Elderly veterans targeted in $134 million Medicare, VA healthcare fraud scheme

Two men were convicted Nov. 5 for their role in a fraudulent scheme against Medicare and the Department of Veterans Affairs’ Civilian Health and Medical Program (CHAMPVA) after submitting at least $134 million in fraudulent claims, according to a statement. United States press. Florida Intermediate District Attorney’s Office.

Michael Nolan, 48, of Tampa, Fla., and Richard Epstein, 29, of Aurora, Colo., were both ordered to jointly pay $29,020,304 in restitution, as well as $2.1 million and $3 million respectively.

U.S. District Judge Virginia M. Hernandez Covington also sentenced Nolan to six years and six months in prison and Epstein to five years and three months in federal prison. Nolan and Epstein will also face three years of supervised release at the end of their respective sentences.

According to court documents, in October 2016, Epstein and Nolan created and ran a telemarketing company in Tampa called REMN Management LLC that targeted elderly patients by generating thousands of medically unnecessary orders for durable medical equipment – ​​such as braces. like back and knee braces – and genetic testing for cancer.

Epstein and Nolan also created and operated Comprehensive Telcare, LLC, a “telemedicine” business. Prosecutors say they used to bribe doctors to sign medical prescriptions no matter what. According to court documents, these orders were then illegally sold to conspiratorial customers to submit their own fraudulent claims to Medicare and CHAMPVA.

As of April 2019, the fraud and corruption scheme had resulted in the submission of at least $134 million in fraudulent claims to the two federal health benefit programs. According to the press release, the scheme also ultimately netted Epstein, Nolan and their co-conspirators $29 million in payouts.

Nolan and Epstein pleaded guilty to fraud charges on July 31.

“The VA’s Office of Inspector General’s continued oversight of the VA’s multiple healthcare programs, including CHAMPVA, is one of the agency’s highest priorities. We thank our outstanding law enforcement partners for their efforts in this joint investigation,” Special Agent David Spilker of the VA Office of Inspector General’s Southeast Field Office said in the release. hurry.

“They preyed on the elderly and military veterans for subjecting them to unnecessary medical tests and for using unnecessary medical equipment for their own financial gain,” also said Brian Payne, IRS Criminal Investigations Special Agent.

Payne added that he hopes the prison sentences and hefty fines will bring a sense of justice to those affected.

The matter was investigated by the U.S. Department of Health and Human Services – Office of Inspector General, the FBI, the VA Office of Inspector General, and the United States Field Office. IRS criminal investigations in Tampa.

The case was prosecuted by Assistant U.S. Attorneys Tiffany E. Fields, Jay G. Trezevant, James A. Muench, and Justice Department Attorney Gary A. Winters.

Rachel is a Marine Corps veteran, a Penn State alumnus, and a master’s candidate at New York University for Business and Economic Reporting.