Colombian National Agrees to Plead Guilty to $109 Million Medicare Fraud Scheme
BOSTON – A Colombian national residing in Lighthouse Beach, Fla., has agreed to plead guilty in connection with submitting more than $109 million in false and fraudulent claims for durable medical equipment (DME) such as arm, back, knee and shoulder braces.
Juan Camilo Perez Buitrago, 31, was charged by information with one count of health care fraud and one count of payment of kickbacks in connection with a federal health care program. A plea hearing has not yet been scheduled.
According to charging documents, Perez manufactured and submitted false and fraudulent Medicare claims by instructing his employees to establish shell companies in more than a dozen different states, including Massachusetts. Perez directed employees to list his mother, wife, and yacht captain as corporate directors and to use fictitious names when registering the shell companies as DME providers. Perez allegedly purchased Medicare patient data from foreign and domestic call centers that targeted elderly patients, and instructed call centers to contact the Medicare beneficiaries with an offer of ankle, arm, back, knee, and/or shoulder braces “at little to no cost.” He then submitted Medicare claims for those patients without obtaining a prescriber’s order to ensure that the braces were medically necessary. It is further alleged that he submitted blatantly fraudulent claims, including claims for deceased patients and repeat claims for the same patient and the same DME. Perez failed to provide any DME for more than $7.5 million in claims. When Perez did provide DME to patients, he typically billed insurance policies more than 12 times the average price of the DME that he provided to the patient.
In total, the charging document alleges that Perez submitted $109 million in Medicare claims and collected more than $12 million.
Each charge provides for a sentence of up to 10 years in prison, three years of supervised release and a fine of $250,000. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.
United States Attorney Andrew E. Lelling; Johnnie Sharp Jr., Special Agent in Charge of the Federal Bureau of Investigation, Birmingham Field Division: Phillip Coyne, Special Agent in Charge of the Department of Health and Human Services, Office of the Inspector General, Boston Division; and Joseph W. Cronin, Inspector in Charge of the U.S. Postal Inspection Service made the announcement today. Assistant U.S. Attorney Elysa Q. Wan of Lelling’s Health Care Fraud Unit is prosecuting the case.