You are only as good as your team. Trust, collaboration and shared goals, fostered by team loyalty, ensures success and financial gain for businesses and collaborations alike. Unless it involves fraud…because there is no loyalty when it comes to fraud. On November 27, 2024, Luis Lacerda was sentenced to three and half years in prison for his role as ringleader of a multiple state Medicare fraud scheme, a much lesser sentence than the recommended 10-year prison term for a scheme that size. But Lacerda provided substantial evidence that allowed investigators to build cases against more than 20 suspected fraud operators from Miami to Detroit. And in tattling to investigators of his fellow fraudster’s crimes, Lacerda received some leniency. But the lessening of his punishment doesn’t take away from the fact that he stole $54.3 million from the U.S. taxpayer.
Between 2019 and 2021, Lacerda operated a telemarketing call center that recruited Medicare beneficiaries to accept prescriptions for various topical medications which the beneficiaries did not want or need. He then paid kickbacks and bribes to telemedicine companies that contracted with physicians to sign the prescriptions without examining the patients in person. If they had, they would have realized that the patient had no need for anti-fungal ointment.
With those signed prescriptions, Luis Lacerda filed almost 140,000 fraudulent claims for Medicare reimbursement from pharmacies located in New York, Michigan, Indiana and Tennessee. No coincidence, Lacerda was a part owner in many of the pharmacies, which allowed him to recycle the prescriptions at each pharmacy. Many patients received 50, 80, even 120 prescriptions they didn’t need.
Excellent job by the U.S. Department of Health and Human Services – Office of Inspector General and the Federal Bureau of Investigation.
Today’s Fraud of The Day is based on article “Facing prison, pharmacy ring helps feds in Jacksonville fight $250 million in Medicare fraud” published by the Florida Times-Union on November 27, 2024.
Four men have landed reduced sentences for their parts in an eight-state Medicare fraud ring after helping authorities uncover other fraudsters blamed for cheating the government out of about $250 million.
“There aren’t many comparable cases like this,” Assistant U.S. Attorney David Mesrobian told Chief U.S. District Judge Timothy Corrigan during a hearing Tuesday in Jacksonville’s federal court. The men will serve sentences ranging from probation to 41 months behind bars and committed to paying restitution toward $54.3 million Medicare paid on swindles of the government health care program at businesses including the now-defunct Cure Pharmacy on Merrill Road in Arlington.
