Health Care Fraud — Billing Schemes

This week three cases involving the fraudulent billing of Medicare for services or supplies that were never provided illustrate that Medicare Fraud is pervasive nationwide.

In Louisville, Kentucky authorities are tracking down Rodolfo Bouza owner of Newberg Services Inc., for fraudulently billing Medicare for $750,000 for bandages and durable medical equipment that were never produced.  In court documents Bouza’s scheme allegedly started in Miami, Florida and spread nation wide.

In Kittery, Maine Peter Ensinger was convicted for billing Medicare and other insurance companies for products that were never delivered to the patients, billing for more expensive products than the product that was actually delivered, and for continuing to bill for the product after the patient had returned the equipment.

In Humble, Texas Lula Thurman pleaded guilty to bilking Medicare and Medicaid of $483,833 by utilizing special modifier codes established for replacing medical equipment lost or damaged during a catastrophe or disaster such as Hurricane Katrina.  Thurman, owner of LT’s Faith-N-Action provided her customers new wheelchairs utilizing this code even though the customers did not qualify to receive the equipment under that code.

Posted in Health Care Fraud, Medicaid Fraud, Medical Billing Fraud, Medical Devices, Medicare FraudNo Comments

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