Monday, May 06, 2019

CEO of medical equipment company sentenced to 40 months for Medicare fraud


Criminal enterprise is first sentence in nationwide 'Operation Brace Yourself'

SAVANNAH, GA: The chief executive officer of a string of Savannah-based durable medical equipment companies was sentenced to more than three years in prison for a scheme that defrauded Medicare out of millions of dollars.

Roderic Bain, 57, of Savannah, who pled guilty to one count of False Statements Relating to Health Care Matters, was sentenced in U.S. District Court in Savannah to serve 40 months in prison and to pay more than $1.9 million in fines and restitution, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia.

According to court documents and as previously announced, Bain, who owned and operated a series of durable medical equipment companies, oversaw a multi-year scheme resulting in nearly $10 million in claims billed to Medicare. Working with a number of others, Bain operated a network that paid kickbacks to obtain patient information, specifically that of Medicare patients. Through a third-party biller, Bain would then bill Medicare Part B and Part C plans for medically unnecessary medical equipment and orthotics, including a variety of back and knee braces that were not ordered as medically necessary by a physician. During the course of the investigation, agents determined Bain and his affiliates were linked to a larger nationwide scheme, recently announced as “Operation Brace Yourself.” Bain is the first defendant sentenced under the ongoing investigation.

 “Schemes like this put greed before need – using the identities of those who are assumed to be medically fragile to exploit programs intended for the benefit of patients,” said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia. “Ultimately, such fraud hurts all patients by further straining the limited funding available for healthcare in an already struggling system.”

“Roderic Bain is only one piece of the puzzle, who for just his part in a nationwide scheme was responsible for nearly $10 million in fraudulent Medicare claims. That is a snapshot of how prevalent the problem of healthcare fraud is,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “Every tax-paying citizen is a victim when providers like Bain are driven by personal greed. We are proud of the work our agents and law enforcement partners are doing, and will continue to do, to stem this scourge on our federally-subsidized programs.”

“This sentence is a warning to those who enrich themselves through fraud scams at the expense of taxpayers,” said Special Agent in Charge Derrick L. Jackson of the Department of Health and Human Services, Office of Inspector General. “Working closely with our law enforcement partners, we will continue to crack down on such schemes, which waste taxpayer funds designed to care for vulnerable patients.”

“Cases of this magnitude can only be tackled using a strategy that recognizes that the most effective way to fight these large criminal networks is by combining the strengths, resources, and expertise of our federal agencies,” said Resident Agent in Charge Glen M. Kessler of the U.S. Secret Service. “For those companies, medical professionals and criminal organizers that exploit America’s healthcare system, we will continue working with our law enforcement partners to prosecute those who put greed before the welfare of our citizens.”

Nationwide, “Operation Brace Yourself” involved the payment of illegal kickbacks and bribes by companies in exchange for the referral of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces that are medically unnecessary. Some of the defendants controlled an international telemarketing network that lured hundreds of thousands of elderly and/or disabled patients into a criminal scheme that crossed borders, involving call centers in the Philippines and throughout Latin America. The defendants paid doctors to prescribe medical equipment either without any patient interaction or with only a brief telephone conversation with patients they had never met or seen. As announced recently, “Operation Brace Yourself” led to the execution of more than 80 search warrants in 17 federal districts with charges against 24 defendants so far.

This investigation remains ongoing. Any doctors or medical professionals who have been involved with alleged fraudulent telemedicine and medical equipment marketing schemes should report this conduct to the FBI hotline at 1-800-CALL-FBI. Any beneficiaries who believe their identity may have been used fraudulently also should contact the FBI hotline.

The operation was investigated in the Southern District of Georgia by the FBI, the Health and Human Services Office of Inspector General, and the United States Secret Service. Assistant United States Attorney J. Thomas Clarkson is prosecuting this case on behalf of the United States.

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