In some situations, people get so wrapped up in doing the right things that they miss seemingly obvious warning signs. People who are focused on helping others might not realize that they are being taken advantage of, and they might make simple mistakes that cause huge ripples.
Unfortunately, trying to do the right thing is not enough to keep a person out of the criminal justice system in Texas. Because of a situation like that, three people were recently found guilty of health care fraud and conspiracy to commit fraud.
A jury recently found a pastor, his wife and an employee who worked for the couple guilty of a fraud scheme that allegedly involved more than $14 million in illegitimate Medicare claims.
The pastor stated that he didn't know he was doing anything wrong. His criminal defense attorney reported that "it was marketers and clinic operators who were responsible for the phony prescriptions, and that his client was fooled into believing he was conducting legitimate business."
The attorney went on to say his client was duped. He didn't know that some of the Medicare claims he was submitting were on behalf of individuals who were dead. In addition, when he ordered power wheelchairs for people, it was because he believed those individuals needed the wheelchairs.
According to one newspaper article, the pastor filed approximately $14.2 million in claims, and he received about $6.6 million in reimbursements. Like any successful businessman, the pastor used the money to support his lifestyle. The pastor's defense attorney stated, "All the money he was earning, as far as he knew, was legitimate."
So why wouldn't he spend it to support a comfortable lifestyle? Unfortunately, because the money was spent on luxury cars, international travel and nearly half a million dollars put toward remodeling his home, the man was criticized for using Medicare "as his personal piggy bank."
The three individuals will be sentenced in November, and we will report more information as it becomes available.
Source: Los Angeles Times, "Pastor, 2 others found guilty in Medicare fraud," Victoria Kim, Aug. 11, 2011
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