A court in the United States has convicted two people who own a transport firm on two count charges bothering on participating in health care fraud and creating a strategy that ensured that the United States made a loss of about ten million eight hundred thousand dollars.
The revelation was made in a statement that was jointly signed by Justice Department Criminal Division Assistant Attorney Brian A. Benczkowski, Shawn N. Anderson, Eli S. Miranda, a Special Agent of the Federal Bureau of Investigation, Justin Campbell, a Special Agent of the Internal Revenue Service, and Timothy D. Francesca, a Special Agent of the United States Department of Health and Human Services.
Clifford P. Shoemake was convicted to seventy-one months in prison while Kimblerly Clide was convicted to 63 months. The sitting judge did not stop at convictions alone, he mandated both of them to pay a compensation fee of $10,884,964.69 and also confiscate to the authorities the exact fee they were asked to pay as fine. This conviction was made after they have confessed partaking in health care fraud and partaking in a plot to deal in currencies with earnings from fraudulent activities they have carried out.
The federal government created TRICARE and MEDICARE schemes for better welfare of the citizens of the United States which under some situations compensate contributors for ambulance transportation, health care services that are important, and minor services given to those that are entitled to Medicare treatments with chronic kidney disease which results in the gradual loss of the kidney. In such cases, the use of ambulances is important for the effective transportation of these patients to health care centers. In some cases, they might need to be transferred from one health care center to another for advanced treatment.
An account of their admissions during the trial indicated that for up to four years, they both planned to dupe TRICARE and Medicare by forwarding details for the compensation of medically irrelevant ambulance services that were given to Medicare beneficiaries with chronic kidney disease by GMT. It was acknowledged by the defendants that they were aware of the fact that GMT was conveying patients who were not qualified for the ambulance transportation service under the TRICARE and Medicare guidelines and regulations. The appellants confessed that they knew that the TRICARE AND MEDICARE regulations did not permit them to give ambulance service to some of the patients they were giving ambulance services to. Some of the patients they were carrying with their ambulance were not entitled to it.
The fraud committed saw the accused persons directing employees of GMT to eliminate references indicating that the GMT patients could walk from the internal documents. This was mainly because they were aware that the regulatory agencies would not be providing rebates. They further acknowledged that they were aware of the concerns regarding TRICARE and Medicare billing processes as raised by employees of GMT. Based on the documents provided to the court, the claims worth about $32 million were presented by Medicare over the period in review. This in turn led to payments over $10.8 million paid to GMT illegally.
In addition to that, the appellants also confessed to plot to carry out illegal money deals with the earnings they were expecting from the fraudulent health care scheme they carried out. They confessed to the Judge that the earnings they got from their fraudulent health care schemes they carried out were used for their own personal benefit. Some of the earnings were also used to pay direct tax, rents, and other items.
This matter was probed by Senior lawsuit attorney of the Federal Bureau of Investigation John A. Michelich and litigation lawyer of the Criminal Division Fraud Section, Micheal McCarthy. The matter was charged to court by Marivic David.
The Medicare Fraud Division since its establishment has been able to prosecute more than 4200 appellants who have tried to defraud Medicare of amounts that are equivalent to 19 billion dollars.
Abetting Telemedicine fraud is wrong and has serious consequences according to the law. If you find yourself in a situation where you are accused of Telemedicine fraud or aiding it, the law still presumes you innocent until a court of competent jurisdiction finds you guilty. To defend your constitutional right in court, you need a lawyer. The Healthcare Fraud Group involves the best Defense lawyers that can represent you efficiently in court. Contact us today on 888-402-4054 for any legal assistance you may need.