Karen T. Rayburn, a patient recruiter for a number of Louisiana durable medical equipment (DME) companies, pleaded guilty and will serve 18 months in prison for participating in a Medicare fraud scheme. Ms. Rayburn allegedly received illegal kickbacks for providing personal information about Medicare beneficiaries and prescriptions for DMEs. Her work assisted the DME companies in filing false claims to Medicare for medically unnecessary DMEs. Ms. Rayburn was also sentenced to spend two years in supervised release and to pay $3.18 million in restitution.
Patient Recruiter Helped DME Companies Commit Medicare Fraud by Obtaining DME Prescriptions
Between 2004 and 2009, Ms. Rayburn worked as a patient recruiter for Medical 1 Patient Services LLC, Healthcare 1 LLC and Lifeline Healthcare Services Inc. These Louisiana-based DME companies were fraudulently billing the Medicare program for medically unnecessary DMEs. Ms. Rayburn and other patient recruiters were hired to get personal information about Medicare recipients and prescriptions for DMEs like leg and arm braces, power wheel chairs and wheel chair accessories.
The DME companies then used the DME prescriptions to file false claims against the Medicare program. From 2004 to 2009, the companies submitted over $21 million in false claims to Medicare, according to the Justice Department. Based on the prescriptions collected by Ms. Rayburn herself, the companies submitted over $6 million in false claims.
Whistleblowers Are Valuable Partners in Fighting Medicare and Medicaid Fraud
Federal authorities are responsible for stopping and prosecuting false claims against Medicaid and Medicare, but to do that effectively, they often need to rely on information provided by whistleblowers. If you know that Medicaid or Medicare fraud is going on, you can help stop it. The information provided by whistleblowers is so valuable that the qui tam provisions of the False Claims Act authorize whistleblowers to file suit against the wrongdoers and to share in a portion of any money recovered in the lawsuit.
Whistleblowers need to know about their legal rights under the False Claims Act. Waters & Kraus’ team of highly skilled and experienced attorneys are ready to help you in this process. Contact us or call our whistleblower attorneys at 800.226.9880 to learn more about our practice and how we can assist.