On Wednesday, five individuals pleaded guilty in connection with participation in health care fraud scheme run out of clinic in Jefferson Parish. The scheme apparently involved claims submitted to Medicare and Medicaid.
Health care fraud, as we have mentioned on this blog in the past, is part of a larger category referred to as “white collar crimes.” These include charges of wire fraud, mail fraud, extortion, embezzlement, money laundering, as well as Medicare and Medicaid fraud. Health care fraud is an expensive crime which costs Americans roughly $100 billion every year, and officials have been cracking down on those engaged in it.
Three Louisiana doctors, 12 individuals, and seven companies were reportedly indicted last month in connection with the Jefferson Parish scheme. Five defendants have pleaded guilty charges, as have four of the companies.
According to sources, those involved in the scheme were accused of billing Medicare and Medicaid for medical tests which were never performed. The companies allegedly used recruiters to snare patients into booking appointments at two clinics and were given prescription narcotics in return. Employees at the clinics are said to have received drugs and cash.
Two individuals from Metairie have pleaded guilty to conspiracy to commit health care fraud, as well as an individual from Kenner, one from Sherman Oaks California. A third individual from Metairie pleaded guilty to health care fraud. The individual from Kenner reportedly also pleaded guilty to conspiracy to commit money laundering. Several Louisiana-based clinics and one from California have pleaded guilty to involvement in the scam.
Fraud charges can be tricky to prove, since mistakes can be made. Prosecutors are required to show that defendants had the requisite intent, and they will use any inference they can to establish that intent. Defense attorneys keep prosecutors honest and ensure that the defendant gets an opportunity to present their best defense.
Source: nola.com, “5 plead guilty in health care fraud,” January 11, 2012.