The cases of prosecutions involving healthcare fraud have been a lot in the news lately. It seems healthcare benefit programs and the beneficiaries are too easy a prey for individuals that engage in these fraudulent practices. However, the law also seems to be vigilant. There are correctly a lot of prosecutions going on and many more waiting for court dates. The reality can be daunting because there seem to be more cases uncovered. We can surmise that many of these fraudulent activities might be going on now unnoticed, costing the healthcare programs large sums of money and cheating beneficiaries out of their money.
Carlos Belone, 37, of Coconut Creek, Florida, was arrested on July, 10th 2020, on allegations of engagement in healthcare-related fraud. According to an announcement by the following parties: Omar Perez Aybar of the U.S. Department of Health and Human Services-Oﬃce of the Inspector General (HHS-OIG), and Special Agent in Charge Kevin Kupperbusch of the Small Business Administration’s Oﬃce of the Inspector General (SBA-OIG), Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Oﬃce; Belone was arrested on allegations that he tried to secure Paycheck Protection Program (PPP) loans. They further stated that these loans were used for fraud schemes targeted at Medicare. The fraudulent schemes intended to defraud Medicare of over $5.6 million. The PPP makes it possible for organizations or small businesses to acquire loans that have maturity rates of two years and an interest rate of one percent. Interest and principal are given if the bodies that requested the loan spend its proceeds on certain things like interest on mortgages, payroll costs, within a set time.
Investigating the case is SBA-OIG, the FBI’s Miami Field Oﬃce, and HHS-OIG. However, the Department of Justice of Justice acknowledged the assistance provided by the U.S. Attorney’s Oﬃce for the Southern District of Florida, the Florida Department of Revenue, IRS Criminal Investigation, and the U.S. Department of Labor’s Oﬃce of Inspector General. Trial Attorney Sara Clingan of the Criminal Division’s Fraud Section will oversee prosecution.
He was formally charged by criminal complaint in the Southern District of Florida with conspiracy to commit healthcare fraud, payment of healthcare kickbacks, wire fraud, and making false statements to a ﬁnancial institution. U.S. Magistrate Judge Lurana S. Snow presided over his initial appearance. Contents of the complaint show that he submitted numerous fraudulent PPP loan applications to financial institutions that are federally insured and SBA-approved lenders in the name of R&S Pharmacy Inc. a company owned by Belone specializing in durable medical equipment.
He submitted these dubious claims to Medicare, for orthotic braces that had no medical relevance, or were provided with misrepresentation. During the investigation, it was uncovered that some of the patients either did not need these orthotic braces, gave no authorization for the use of their Medicare number to have such claims submitted, and never received such braces as claimed by Belone and his co-conspirators.
The complaint went further to outline that Belone submitted fake tax documents and tampered with the financial records of his company; all these done to reinforce the fraudulent PPP loan applications. These fraudulent schemes secured him over $22,000 in PPP loan proceeds. This was followed by payments made or fostering of payments to a company suspected to have helped in supporting the frauds carried out on Medicare. He was reported to have moved up to $12,000 of the PPP loan money to a personal account.
The expenses made by the PPP are part of the relief provided by the Coronavirus Aid Relief and Economic Security (CARES) Act. This Act was enacted by federal law on March 29. The aim is to provide emergency financial assistance to Americans that are adversely affected by the economic effects of the COVID-19 pandemic. The Act authorizes up to $349 billion in forgivable loans to small businesses for job retention and other expenses through the PPP. An additional $300 billion was authorized by Congress in April 2020.
Leading the Medicare Fraud Strike Force is the Fraud Section; it was formed in March 2007. However, agencies like HHS-OIG and HHS Centers for Medicare & Medicaid Services, have displayed joint efforts in combating the instances of these fraudulent practices. Over 4,200 defendants have been charged by the Fraud Section for fraudulent practices that have cost the Medicare program up to $19 billion.
Every legal proceeding requires the right legal representation. When it comes to healthcare fraud, the judgments may appear to be severe, so proper legal counsel is a necessity. The individuals that find themselves in the middle of this legal battle need to immediately secure proper legal help. The wrong legal representation can have repercussions that may outweigh the crime. The Healthcare Fraud Group can assist individuals that are in this situation. Our main aim is to ensure that you are effectively represented in the court of law. Contact us at 888-402-4054 for free consultations.