Medicare Compliance & Reimbursement
DOJ Circles Fraud Ring, Prison Possible For Leader
Just because a real physician wrote the prescription doesn't make it any less fraudulent, especially if the doctor receives kickbacks.
The Department of Justice filed several charges against Patricia Garcia of Miami-Dade County, FL for paying illegal kickbacks and defrauding Medicare, according to an April 15 press release.
These charges are connected with the DOJ's investigation of local assisted-living facilities, medical equipment companies, pharmacies and physicians purportedly involved in a huge kickback network.
Garcia and her family members operated several medical equipment companies and a pharmacy in Miami-Dade County. Garcia and her co-conspirators allegedly submitted claims for unnecessary respiratory equipment and medications, returning kickback payments to Medicare beneficiaries who agreed to allow the group to use their Medicare numbers. The group also paid kickbacks to physicians who wrote the fraudulent prescriptions, the DOJ alleges.
Garcia also purportedly paid illegal kickbacks to medical equipment owners for their patient referrals to her pharmacy, Diana Pharmacy Discount, Inc. From January 1999 to April 2004, Garcia and her co-conspirators allegedly paid medical equipment owners more than $2.2 million in kickbacks and defrauded Medicare for more than $1 million.
Outcome: If convicted on these charges, Garcia could face up to 10 years imprisonment. To date, courts have convicted 21 conspirators on Medicare fraud and kickback charges in connection with this case.
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