MASSDEVICE ON CALL — A federal grand jury indicted 10 individuals related to 2 schemes to defraud Medicare that cost the health care program more than $2 million in false claims for durable medical equipment.
Husband and wife Gilberto Gómez and Yolanda García-Rodríguez were accused of using 3 different companies to submit false claims, purchasing each new company as the prior was placed in pre-payment status by Medicare.
The duo allegedly submitted more than 1,500 false claims under Monte Mar Health Corp., of which Gomez was president, from about Nov. 2008 to May 2010, costing Medicare more than $1.4 million, according to the Dept. of Health & Human Services release.
When Monte Mar landed in pre-payment status the defendants purchased Promeds, through which they submitted at least 359 bad claims, and when that turned sour they purchased Quality, through which they submitted at least 115 false claims, according to HHS.
Through the 3 companies, Gómez and García-Rodríguez allegedly filed more than $4 million in false claims, costing Medicare about $2 million.
The health agency also indicted Dr. Francisco Garrastegui on grounds that he signed and completed false progress notes, prescriptions and other documents related to the claims in exchange for kickbacks. 3 independent sales coordinators and one billing director were also included in the 39-count indictment for their participation in creating and submitting false claims.
The government seeks to forfeit two bank accounts, one investment account, and a condominium located in San Juan, Puerto Rico, according to the release.
The second indictment was handed to 4 individuals involved with Preferred Medical Equipment for at least 95 fraudulent claims for medical equipment, including power wheelchairs, power pressure reducing air mattresses, wheelchair accessories, lumbar-sacral orthosis, knee orthosis and hospital beds.
Dr. Garrastegu and 3 of the independent sales coordinators accused in the first scheme were also indicted as part of the second scheme.
The claims amounted to about $210,000, costing Medicare around $108,000. The government is seeking to reclaim the Medicare funds dispersed as well as one bank account, according to the release.
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