At a time when our attention is drawn to massive Medicare fraud investigations involving hundreds of defendants, it is important to remember that the government brings out its full firepower to investigate and prosecute individuals as well.
This week a United States District Judge in Florida sentenced an individual Occupational Therapy Assistant to 30 months in federal prison for defrauding Medicare and Medicaid. The court also ordered the defendant to forfeit $455,537.30 in overpayments.
According to a press release from the local U.S. Attorney's office, the defendant owned Active Life Rehab, Inc. He was charged with health care fraud and aggravated identity theft for submitting fraudulent claims of more than $1 million to the Medicaid program. The claims submitted were for occupational therapy services that were either not provided at all, or not provided as billed to Medicaid.
The fraud allegedly was carried out by falsifying patient records, "upcoding," and using unauthorized Medical Provider Numbers of other licensed occupational therapists to submit claims to Medicaid for payment to Active Life Rehab. False claims were also submitted to Medicare. In total, Medicaid and Medicare were billed approximately $1.5 million of which $455,537.30 was unwarranted.
This case was investigated by the Tampa Bay Medicare Fraud Strike Force, which comprises agents from the Tampa Regional Office of the Department of Health and Human Services, Office of the Inspector General (HHS-OIG), the Federal Bureau of Investigation (FBI), the Florida Attorney General’s Medicaid Fraud Control Unit (MFCU), Florida Department of Law Enforcement (FDLE), and the Defense Criminal Investigative Service Office of Investigations.
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