Double Dose


Doctors usually advise against taking a double dose of medication to catch up when a recommended spoonful, pill or shot has been missed. (Sometimes the side effects of missing a dose can be detrimental to one’s health when the doctor’s orders are not followed.)The owner of two pharmacies in the Miami area used her businesses to claim way more than a double dose – more like an overdose – of Medicare reimbursements she was not entitled to. (One of the side effects of her illegal acts could be prison.)

Fraudsters sometimes use family members to help carry out their scams. The woman at the center of this particular case used her son, who was a pharmacy technician at one of her two pharmacies to assist with paying kickbacks to Medicare beneficiaries. The son’s part involved writing checks to money launderers in order to obtain cash to pay the kickbacks to the Medicare beneficiaries. (The mastermind mom accumulated $16 million in overpayments from Medicare by also writing prescriptions that were medically unnecessary and sometimes never even dispensed to the beneficiaries.)

Both the 54-year-old mother and 29-year-old son pleaded guilty to one count of conspiracy to commit health care fraud in the multi-million-dollar Medicare fraud scheme. (It looks like she’ll be forced to follow the judge’s orders and swallow a bitter pill dispensed by the justice system when sentenced later this Fall.)

Source: Today’s ”Fraud of the Day” is based on a Department of Justice press release entitled, ”Mother and Son Plead Guilty to Orchestrating $16 Million Medicare Fraud Scheme at Two Miami Pharmacies,” released on August 30, 2016.

A mother and son based in Miami each pleaded guilty today to fraud charges for their roles in a $16 million Medicare fraud scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.