芝加哥男子Herbert Kimble医保诈骗3.65亿美元获刑20年：潜逃菲律宾被捕引渡回美
南卡罗来纳州 Columbia——美国司法部南卡罗来纳区联邦检察官办公室10月26日宣布，60岁的芝加哥男子 Herbert Leon Kimble 因共谋诈骗美国政府及缺席出庭，被联邦法院判处20年监禁，并须向联邦医疗保险（Medicare）赔付逾1.99亿美元、没收逾1.95亿美元违法所得。
司法部称，Kimble 是这起全国性诈骗的核心策划者之一：团伙利用境外呼叫中心与空壳远程医疗公司，为矫形支具生成医学上不必要的处方，以欺骗性广告招揽弱势的 Medicare 受益人，再把他们的个人信息连同医生签署的订单卖给耐用医疗设备（DME）公司，换取伪装成合法商业付款的非法回扣。参与的医疗人员很少进行真正的问诊，只是批量签署预选的支具订单，以最大化 Medicare 报销。
Kimble 本人在菲律宾遥控运作，协调患者与处方的获取并供应给 DME 公司，这些公司合计向 Medicare 提交了数亿美元虚假申报。司法部称，Kimble 一人造成的虚假申报逾3.65亿美元，其中 Medicare 实际赔付逾1.99亿美元，他个人获利逾1.95亿美元，并用赃款在菲律宾购买了香格里拉酒店的豪华公寓。
Kimble 曾于2019年就共谋诈骗美国政府认罪，但2024年多次缺席法庭程序，法院发出逮捕令，他被列入联邦调查局（FBI）头号通缉诈骗犯名单，数日后在菲律宾被捕并被遣返回美，随后因三项缺席出庭罪名被起诉，并就原指控与新起诉达成新的认罪协议。
联邦地区法官 Joseph F. Anderson Jr. 判处 Kimble 240个月监禁，其后3年法庭监督释放；联邦制度没有假释。司法部国家欺诈执法司助理司法部长 Colin M. McDonald 表示，此案证明逃往海外也躲不过司法部的追诉；南卡罗来纳区联邦检察官 Bryan Stirling 称这是美国历史上规模最大的国际医疗诈骗案之一。此案由 FBI、卫生与公众服务部监察长办公室（HHS-OIG）与国税局刑事调查局（IRS-CI）联合调查。
Chicago Man Herbert Kimble Sentenced to 20 Years for $365 Million Medicare Fraud Scheme Run From the Philippines
COLUMBIA, South Carolina — Herbert Leon Kimble, 60, of Chicago, has been sentenced to 20 years in federal prison for conspiracy to defraud the United States and failure to appear, the U.S. Attorney's Office for the District of South Carolina announced. He was also ordered to forfeit more than $195 million and to pay more than $199 million in restitution to Medicare.
According to the Justice Department, Kimble helped orchestrate a nationwide scheme that used offshore call centers and sham telemedicine companies to generate medically unnecessary prescriptions for orthotic braces. The operation recruited vulnerable Medicare beneficiaries through deceptive advertising and sold their information, together with signed doctors' orders, to durable medical equipment (DME) companies in exchange for illegal kickbacks disguised as legitimate business payments. The medical professionals involved rarely conducted real consultations and simply signed preselected brace orders to maximize Medicare reimbursement.
Acting as a central architect from the Philippines, Kimble coordinated the procurement of patients and prescriptions and supplied them to DME companies that collectively billed Medicare for hundreds of millions of dollars in fraudulent claims. In total, Kimble caused more than $365 million in fraudulent claims to Medicare, of which Medicare reimbursed more than $199 million, and he personally profited by more than $195 million, using proceeds in part to buy a luxury condo at the Shangri-La hotel in the Philippines.
Kimble originally pleaded guilty in 2019, later failed to appear for multiple court proceedings in 2024, was placed on the FBI's Most Wanted Fraudsters list, and was apprehended in the Philippines days later and returned to the United States. U.S. District Judge Joseph F. Anderson Jr. sentenced him to 240 months in prison followed by three years of court-ordered supervision; there is no parole in the federal system. The case was investigated by the FBI, the HHS Office of Inspector General and IRS Criminal Investigation.
来源：GSM·美国（原文链接）
图片来源：位于南卡罗来纳州 Columbia 的 Strom Thurmond 联邦大楼与联邦法院（w_lemay 摄，CC BY-SA 2.0）— via Wikimedia Commons
