佛州男子对4200万美元医保欺诈认罪 赃款买下逾60万美元游艇
佛罗里达州 Pinellas 县 Tarpon Springs 市男子 Chad Monroe 于11月13日向联邦法院认罪，美国司法部（DOJ）当天宣布，现年48岁的 Monroe 承认参与一宗金额达4,200万美元的联邦医疗保险 Medicare 欺诈，并另承认以欺诈手段取得一笔薪资保护计划（PPP）贷款。
据法庭文件与庭上陈述，Monroe 与同伙提交的是受益人并不需要、甚至并不想要的耐用医疗设备与癌症基因检测虚假索赔，设备包括膝、腕、踝与背部支具。Monroe 一伙开设了 Maksix Medical Products Inc.、Orthotech Atlanta, LLC 与 1st Choice Medical Supply LLC 三家耐用医疗设备公司，用它们向 Medicare、Medicare Advantage 计划与军人医疗系统 TRICARE 提交了超过2,600万美元的虚假索赔。
司法部称，Monroe 指使同伙在 Medicare 登记文件上撒谎，隐瞒他对这些公司的所有权与实际角色；为取得开具设备与基因检测的医生处方单，他向所谓的远程医疗公司支付非法回扣。Monroe 还通过自己名下的 Health and Life Networking LLC 把基因检测处方单卖给同伙经营的实验室，从中收取超过1,500万美元的非法回扣。
此外，Monroe 指使一名同伙为 1st Choice Medical Supply LLC 提交一笔超过3万美元的欺诈性 PPP 贷款申请，在公司所有权等问题上作虚假陈述以取得贷款资格。
司法部称，Monroe 把欺诈所得用于奢侈生活，包括购买一艘价值超过60万美元、长47英尺、名为“The Rogue Shark”的游艇，一辆 Cadillac Escalade 与其他豪华车辆。政府在办案中已扣押该游艇与超过100万美元资金。
Monroe 承认一项共谋实施医疗保健欺诈罪与一项电信欺诈罪，量刑日期尚未确定。医疗保健欺诈共谋罪最高可判10年监禁，电信欺诈罪最高可判30年监禁，最终刑期将由联邦地区法院法官在考虑美国量刑指南与其他法定因素后决定。
宣布认罪的包括司法部国家欺诈执法司助理司法部长 Colin M. McDonald、卫生与公众服务部监察长办公室（HHS-OIG）特别探员主管 Isaac M. Bledsoe、联邦调查局（FBI）Tampa 外地办公室特别探员主管 Rodney Crawford 等官员。此案由 HHS-OIG、FBI、战争部监察长办公室下属国防刑事调查局（DCIS）与国税局刑事调查局（IRS-CI）联合调查，国家欺诈执法司医疗保健欺诈科负责起诉。
（来源：美国司法部）
Florida Man Pleads Guilty to $42 Million Medicare Fraud; Proceeds Bought a Yacht Worth Over $600,000
Tarpon Springs, Florida — Chad Monroe, 48, of Tarpon Springs, in Pinellas County, Florida, pleaded guilty on November 13 to a $42 million fraud on Medicare, the U.S. Department of Justice (DOJ) announced the same day. Monroe also pleaded guilty to fraudulently obtaining a Paycheck Protection Program (PPP) loan.
According to court documents and statements made in court, Monroe conspired with others to submit fraudulent claims for durable medical equipment (DME), such as knee, wrist, ankle, and back braces, and cancer genetic testing that Medicare beneficiaries did not want or need. Monroe and his co-conspirators opened three DME companies, Maksix Medical Products Inc., Orthotech Atlanta, LLC, and 1st Choice Medical Supply LLC, which they used to submit over $26 million in false and fraudulent claims to Medicare, Medicare Advantage plans, and TRICARE.
The Justice Department said Monroe directed co-conspirators to lie on Medicare enrollment documents to hide his ownership of and role at the companies. To generate doctors' orders for the equipment and genetic testing, Monroe paid illegal kickbacks to purported telemedicine companies. Through his company Health and Life Networking LLC, Monroe also sold doctors' orders for genetic testing to co-conspirator laboratories, which paid him over $15 million in illegal kickbacks.
Monroe also directed a co-conspirator to submit a fraudulent PPP loan application for over $30,000 for 1st Choice Medical Supply LLC, lying about, among other things, the company's ownership to qualify for the loan.
The Justice Department said Monroe used the proceeds to fund a lavish lifestyle, including purchasing a 47-foot yacht valued at over $600,000 called "The Rogue Shark," a Cadillac Escalade, and other luxury vehicles. In connection with the charges, the government seized the yacht and more than $1 million.
Monroe pleaded guilty to one count of conspiracy to commit health care fraud and one count of wire fraud. A sentencing date has not been set. He faces a maximum of 10 years in prison on the health care fraud conspiracy count and 30 years on the wire fraud count, with the sentence to be determined by a federal district court judge after considering the U.S. Sentencing Guidelines and other statutory factors.
The announcement was made by Assistant Attorney General Colin M. McDonald of the Justice Department's National Fraud Enforcement Division, HHS Office of Inspector General (HHS-OIG) Special Agent in Charge Isaac M. Bledsoe, and FBI Tampa Field Office Special Agent in Charge Rodney Crawford, among other officials. HHS-OIG, the FBI, the Defense Criminal Investigative Service (DCIS), and IRS Criminal Investigation (IRS-CI) investigated the case, and the National Fraud Enforcement Division's Health Care Fraud Section is prosecuting it.
(Source: U.S. Department of Justice)
来源：美国司法部
发布：GSM·美国（发布链接）
图片来源：图：美国司法部总部大楼入口。固定图库联邦核心包，CC BY 4.0。 / Photo: Entrance of the U.S. Department of Justice headquarters. Federal core asset pack, CC BY 4.0.
GSM Global · 本篇英文版 English edition of this story
