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Medicare Fraud Crackdown Sends South Florida Doctors to Prison

Dr. Isaac Kojo Anakwah Thompson, M.D. of Delray Beach, Florida was recently convicted of a Medicare fraud scheme resulting in over $2 million that he has been ordered to repay. Not only is Dr. Thompson required to repay the illegally acquired funds, but he has also been sentenced to 46 months in prison followed by two years of supervised release. Dr. Henry Lora of Miami Florida also plead guilty to Medicare fraud and was ordered to repay $20 million in addition to a nine year prison sentence.

Dr. Thompson’s conviction comes on the heels of the largest Medicare fraud takedown in the history of the Medicare Fraud Strike Force, which was created in 2007.

The Medicare Fraud Strike Force has Grown as a Result of the Affordable Care Act

Since its beginning, the Strike Force has increased its office locations from two cities to nine. Florida has two of its own offices located in Miami and Tampa. In part, the reason that the Strike Force has been able to increase its numbers and strength is because of the Affordable Care Act (ACA), which allocates an additional $350 million specifically for fraud prevention. Although originally shrouded with legal uncertainties, in 2012, the U.S. Supreme Court upheld the ACA.

In addition to the increased financial resources provided by the ACA, it additionally provides for data sharing between the FBI and the agencies that regulate health and human services. Accordingly, the Strike Force is more easily able to use this shared data to connect the dots of a case, so to speak. The ACA also provides for more serious sentencing penalties for those convicted.

Numerous Laws and Administrative Rules Govern Medicare Fraud

Fraud cases vary, but the most common types of Medicare fraud include medical identity theft, unnecessary billing, billing for services not provided, upcoding, unbundling and receiving kickbacks. Federal laws governing Medicare fraud are not limited to just one statute. The following comprise much of legislation imposing penalties on Medicare fraud:

  • False Claims Act
  • Anti-Kickback Statute
  • Physician Self-Referral Law
  • Social Security Act
  • United States Criminal Code

In addition to the statutes listed above, the Medicare program has administrative regulations that can further penalize those who’ve committed acts of Medicare fraud. Penalties include fines up to hundreds of thousands of dollars, paying back any monies illegally received, revocation of your professional license and jail time.

Medicare Fraud Cases Require Legal Representation

Medicare fraud is a serious offense governed by multiple agencies and laws. Your entire livelihood is at stake when it comes to the related penalties if convicted. Such severe consequences require the knowledge of an attorney well versed in Medicare fraud cases.

If you’ve been charged with Medicare fraud, or if you suspect that activities you’ve been involved with may constitute Medicare fraud, call Jeffrey S. Weiner in Miami today. Our law firm has represented physicians in all aspects of Medicare fraud cases and we will provide the legal representation you need to navigate the complex and serious world of Medicare fraud.

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