Posted on 07/13/2009 8:07:58 PM PDT by Larry381
Geoffrey Ramseur, 52, of Rockledge, Florida (formerly of Northville, Michigan), was sentenced yesterday to 20 months in prison and ordered to pay restitution in the amount of $121,000.00 after having been convicted on health care fraud charges, announced United States Attorney Terrence Berg.
Mr. Berg was joined in the announcement by Special Agent Andrew G. Arena, Federal Bureau of Investigation, Detroit Field Division.
On November 7, 2008, Ramseur pleaded guilty to conspiracy to commit mail fraud against Blue Cross/Blue Shield of Michigan (“BC/BS-MI”) before Judge Denise Page Hood.
According to court records, during 2002-2004, Ramseur was a chiropractor who conducted business in Detroit, Farmington Hills, and Southfield. He was a registered care provider with BC/BS-MI and was authorized to treat patients and to seek payment from BC/BSMI for the services provided. Ramseur would submit billings to BC/BS-MI electronically for services alleged performed upon patients, and it would send payments to Ramseur via checks mailed through the United States Postal Service.
It was the object of the Ramseur’s conspiracy to send false bills to BC/BS-MI for fictitious chiropractic services that were never provided to the alleged “patients.” Ramseur would bill BC/BS-MI for chiropractic services regarding patients whom he had not treated. In billing BC/BS-MI for the services, Ramseur falsely represented to BC/BS-MI that the chiropractic services had, in truth and in fact, been provided to the patients involved, and the Ramseur was entitled to payment for the services.
Ramseur would pay employees of Bing Steel (Detroit) and Veltri Metal Products Inc. (Royal Oak) to obtain their Social Security Numbers (“SSN”) and a copy of their BC/BS-MI cards so that Ramseur could then fraudulently bill BC/BS-MI for alleged treatment of the employees. Ramseur would pay each employee approximately $100.00 to $200.00 in cash for the use of their SSN and BC/BS-MI membership identification.
Bing Steel provided health care coverage for its union workers through BC/BS-MI. For the time period of October 2, 2002, through April 24, 2004, Ramseur billed BC/BS-MI approximately $855,030.00, which allegedly represented treatments he provided to 175 Bing Steel employees, their spouses or dependents (in the form of 17,115 patient services). BC/BS-MI paid Ramseur $419,010.86 for these alleged services.
Flex-N-Gate Corporation operated a manufacturing plant in Royal Oak, Michigan, which until 2004 was owned by Veltri Metal Products, Inc. Flex-N-Gate (and Veltri) provided health care coverage for some of its employees through BC/BS-MI. For the time period of February 4, 2002, through April 29, 2004, Ramseur billed BC/BS-MI approximately $270,890.00, which allegedly represented treatments he provided to 49 Veltri employees, their spouses or dependents (in the form of 4,889 patient services). BC/BS-MI paid Ramseur $124,453.62 for these alleged services.
United States Attorney Berg stated, “Fighting health care fraud is critical to the integrity of our health care system. Health care providers hold the public trust and when they choose to violate that trust, my office will hold them accountable. The sentence in this case demonstrates that when greed takes the place of legitimate patient care, the consequence will be prison.”
Medicaid could recoup billions by monitoring those claiming disability by using the same investigatory tactics as Workman’s Comp. Once recipients “qualify” for it, it’s a regular paycheck without working.
This was in 2004, and they are only now just getting around to wrapping it up.
Does make you wonder about our government’s ability to protect us from obvious, well documented fraud done by an obvious idiot.
Guess what happens when the perps are smarter, or victim is a faceless government program?
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