braces. The government sting, called “Operation Brace Yourself,” started in South Carolina, but soon spread across the country and eventually to Asia.

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