Hemorrhaging Money

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New Medicare Card ++First one rejected for Copyright Trademark issues. Please let me know what I need to remove or alter. Is it the DHHS LOGO? Card design curve? Part of number shown? You accept Social Security cards with the same logo. This was accepted in 2018. iStock # 653549364. Just let me know how to get the new card accepted… thanks!++++

Fraudsters are always looking for ways to fraudulently make money off of the Medicare program. A prime example is the president and owner of a wound care supplier who changed data on Medicare claims to inflate payments for his company’s supplies from at least 2011 through 2015. In the process, Alan Trent Harley of Florida defrauded the Medicare program of more than $870,000 through fraudulent claims for Central Medical Systems. (That’s a heck of a lot of gauze!)

His employees provided Harley with accurate data on the type and quantity of wound care supplies provided to patients, but he routinely changed that information in the billing system to jack up the prices before submitting claims to Medicare. A former office manager filed a civil lawsuit against Harley and his company for violating the False Claims Act by billing Medicare for more expensive products than were provided to patients and even for products that were never sent. (Let’s hear it for whistleblowers! Who knows how much more this crook would have stolen.)

After multiple former employees reported that Harley falsified billings, the federal government took over the lawsuit, alleging that Harley billed Medicare for thousands more products that it had purchased. Under the False Claims Act, the government could have recovered triple damages plus civil penalties. (Which would be richly deserved.)

Rather than face a jury, Harley pleaded guilty to wire fraud in December 2020. In March he was sentenced to 15 months in federal prison and ordered to forfeit more than $870,000 traceable to the proceeds of his scheme. 

Today’s Fraud of the Day comes from a press release the U.S. Attorney’s Office for the Middle District of Florida, “Owner Of Central Medical Systems Sentenced to 15 Months for Medicare Billing Fraud,” dated March 26, 2021.

Orlando, Florida – U.S. District Judge Paul G. Byron has sentenced Alan Trent Harley (62, Chuluota) to 15 months in federal prison for wire fraud. The court also ordered Harley to forfeit more than $870,000, which is traceable to proceeds of the offense.

Harley had pleaded guilty on December 4, 2020.

Additional information is from a Capital Gazette article, “Feds pursue civil Medicare fraud charges against Oviedo firm”, dated March 29, 2018.

 

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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.