BOSTON – Two women pleaded guilty today in connection with a multi-million dollar Medicare fraud scheme.
Talia Alexandre, 30, of Palm Springs, Fla., pleaded guilty to one count of receiving kickbacks in connection with a federal health care program. Stefanie Hirsch, 51, of Los Angeles, Calif., pleaded guilty to violating the HIPAA statute. U.S. Senior District Court Judge George A. O’Toole Jr. scheduled the sentencing hearings for June 24, 2021.
According to charging documents, co-conspirator Nathan LaParl and Alexandre sold Medicare patients’ personal and medical data to Juan Camilo Perez Buitrago. Alexandre and LaParl 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 Alexandre and LaParl sold to Perez Buitrago. Alexandre received more than $1.4 million from Perez Buitrago 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, Perez Buitrago and 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 and Perez Buitrago access to that clearinghouse and charged them about $0.25 per patient eligibility check. Using Hirsch’s credentials, LaParl accessed the personal and medical data of more than 350,000 patients and Perez Buitrago’s credentials were used for 150,000 patients.
LaParl pleaded guilty in January 2021 and is scheduled to be sentenced on May 20, 2021. In October 2020, Perez Buitrago pleaded guilty to health care fraud and paying kickbacks in connection with a federal health care program and is scheduled to be sentenced on May 5, 2021. Two other defendants, Jessica Jones and Elizabeth Putulin, pleaded guilty in January 2021 and are scheduled to be sentence on May 19, 2021.
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.