Home Health

Healthcare Fraud Schemes to Know Exist — But Avoid Like the Plague

Healthcare fraud is a severe issue — possibly more significant than you may have ever thought. It’s sometimes called a victimless crime, but that’s misinformation at its worst.

According to the U.S. Sentencing Commission, there were 431 healthcare fraud offenders in fiscal year 2022. Healthcare fraud is responsible for losses in the tens of billions of dollars annually, which is one reason why health insurance premiums are cost-prohibitive for many. 

Since healthcare fraud hurts you, your family, your friends, and others, indifference isn’t an option. Keep reading to learn about three healthcare fraud cases that have occurred over the last few months. Be prepared to be amazed by the unabashed gall of some of these perpetrators.

  1. Suffolk, Virginia Man Pleads Guilty to $2 Million Medicare Fraud 

The U.S. Attorney’s Office, Eastern District of Virginia, announced in late October that 40-year-old Julian Latty of Suffolk, Virginia, pleaded guilty to Medicare fraud worth north of $2 million through illegal claims for braces and other medical equipment. 

Court documents show that Latty and 37-year-old Jordan Thomas Broome of Texas created a Virginia Beach business in 2017 and registered it to receive Medicare reimbursements the following year. However, the two men fraudulently billed Medicare for north of $4 million over the next two years. 

How did the two men pull it off? They got their hands on personally identifiable data of Medicare beneficiaries and compensated doctors to sign prescriptions for braces the beneficiaries didn’t require. The investigation into the fraudulent behavior started after beneficiaries told Medicare they were getting back and knee braces delivered via mail that they had never ordered. Broome was given a 66-month prison term, while Latty will be sentenced late next February. He’s facing a maximum prison sentence of five years.  

  1. Bay Area Doctor Convicted of Health Care Fraud and Kickback Scheme

Kickbacks are a common theme in many healthcare fraud schemes — and it certainly was in the case of Dr. Henry Geoffrey Watson in Oakland, California. In early November, he was convicted by a federal jury of charges related to a kickback scheme

The kickbacks involved patient referrals to home health agencies. The kickback schemes lasted from 2013 to 2019. In the first instance, Dr. Watson reached a deal to refer patients to Amity Home Health Care in exchange for unlawful kickback remunerations. He received payments, sometimes cash payments of $3,000 monthly, from Amity and Amity CEO Amanda Singh for referring Medicare patients to the home health agency. Watson’s sentencing hearing is slated for late February following his conviction.

  1. Nurse Impostor Pleads Guilty to ID Theft and Creating False Medical Records 

49-year-old Leticia Gallarzo of Allegan County, Michigan, has pleaded guilty to using someone else’s ID to obtain employment as a licensed registered nurse to create false statements about healthcare matters. When applying for a position at a nursing facility, she fraudulently said she was a licensed RN and had earned a degree in nursing  

After getting a job, she evaluated and assessed patients at the nursing home and fraudulently signed electronic medical records related to Medicare. A sentencing date hasn’t yet been announced.

These are just three examples of healthcare fraud. Unfortunately, it happens a lot more than you might think. While it might not seem as serious as a violent crime, healthcare fraud can make things more difficult for people if premiums skyrocket because of rampant fraud.

If you ever find yourself on the receiving end of healthcare fraud charges, the first thing you must do is hire the right law firm. You need a lawyer experienced at defending people accused of a white-collar crime so that you get the best legal representation possible.