What is Medicare Fraud?

Medicare fraud occurs when a hospital, nursing home, doctor's office, hospice care facility, ambulance service, pharmacy, rehabilitation center, or any other type of healthcare provider overbills Medicare.

 

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Medicare fraud whistleblowers are almost always healthcare professionals. They are commonly employed as hospital administrators, nurses, hospice or nursing home workers, ambulance drivers, pharmacists, or as any other type of healthcare professionals.

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Los Angles Woman Sentenced to Sixty Months Imprisonment following her Involvement in a Medicare Fraud plot worth $6.2 Million
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A woman from Los Angles was sentenced to a sixty months imprisonment period after pleading guilty to making use of stolen physician's identities as well as counterfeit medical clinics to swindle Medicare up to $6.2 Million.
The culprit, Carolyn Ann Vasquez aged 47, was ordered to repay the $6.2 million as restitution following a ruling by Judge Consuelo B. Marshall of the U.S Central District of California. Additionally, the Judge also ruled for a year period of supervised release after  Vasquez prison term.

As of March 2011, Vasquez took a guilty plea to conspiracy in committing a health care scam. In the plea agreement, she admitted to conspiring with her accomplices to using several fraudulent medical clinics in Los Angeles region to defraud medicare between 2007 and 2008. 

Vasquez confessed that her co-conspirators used false Medicare provider’s identities and numbers of physicians who worked as well as those who did not work at the said clinics to put forward fake claims for; asking for compensation on services that the said physicians supposedly performed, to order power wheelchairs, diagnostic tests and medical equipment that the said physicians allegedly prescribed or ordered. 

According to the documents filed in court, Vasquez recruited several physician assistants to work at various clinics and followed her direct orders and orders given by her accomplices. The recruited assistants would basically conduct gratuitous medical services and to order medical equipment, wheelchairs as well as diagnostic tests which were medically uncalled for. 

The filed evidence further explains that Vasquez gained unauthorized access to physicians’ personal records and Medicare information that she stole so as to further her fraudulent activities at the various medical clinics. In her testimony, she admitted to getting in touch with physicians regarding a job in one of the counterfeit medical clinics, though the physicians declined the job offers. 

Nonetheless, her co-conspirators printed out prescription pads that bared the physicians name as well as their Medicare provider identification number. She further admitted that she instructed the recruited physicians’ assistance to use the forged prescription pads for prescribing medical diagnostic tests, order for a variety of medical equipment and power wheelchairs. 

Due to her actions, Medicare was defrauded approximately $6.2 million. Eduard Aslanyan, Vasquez’s co-defendant also pleaded guilty to charges of conspiracy as related to the case. The physician’s assistants hired by Vasquez like David Garrison were arraigned in court waiting for trial.

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