Florida man pleads guilty to $42m durable medical equipment and cancer genetic testing fraud on medicare — DOJ

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Swathi D
Swathi D
Swathi is an expert in geopolitical and regulatory compliance matters and contributes regularly to the Regtechtimes.

A Florida man pleaded guilty today to a $42 million fraud on Medicare involving false claims for durable medical equipment (DME) and cancer genetic testing. He also pled guilty to fraudulently obtaining a Paycheck Protection Program (PPP) loan. According to court documents and statements made in court, Chad Monroe, 48, of Tarpon Springs, Florida, conspired with others to submit fraudulent claims for DME.

Key details of the case

Such as knee, wrist, ankle, and back braces — and cancer genetic testing that Medicare beneficiaries did not want or need. Monroe and his co-conspirators opened three DME companies, Maksix Medical Products Inc., Orthotech Atlanta, LLC. 1st Choice Medical Supply LLC, which they used to submit over $26 million in false and fraudulent claims to Medicare, Medicare Advantage plans, and TRICARE.

Moreover, monroe directed co-conspirators to lie on Medicare enrollment documents to hide Monroe’s ownership of and role at the companies. To generate the doctors’ orders for DME and genetic testing, Monroe paid purported telemedicine companies’ illegal kickbacks. Monroe, through his company Health and Life Networking LLC, sold the doctors’ orders for genetic testing to co-conspirator laboratories.

DOJ

Meanwhile, paid him over $15 million in illegal kickbacks. . Monroe also directed a co-conspirator to submit a fraudulent PPP loan for over $30,000 in which he and his co-conspirator lied about, among other things, the ownership of 1st Choice Medical Supply LLC to qualify for the loan. Monroe used the proceeds of the fraud scheme to fund a lavish lifestyle, including by purchasing a 47-foot yacht valued at over $600,000 called “The Rogue Shark,” a Cadillac Escalade.

Enforcement actions and official statements

Other luxury vehicles. In connection with the charges, the government seized the yacht and more than $1 million. Monroe pleaded guilty to one count of conspiracy to commit health care fraud and one count of wire fraud.

A sentencing date has not been set. He faces a maximum penalty of 10 years in prison on the health care fraud conspiracy and 30 years in prison on the wire fraud charge. A federal district court judge will determine any sentence after considering the U.S. For complete details, refer to the official DOJ press release.

Consequently, sentencing Guidelines and other statutory factors. Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division; U.S.

DOJ

Department of Health and Human Services, Office of the Inspector General (HHS-OIG) Special Agent in Charge Isaac M. Bledsoe. Special Agent in Charge Rodney Crawford of the FBI Tampa Field Office; Department of War Office of Inspector General’s Defense Criminal Investigative Services (DCIS) Acting Special Agent in Charge Nakia M. For related coverage, see DOJ’s fraud division, department of agriculture, and USDA OIG uncover nearly $42m in SNAP benefit fraud.

Alexander of the DCIS Southeast Field Office. Acting Special Agent in Charge Charles Miller of the IRS Criminal Investigation (IRS-CI) Florida Field Office made the announcement. HHS-OIG, FBI, DCIS, and IRS-CI investigated the case.

Subsequently, assistant Deputy Chief Catherine Wagner, Deputy Chief D. Keith Clouser, and Trial Attorney Paul J. Koob of the National Fraud Enforcement Division’s Health Care Fraud Section are prosecuting the case. For related coverage, see Cleveland gang members convicted of racketeering, murder, kidnapping, drug trafficking, and firearms offenses — DOJ.

On April 7, the Department of Justice announced the creation of the Fraud Division. The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D.

Vance to eliminate fraud, waste, and abuse within Federal benefit programs. The Department of Justice’s Health Care Fraud Strike Force Program, currently comprised of nine strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion since 2007. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.

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