Medicare Compliance & Reimbursement

Enforcement:

Don't Let Networking Weave A Tangled Web

Watch for tactics that build provider alliances-but sabotage compliance

The owner of several Miami, FL durable medical equipment companies reportedly had an extensive set of connections - but he may have overstepped the law to get them.

Prosecutors charged Alberto Bengochea Feb. 15 for involvement in a kickback network involving local assisted living facilities, medical equipment companies, pharmacies and physicians.

Marcos Daniel Jimnez, U.S. Attorney for the Southern District of Florida, says for six years Bengochea paid 230 Medicare beneficiaries between $100 and $150 per month. In return, the beneficiaries agreed to let him use their Medicare numbers to bill unnecessary respiratory equipment and related medications. Patients and physicians involved in the scheme allegedly received more than $1.5 million in kickbacks. Meanwhile, Bengochea pocketed more than $3.9 million from Medicare, Jimnez said.

Bengochea was also reportedly involved in a second scheme in which he paid more than $2.5 million to medical equipment owners for their patient referrals to his pharmacies.

If convicted, Bengochea could serve 10 years in jail and pay an unspecified amount of fines and restitution.

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