Three Defendants Charged in Multi-Million Dollar Medicare Fraud Scheme
BOSTON – Three individuals were charged today in connection with a multi-million dollar Medicare fraud scheme, bringing the total number of defendants to six.
Nathan LaParl, 34, of Boca Raton, Fla., and Talia Alexandre, 30, of Palm Springs, Fla., were each charged by Information with one count of receiving kickbacks in connection with a federal health care program. LaParl and Stefanie Hirsch, 51, of Los Angeles, Calif., were also charged by Information with violating the HIPAA statute.
According to charging documents, LaParl and Alexandre sold Medicare patients’ personal and medical data to Juan Camilo Perez Buitrago. LaParl and Alexandre worked with foreign call centers to contact Medicare patients to ask if they were interested in durable medical equipment (DME) such as arm, back, knee and shoulder braces “at little to no cost.” The call centers collected demographic and insurance information from Medicare patients, which LaParl and Alexandre sold to Perez. Together, LaParl and Alexandre received more than $1.6 million from Perez for the patient data. Perez Buitrago used that patient data to submit more than $109 million in false and fraudulent claims, submitting claims for DME that was not prescribed, not necessary, and, in many instances, never requested or received.
To perpetuate the scheme, LaParl checked Medicare patients’ insurance eligibility by improperly accessing a patient eligibility tool provided by Hirsch. Hirsch owned EI Medical, Inc., a Medicare-enrolled wheelchair and scooter repair company that qualified for access to a health care clearinghouse that contains Medicare patients’ personal, medical and insurance information. Hirsch improperly gave LaParl access to that clearinghouse and charged him about $0.25 per patient eligibility check. Using Hirsch’s credentials, LaParl accessed the personal and medical data of more than 350,000 patients.
Perez was charged in July 2020 and is scheduled to plead guilty on Oct.5, 2020. Two other defendants, Jessica Jones and Elizabeth Putulin, were charged on Sept. 29, 2020 and have agreed to plead guilty.
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.