Getting the Boot

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15815624 - closeup of medicare enrollment form and pen

When someone “gets the boot,” it typically means that they get dismissed, or kicked out of a job or an establishment. A Bloomfield Hills, Michigan doctor could possibly “get the boot” from the podiatrist profession when sentenced for Medicare fraud. Ironically, because he unnecessarily prescribed “Unna Boots” for his patients and asked the government to pick up the tab, he’s limping toward his court date with a fraud conviction as his Achilles heel.

Here’s what you need to know about an Unna Boot. It is a type of gauze bandage that can treat conditions such as ulcers caused by diabetes, and it can also support sprains and strains of the foot, ankle and lower leg. It contains a mixture of medical ointment that promotes healing to the injured area and prevents swelling in the leg or foot.

For more than seven years, the Detroit-area podiatrist ran a fraud scheme that involved submitting false and fraudulent claims for Unna Boots. (The doctor submitted applications to Medicare for this type of dressing, when he knew that his patients routinely received nothing more than a dressing without the medical ointment.)

The foot specialist billed Medicare for more than $1 million in services that were never rendered and bandages that were never used. (I’m guessing the charges were for many times worth the actual cost of the bandage, like hundreds of dollars for a bandage that may cost $10.) As a result of his illegal billing practices, the 70-year-old podiatrist pleaded guilty to one count of healthcare fraud and is scheduled to be sentenced.

This case was investigated by the Federal Bureau of Investigation and the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). The investigation was initiated as part of the Medicare Fraud Strike Force, which is a joint initiative between the Department of Justice and HHS. The Medicare Strike Force has charged over 3,500 defendants and “given the boot” to many who have collectively falsely billed the government healthcare program for more than $12.5 billion. It looks like today’s fraudster has been added to their long list of successful prosecutions and convictions.

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, Detroit-Area Podiatrist Pleads Guilty to Health Care Fraud,” released on January 24, 2018.

A Detroit-area podiatrist pleaded guilty today to health care fraud for his participation in a $1 million scheme involving podiatry services that were never rendered.

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.

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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.