Home Health Fraud & Kickbacks

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Shot of a young nurse caring for a senior man in a retirement home

Four Los Angeles-area residents went from running healthcare businesses to serving time behind bars for their roles in a healthcare fraud scheme that stole at least $22 million from Medicare.

A 43-year-old woman and a 61-year-old man were the owners and operators of Fifth Avenue Home Health. (Just so you know, this was nowhere near the infamous Fifth Avenue.) They pleaded guilty to conspiring with two others to fraudulently bill Medicare for services that either weren’t rendered or were not medically necessary, and for paying their co-defendants and others for illegal kickbacks to send business their way.

The pair each pleaded guilty to one charge of conspiracy to commit healthcare fraud. The woman is serving a 10-year prison sentence and the man is serving 6 ½ years in prison. Both were ordered to pay $4.3 million each in restitution and forfeit multiple properties. (Ouch! That’s a lot of kickbacks.)

The pair they conspired with – a 73-year-old man, who owned a healthcare clinic, and a 62-year-old woman, also from the L.A. area – were convicted of healthcare fraud by a jury. According to testimony, the four recruited Medicare patients to the man’s clinic for the purpose of billing Medicare for false claims. They submitted false claims for home health, diagnostic testing and durable medical equipment. (The other two fraudsters got the hint to plead guilty rather than face trial.) 

Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. (That means the risk of getting arrested for Medicare fraud is pretty high, so don’t even try it.)

Today’s Fraud of the Day is based on an article, “L.A. doctor and a conspirator are found guilty in $22-million Medicare scam,” published by the Los Angeles Times on June 7, 2019.

A doctor and a woman who recruited patients to his Los Angeles clinic were found guilty Friday of healthcare fraud for their roles in a scheme that swindled Medicare out of $22 million.

At the conclusion of a seven-day trial, federal jurors found Robert Glazer, 73, who owned Glazer Clinic, guilty of a count of conspiracy to commit healthcare fraud and 12 counts of healthcare fraud. Marina Merino, 62, who recruited patients as part of the scam, was convicted of a count of conspiracy to commit healthcare fraud and eight counts of healthcare fraud, according to federal prosecutors.

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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.