When it comes to criminal activity, not even the nation’s health programs have been spared as reports of Medicare and Medicaid fraud have led to charges filed against two perpetrators.
Pilar Garcia Lorenzo, the woman behind one of the biggest Medicare scams in history, was convicted by a federal jury for leading the multimillion-dollar plan.
Lorenzo was the founder of Gold Care Home Health Services, Inc. The company processed millions of dollars in fictitious claims to Medicare in 2014 for home health services that never happened, and had not been allowed by legitimate physicians, a press release from the US Attorney for the Middle District of Florida states.
Medicare reimbursed some $2.5 million and around $2 million of the funds raked in by the home care company were laundered via cash transactions by fake shell companies, the Tampa Bay Business Journal reports.
The case was investigated by the Medicare Fraud Strike Force, which look into suspicious activity across nine cities in the country. The strike force has charged over 2,900 people who have illegally billed Medicare for some$10 billion in total.
Lorenzo was found guilty by a jury on October 6, and will face sentencing on January 5. She’s not the only one who’s been found guilty of swindling the federal government through the national health program.
In Missouri, a man named Michael A. Tucker pleaded guilty to the same charges – health care fraud – after investigations revealed that he submitted falsified reports and claimed for more expensive services. Employees at Tucker’s Family Medical Center clinics recorded the correct procedures, but Tucker regularly turned in reports for more complex procedures to both Medicare and Medicaid in order to collect higher fees. The four clinics, located all over the state, have been shut down since, KTTN reports.
Tucker’s case was initially opened by the Missouri Attorney General’s Medicaid Fraud Control Division. He has been sentenced to 366 days in federal prison, and ordered to shell out $54,273 in reimbursements.