Man Admits Medicare Fraud Related to Florida Durable Medical Equipment Clinic

December 27, 2013 — What action can health care workers take to prevent Medicare from being bombarded with fraudulent claims filed by durable medical equipment suppliers and other health care providers? To tackle the problem, the U.S. Justice Department counts on information from health care insiders. The False Claims Act includes qui tam language that empowers insiders to file a lawsuit for the benefit of the government. To incentivize informants to come forward, the Act entitles tipsters to a handsome share of the recovery.

Former Owner of Miami DME Clinic Pleads Guilty in $11 Million Medicare Fraud Scheme

The former owner of a Florida durable medical equipment (DME) clinic has pleaded guilty for his part in running an $11 million Medicare fraud scam. Francisco Enrique Chavez, of Miami, Florida has pleaded guilty to one count of health care fraud.

According to the U.S. Justice Department, Chavez was the president of the now defunct World Class Medical Clinic Corp. (World Class) in Miami. Between March and August 2006, Chavez either submitted himself or caused to be submitted around $11,303,494 in fraudulent Medicare claims. The DME for which Chavez submitted claims was not medically necessary, nor was it prescribed by a physician. Medicare paid over $1.7 million on these fraudulent claims. The payments from Medicare were deposited into corporate bank accounts that Chavez controlled. From there, the money was withdrawn by Chavez and deposited into personal and shell entity bank accounts, all as part of Chavez’ scheme to hide his lucrative Medicare fraud operation.

After fleeing the country, Chavez was extradited from Spain to Florida in August 2013. At sentencing in February 2014, the fraudster could receive a ten-year prison sentence.

Blowing the Whistle on Health Care Fraud

Most health care employees want no part of a Medicare fraud operation. These hardworking insiders deserve to understand their rights as set forth in the False Claims Act before they file a lawsuit. With experienced whistleblower lawyers in California, Texas and the Washington, D.C. area, Waters & Kraus understands how to safeguard your interests. When you’ve decided to notify the government, contact us by email or call our False Claims Act lawyers at 855.784.0268 to find out more about our qui tam practice.

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