November 15, 2013 — Each year, the U.S. Justice Department counts on tips from whistleblowers to recoup millions of dollars that would otherwise be lost on fraudulent Medicare scams. The qui tam provisions incorporated in the False Claims Act arm health care insiders with the tools they need to fight fraud in the health care field. In return for bringing a claim on the government’s behalf, tipsters keep a share of any recovery from the suit.
Medicare Fraudsters Laundered Funds Through Shell Companies
Alain Remy and Rafael Roche pleaded guilty in October to charges that the pair laundered the proceeds from a Medicare fraud operation in Florida. The fraud scheme allegedly centered around Renew Therapy Center of Port St. Lucie LLC (Renew Therapy), an outpatient rehabilitation facility in Port St. Lucie, Florida. Between November 2007 and August 2009, Renew Therapy submitted over $10.5 million in fraudulent claims to Medicare, seeking reimbursement for therapy services that had not been properly prescribed and were not properly provided to Medicare beneficiaries.
In response to the fraudulent claims, Medicare paid $6,248,056 into a bank account owned by Renew Therapy. Of that amount, a combined total of $1.8 million allegedly went to IRE Diagnostic Center Inc. and Ariguanabo Investment Group Inc., shell companies controlled by Remy and Roche.
According to the Justice Department, the pair laundered over $600,000 through IRE Diagnostic Center between August 2008 and January 2009. From the IRE Diagnostic Center bank account, the funds went to various individuals and companies, including A&R Medical Services of South Florida Inc., a different shell company run by Remy and Roche.
Between February and September 2009, Remy and Roche allegedly laundered in excess of $1.2 million through Ariguanabo Investment Group. From there, the money similarly traveled to various entities, including one of Remy’s shell companies, Ibiza Future Planning Inc.
Conscientious Health Care Insiders File Suit to Stop Medicare Fraud
False Claims Act violations involving sham Medicare claims similar to those in this case frequently involve the coerced participation of employees who are worried about keeping their jobs. Rather than participate in a Medicare scam, many health care employees choose instead to collaborate with the Justice Department. The qui tam attorneys with Waters & Kraus offer brave informants the legal representation they deserve. Contact us by email or speak with our False Claims Act attorneys at 855.784.0268 to learn more about bringing a whistleblower lawsuit.