Two Defendants Agree to Plead Guilty to Multi-Million Dollar Medicare Fraud Scheme
BOSTON – A Colorado woman and a Florida woman have agreed to plead guilty in connection with a multi-million dollar Medicare fraud scheme.
Jessica Jones, 30, of Louisville Colo., and Elizabeth Putulin, 30, of Coconut Creek, Fla., were each charged by Information with one count of conspiracy to commit health care fraud. Plea hearings have not yet been scheduled by the Court.
According to charging documents, Jones and Putulin conspired with Juan Camilo Perez Buitrag to submit more than $109 million in false and fraudulent claims for durable medical equipment (DME) such as arm, back, knee and shoulder braces. Perez was charged in July 2020 and has agreed to plead guilty. A plea hearing for Perez is scheduled for Oct. 5, 2020.
It is alleged that the Jones and Putulin helped Perez manufacture and submit false and fraudulent Medicare claims by establishing shell companies in more than a dozen different states, including Massachusetts. Perez directed employees, including Jones and Putulin, to list his mother, wife and yacht captain as corporate directors and to use fictitious names when registering the shell companies as DME providers. At Perez’s request, Jones and Putulin 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.” Perez 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.
Jones and Putulin further facilitated the fraud by answering frequent phone calls from Medicare patients who received DME that they did not request, want or need. Jones and Putulin also responded to insurance companies’ requests for prescriber’s orders and medical records, which they were unable to provide.
The charging statute 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.