Two Guamanians were sentenced to Federal custody last week after pleading guilty to involvement in a scheme to launder money and defraud Medicare and TRICARE of about $10.8 million.
Investigators say the two men, one 63 years old and the other three years his junior, submitted claims to both Medicare and TRICARE for medically-unnecessary ambulance services the ambulance company they owned provided to individuals with end-stage renal disease (ESRD).
Per investigators, the duo did not familiarize themselves with Medicare and TRICARE guidelines regarding what sorts of ambulance transportation qualified for reimbursement under the plans. They say from the spring of 2010 to the spring of 2014 their firm transported patients who were not bed-ridden and did not have medical conditions that qualified them for ambulance transportation.
In an effort at concealing their acts, the defendants allegedly directed employees of their business to scrub references to their patients’ ability to walk in internal documents, as they were aware that they would risk losing reimbursement from Medicare and TRICARE for services rendered for those who were ambulatory.
All in, the portion of fraud alleged to have been conducted by the defendants added up to $32 million, with around $10.8 million of the fraudulently-claimed services reimbursed by Medicare and TRICARE. Investigators say the defendants used the fraudulent funds for personal expenses, including vacations and real estate, and claimed the expenses as business expenses in an effort at masking their illicit spending habits.
Last week U.S. District Judge Frances Tydingco-Gatewood of the District of Guam sentenced the elder defendant to 71 months in Federal custody and sentenced the younger defendant to 63 months of the same. He also sentenced them to pay $10,884,964.49 in restitution as well as forfeiting a like amount.
The Law Offices of Bjorn Brunvand have been representing people charged with capital murder, felony drug charges, drunk driving, government fraud, and white-collar crimes for over a quarter century. Conact our office today to discuss your Tampa Bay-area state or federal charges.