Posted on 02/05/2020 5:43:30 PM PST by ransomnote
The owners of two telemedicine companies were charged in an indictment unsealed yesterday for allegedly orchestrating a nationwide scheme to receive kickbacks and bribes in exchange for the ordering of medically unnecessary orthotic braces (braces) for beneficiaries of Medicare.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, First Assistant U.S. Attorney Rachael Honig of the District of New Jersey, Deputy Inspector General for Investigations Gary Cantrell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Director Terry Wade of the FBI’s Criminal Investigative Division made the announcement.
Reinaldo Wilson, 51, and Jean Wilson, 49, husband and wife of Richmond Hill, Georgia, the owners of purported telemedicine companies Advantage Choice Care LLC (ACC) and Tele Medcare LLC (Tele Medcare), were each charged with one count of conspiracy to defraud the United States and to pay and receive health care kickbacks, one count of conspiracy to commit health care fraud and wire fraud, three counts of receiving health care kickbacks, and one count of conspiracy to commit money laundering. Reinaldo Wilson and Jean Wilson were arrested this morning and appeared this afternoon before U.S. Magistrate Judge L. Patrick Auld of the Middle District of North Carolina. Reinaldo Wilson is being held pending a bail hearing set for Feb. 11. Jean Wilson was released and will appear for a bail hearing on Feb. 11.
The indictment alleges that Reinaldo Wilson and Jean Wilson owned and operated purported telemedicine companies ACC and Tele Medcare, which had locations in Bayonne, New Jersey, Boca Raton, Florida, and Richmond Hill, Georgia. The indictment further alleges that Reinaldo Wilson and Jean Wilson agreed to solicit and receive illegal kickbacks and bribes from patient recruiters, pharmacies, brace suppliers and others in exchange for the arranging for doctors to order medically unnecessary braces for beneficiaries of Medicare from approximately March 2017 through April 2019. In order to obtain the orders that were transmitted in exchange for kickbacks and bribes, Reinaldo Wilson and Jean Wilson, through ACC and Tele Medcare, recruited and hired health care providers to order braces for Medicare beneficiaries, the indictment alleges. Reinaldo Wilson and Jean Wilson allegedly paid illegal kickbacks and bribes to health care providers to order braces for Medicare beneficiaries that were medically unnecessary, ineligible for Medicare reimbursement and/or not provided as represented.
The indictment further alleges that Reinaldo Wilson, Jean Wilson and others transferred the brace orders to co-conspirator brace suppliers to support in excess of $56 million in false and fraudulent claims to Medicare that were submitted by brace suppliers and that Medicare paid these brace suppliers in excess of $28 million for these claims.
With regard to the money laundering charge, that indictment alleges that between approximately March 2017 and April 2019, Reinaldo Wilson and Jean Wilson agreed to engage in monetary transactions of criminally derived property in amounts greater than $10,000.
An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
This case was investigated by HHS-OIG and the FBI. Trial Attorney Darren C. Halverson of the Criminal Division’s Fraud Section is prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for nearly $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine and DME marketing schemes – including Advantage Choice Care LLC and Tele Medcare LLC – should call to report this conduct to the FBI hotline at 1-800-CALL-FBI.
The year 2020 marks the 150th anniversary of the Department of Justice. Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.
Thanks for the postings
I’m sorry, but we are going to have to start hanging thieves.
There are too many of them and they aren’t afraid of having to go to prison.
I knew this was crooked the first time I saw the ads. Guess it took the feds 50M to notice,
Bet they are Dems.
Gee , Medicare ONLY doled out 28 million of the 56 MILLION fraudulently billed ...for BRACES ! The indictment also says that 15 task forces needed to ferret out such scams have recovered 19 billion since 2007.....I wonder if “private” insurers would have been so careless when billed for 56 MILLION in braces over a 24 month period? Such a clusterF___ medicare and Medicaid .....
Medicare is for old people, implants yes, braces not so much.
These are orthotic braces, not dental braces. Probably for back and knees. It’s a popular Medicare scam - https://www.nbcnews.com/politics/justice-department/feds-take-down-1-billion-fraud-scheme-operation-brace-yourself-n992481
I was picturing some old geezer with braces on his dentures.
Next time I will read more closely.
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