Guadalupe County man arrested in $1.2 billion Medicare scam

Federal agents take part in arrests Tuesday in New York City

In its complaint, the DOJ alleges the defendants were involved in a "complex, multi-layered" scheme of illegal kickbacks and bribes by medical equipment companies in exchange for the referral of Medicare beneficiaries by physicians working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces that are medically unnecessary.

Operation Brace Yourself spanned 20 Federal Bureau of Investigation offices and involved the Department of Health and Human Services inspector general and Internal Revenue Service. Others charged include owners of telemedicine firms and medical equipment companies.

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The defendants allegedly paid doctors to prescribe the braces without meeting patients.

"This Department of Justice will not tolerate medical professionals and executives who look to line their pockets by cheating our health care programs", Benczkowski added.

The largest Medicare fraud scheme in the history of the Federal Bureau of Investigation originated in South Carolina and involves telemarkerers peddling medical braces, worldwide call centers, and kickbacks for those who participated in the United States to the tune of almost $1 billion, U.S. Attorney in South Carolina Sherri Lydon said. Interested beneficiaries would be patched through to call centers, part of what officials described as an "international telemarketing network" with operations in the Philippines and throughout Latin America.

The global call center allegedly paid illegal kickbacks and bribes to telemedicine companies to obtain DME orders for these Medicare beneficiaries.

One of the five telemedicine companies involved, AffordADoc-named alongside Video Doctor USA, Web Doctors Plus, Integrated Support Plus and First Care MD-produced a YouTube video explaining how doctors in its network could supplement their income by $15,000 a month while performing consultations from home or over the phone and internet.

Investigators say that proceeds of the scheme were laundered through worldwide shell corporations, then used to buy luxury cars, yachts, and real estate for members of the fraud ring. "The conspiracy.details broad corruption, massive amounts of greed and systemic flaws in our health care system that were exploited by the defendants".

In addition, the Center for Medicare Services Center for Program Integrity (CMS/CPI) administrative action against 130 DME companies that received more than $900 million after submitting over $1.7 billion in claims, Carpenito said.

"The mammoth coordination and cooperation demonstrated among the various offices, districts, and agencies involved in this case leaves no doubt".

The accused "concocted an elaborate scheme to exploit the US health care system by targeting Medicare beneficiaries, paying doctors for prescriptions, paying kickbacks and bribes, and in turn selling these prescriptions to DME companies to ensure that they could line their pockets", IRS special agent Matthew Line said, according to Tut Underwood of South Carolina Public Radio.

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