Sadly, it appears as if there are far too many ways to rip off Medicare. As the Allegiant Experts Blog has been highlighting for several months, unscrupulous members from all different areas of the medical community have found ways to bilk the national social insurance program out of millions of dollars. We recently pointed out that health insurance fraud is perpetuated right across all disciplines in the world of medicine. And as our many weeks of blogs have proven, health insurance fraud occurs in all states.
Last week, the United States Department of Justice reminded us that the great state of Louisiana is also home to not-so-great individuals who feel that Medicare is the perfect target for get-rich-quick schemes. Tom McCardell was an administrator at Shreveport’s Physicians Behavior Hospital (PBH). Following his recent four-day trial, the 64 year-old was found guilty of no less than 14 counts of paying out illegal kickbacks.
Evidence presented in the case against McCardell showed that between July 2011 and November 2012, he operated a kickback scheme stemming from his work at PBH. As part of his scheme, he employed an Alabama resident, with no medical training or background, to recruit and refer patients to PBH. Thinking these individuals were in legitimate need of psychiatric or substance abuse treatment, the hospital purchased bus tickets for them to travel to its Shreveport location.
As pointed out in the Department of Justice’s press release on the matter, the majority of the patients travelled to PBH unsupervised. McCardell got the hospital to pay the recruiter for his referrals by way of checks written in the name of the recruiter’s son. This, says the report, helped McCardell to evade detection and suspicion. The former hospital administrator even got PBH to create an employee file in the recruiter’s son’s name.
This helped to provide cover for the illegal kickback arrangement made between McCardell and the recruiter from Alabama. In total, McCardell got the hospital to pay the recruiter’s son $41,000 – none of which was legally earned or deserved. This, of course, was only the illegal kickback amount that stemmed from McCardell’s scheme. The total amount bilked from Medicare was far higher.
“As a result of the illegal kickback scheme, the hospital billed more than $6.7 million dollars to Medicare and was paid more than $1.2 million dollars,” reports the U.S. Department of Justice, adding that McCardell now faces up to five years in prison. Following his sentence, the disgraced former administrator will face three years of supervised release. He is also expected to pay a $250,000 for each count.
Unfortunately, it actually comes as no surprise to the team of clinical experts, here at Allegiant Experts, that such instances of health insurance fraud continue to take place. It strengthens our resolve against fraudsters, making us work that much harder to see them face justice. Our team has many years of experience offering its expertise to attorneys who are trying cases against those who commit healthcare fraud. If you’re an attorney who could use our help, please don’t hesitate to reach out to us.
For more information about our experience, expertise and how we may be able help your case, call us at 407-217-5831 or email us at info@allegiantexperts.com.
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