Double Dose

90

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.

Read More

SHARE
Previous articleMoney Doesn’t Grow on Trees
Next articleSome Fraudsters Never Learn

Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.