The owner and operator of a durable medical equipment (DME) supply company was sentenced today to serve five years in prison in connection with a health care fraud scheme involving Latay Medical Services, a DME company based in Gardena, California. In addition to her prison term, the owner was sentenced to serve three years of supervised release and ordered to pay $4,555,198 in restitution.
On March 1, 2013, the owner and operator was convicted by a jury in federal court in Los Angeles of one count of conspiracy to commit health care fraud and 12 counts of health care fraud. During trial, the evidence showed that the former owner and operator of Latay fraudulently billed millions of dollars to Medicare for DME that was either never provided to its Medicare beneficiaries or was not medically necessary.
The trial evidence showed that between January 2005 and October 2009, the owner paid cash kickbacks for fraudulent prescriptions for DME, such as power wheelchairs and hospital beds. The evidence at trial showed that a co-conspirator physician wrote prescriptions for power wheelchairs and other DME that the Medicare beneficiaries did not need and ultimately never used. The co-conspirator physician testified that the DME owner paid him cash kickbacks for every fraudulent prescription that he wrote for the DME and that she used his prescriptions to bill Medicare for the power wheelchairs and other DME. Several Medicare beneficiaries testified that they were lured to medical clinics with the promise of a free recliner sofa, only to receive power wheelchairs that they did not need and did not want. According to the testimony, the beneficiaries were unsuccessful in their attempts to reject delivery of the power wheelchairs from the supply company.
In addition, the trial evidence showed that the owner of Latay billed Medicare for DME supposedly provided and delivered to Medicare beneficiaries who were deceased at the time of service. One particular claim that she submitted to Medicare showed that the Medicare beneficiary’s death preceded the date the Medicare beneficiary supposedly signed for the service.
As a result of this fraud scheme, the owner submitted and caused the submission of over $8.4 million in false and fraudulent claims to Medicare, and received over $4.5 million on those claims.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
See the DOJ Announcement