Guilty Pleas in Massive Health Care Fraud Schemes

Guilty Pleas in Massive Health Care Fraud Schemes

The Department of Justice (DOJ) estimates that health care fraud costs the United States tens of billions of dollars each year, and some estimates are in excess of $100 billion a year. Prosecutors and law enforcement officials responded by focusing on health care fraud schemes and aggressively pursuing those charged with health care fraud crimes.

Recently there have been a number of guilty pleas in massive health care fraud schemes. Three in particular range from $5 million to $20 million in losses to the United States government.

Conspiring to Defraud Medicare of More than $5 Million

Charles Esechie, 47 of Katy, Texas, a registered nurse, pleaded guilty to his role in a Medicare fraud scheme that caused losses to Medicare of more than $5 million. He pleaded guilty to one count of conspiracy to commit health care fraud.

According to Esechie’s plea, he knew that his employer was obtaining Medicare patients by paying illegal kickback payments to patient recruiters for home health care services that he knew were either medically unnecessary or not provided. He further admitted that he knew some of the patients referred by the recruiters were homeless and staying at the health care facility not to receive medical care, but to receive the kickback payments.

Esechie’s crimes were part of a larger health care fraud scheme, a case that is the largest provider attendant services fraud in Texas history. Read about the $17 million Medicare fraud scheme here.

$5.4 Million Health Care Fraud Scheme

Aaron Goldfein, 52, of Bloomfield Hills, Michigan, pleaded guilty to one count of conspiracy to commit health care and wire fraud for his role in a $5.4 million Medicare fraud scheme involving phony physician visits and drug prescriptions.

Goldfein, along with his co-conspirators, held themselves out as licensed physicians and purported to perform home visits and other health care services for Medicare beneficiaries. None of the conspirators were licensed to practice medicine in Michigan. Goldfein would then bill Medicare as if he had completed the visits. He further admitted to a scheme where he would receive kickback payments for writing home health prescriptions.

Two Women Plead Guilty to $20 Million Medicare Fraud Scheme

Mildrey Gonzales, 61 and Milka Alfaro, 40, both of Miami, pleaded guilty to fraud charges for their roles in a $20 million health care fraud scheme. Gonzalez pleaded guilty to one count of conspiracy to commit health care fraud and one count of health care fraud; Alfaro pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud.

Gonzalez and Alfaro admitted to recruiting and paying nominees to falsely represent themselves as the owners of the health care agencies that the two women actually owned. This was done in an effort to conceal their ownership interests from Medicare and the general public. The two women further admitted to paying bribes and kickbacks to medical professionals in exchange for prescriptions written for home health care services and referrals of Medicare beneficiaries to their home health care agencies. In some cases, the Medicare beneficiaries did not need the home health care services for which Medicare paid. As a result Gonzalez’ and Alfaro’s fraudulent scheme, Medicare paid approximately $20 million to their Miami-area home health care agencies.

Medicare Fraud Defense Attorney

Medicare fraud is the most common of all health care fraud prosecutions. It involves the investigation and prosecution of individuals and organizations who are accused of defrauding public health care systems, including Medicare and Medicaid.

Allegations of health care fraud can cause significant damage to your personal and professional reputation. Conviction of Medicare fraud or other health care fraud can result in harsh penalties, fines, even imprisonment. We have the experience and the resources to protect your rights and establish the best possible defense against aggressive prosecution.

Contact us or call now (480) 219-1366 for a case evaluation. Have your questions answered and obtain the peace of mind that comes from having a former Assistant U.S. Attorney on your side.

The attorneys at Ashley D. Adams, PLC handles federal criminal cases throughout the United States, including Arizona, Oklahoma, Utah, and California.