The Nerve of Them


Fraudsters have some nerve to think that they can steal from government health care programs and get away with it. A Detroit-area doctor and owner of a medical billing company were quite confident in their abilities to steal $28 million from Medicare, but fortunately their attempts were blocked by the Medicare Fraud Strike Force.

Over six years, the doctor and his medical billing company fraudulently billed for services such as nerve block injections, which treat pain by numbing groups of nerves. (But the services billed were fraudulent. They were never provided.) Medicare was suspicious of the practice ‘s bills and required the doctor to satisfy a medical review prior to payment. (It ‘s no surprise that the doctor and his billing company got around that parameter.)

The doctor and his billing company created fake medical centers to throw government investigators off their path. They recruited family members and employees to act as “straw owners” and they continued to receive Medicare payments for bogus services.

After a four-week jury trial, the 41-year-old doctor and the 61-year-old medical billing company owner were both found guilty on one count of conspiracy to commit health care and wire fraud and three counts of health care fraud.

As these two criminals await their sentencing, it ‘s a good bet that they are nervous about the possible ramifications of their illegal actions. Congratulations to the Medicare Strike Force for making sure that there will be no way possible to block the pain they will feel once their future is revealed.

Source: Today’s “Fraud of the Day” is based on an article entitled, “Jury Convicts 2 Over $28M Medicare Pain Treatment Fraud,” posted on on May 1, 2017.

Law360, New York (May 1, 2017, 5:42 PM EDT) — A Michigan federal jury on Friday found a Detroit-area doctor and the owner of a medical billing company guilty of perpetrating a $28 million health care fraud that involved billing Medicare for pain treatments that weren’t actually provided, the U.S. Department of Justice said.

Dr. Johnny Trotter, 41, of Oakland County, Michigan, and Elaine Lovett, 61, of Detroit, were each convicted after a four-week jury trial on one count of conspiracy to commit health care and wire fraud and three counts of health care fraud. In addition to the overarching scheme, Trotter and Lovett also worked to dodge Medicare’s investigation into Trotter, the DOJ said.

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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.