Home Health & Hospice Week

Fraud & Abuse:

DME SUPPLIER, DOCTOR ARRESTED IN KICKBACK SCAM

It's not just power wheelchair fraud keeping the feds busy in Texas these days. In the latest DME go-round out of the Lone Star State, durable medical equipment supplier Francisco Giron Flores, Jr. and physician Delio Garcia Romeu were arrested May 12 for health care fraud. Flores is the owner and operator of Texas-based DME companies Bedside Medical Equipment and Supplies and CLD Medical Supply. For five years the supplier allegedly paid Dr. Romeu more than $30,000 for signing off on fraudulent certificates of medical necessity for DME including oxygen concentrators, ventilators and hospital beds. But the doc never actually performed any examinations for the CMNs, charges Texas U.S. Attorney Johnny Sutton. Flores allegedly submitted more than 1,600 claims to Medicare for the falsely certified equipment, with requests for reimbursement totaling about $3.7 million. The men face a 33-count indictment -- "one count of conspiracy to commit health care fraud, 30 counts of making false claims for payment to Medicare and two counts of illegal remunerations," Sutton notes. The supplier and physician could face up to five years'imprisonment on each count, according to Sutton. The Federal Bureau of Investigation conducted the investigation.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.