佛罗里达男子认罪：4200万美元联邦医疗保险欺诈，赃款买下60万美元游艇
美国司法部11月13日宣布，佛罗里达州 Tarpon Springs 居民 Chad Monroe（48岁）当天就一宗4200万美元的联邦医疗保险（Medicare）欺诈案认罪，承认共谋实施医疗保健欺诈与电信欺诈，并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 与同伙开设 Maksix Medical Products Inc.、Orthotech Atlanta, LLC 与 1st Choice Medical Supply LLC 三家耐用医疗设备公司，以受益人并不需要、也未要求的膝、腕、踝、背部支具等设备与癌症基因检测为名，向 Medicare、Medicare Advantage 计划与 TRICARE 提交逾2600万美元的虚假申报。Monroe 指使同伙在 Medicare 登记文件上作假，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医嘱，Monroe 向所谓的远程医疗公司支付非法回扣；他还通过自己的公司 Health and Life Networking LLC，把基因检测医嘱卖给同伙经营的实验室，从中收取逾1500万美元非法回扣。此外，他指使一名同伙为 1st Choice Medical Supply LLC 提交逾3万美元的虚假 PPP 贷款申请，在公司所有权等问题上作假。
司法部表示，Monroe 把赃款用于奢华生活，包括买下一艘价值逾60万美元的47英尺游艇“The Rogue Shark”、一辆凯迪拉克 Escalade 与其他豪华车辆。政府已扣押该游艇与逾100万美元资产。
Monroe 认罪的两项罪名中，共谋医疗保健欺诈最高可判10年监禁，电信欺诈最高可判30年监禁。量刑日期尚未确定，联邦地区法院法官将参考量刑指南等因素裁定刑期。
此案由司法部国家欺诈执法司助理总检察长 Colin M. McDonald 等官员宣布，卫生与公众服务部监察长办公室（HHS-OIG）、联邦调查局（FBI）坦帕外勤办公室、战争部监察长办公室国防刑事调查局（DCIS）与国税局刑事调查局（IRS-CI）参与调查，国家欺诈执法司医疗保健欺诈科负责起诉。司法部表示，其医疗保健欺诈打击力量自2007年以来已起诉6200多名被告，涉案申报金额逾450亿美元。（来源：美国司法部）
Florida Man Pleads Guilty to $42 Million Medicare Fraud Involving Medical Equipment and Genetic Testing
The U.S. Department of Justice announced on November 13 that Chad Monroe, 48, of Tarpon Springs, Florida, pleaded guilty that day to a $42 million fraud on Medicare, admitting to conspiracy to commit health care fraud and wire fraud, and to fraudulently obtaining a Paycheck Protection Program (PPP) loan.
According to court documents and statements made in court, Monroe and his co-conspirators opened three durable medical equipment companies, Maksix Medical Products Inc., Orthotech Atlanta, LLC, and 1st Choice Medical Supply LLC, and used them to submit more than $26 million in false claims to Medicare, Medicare Advantage plans, and TRICARE for equipment such as knee, wrist, ankle, and back braces and for cancer genetic testing that beneficiaries did not want or need. 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 testing, Monroe paid illegal kickbacks to purported telemedicine companies. Through his company Health and Life Networking LLC, he also sold doctors' orders for genetic testing to co-conspirator laboratories, which paid him more than $15 million in illegal kickbacks. He also directed a co-conspirator to submit a fraudulent PPP loan application for more than $30,000 on behalf of 1st Choice Medical Supply LLC, lying about the company's ownership.
The department said Monroe used the proceeds to fund a lavish lifestyle, including a 47-foot yacht valued at more than $600,000 called “The Rogue Shark,” a Cadillac Escalade, and other luxury vehicles. The government has seized the yacht and more than $1 million.
Monroe faces a maximum of 10 years in prison on the health care fraud conspiracy count and 30 years on the wire fraud count. A sentencing date has not been set, and a federal district court judge will determine the sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
The case was announced by Assistant Attorney General Colin M. McDonald of the Justice Department's National Fraud Enforcement Division and other officials. It was investigated by the HHS Office of Inspector General, the FBI's Tampa Field Office, the Department of War Office of Inspector General's Defense Criminal Investigative Service, and IRS Criminal Investigation, and is being prosecuted by the National Fraud Enforcement Division's Health Care Fraud Section. The department said its Health Care Fraud Strike Force Program has charged more than 6,200 defendants who collectively billed more than $45 billion since 2007. (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：美国司法部罗伯特·肯尼迪大楼。Ajay Suresh 摄，CC BY 2.0，经 Wikimedia Commons。
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