A Clarence Center man is facing prison time for his alleged role in an elaborate, multi-layered scheme that the U.S. Department of Justice said resulted in $29 million in false and fraudulent claims to Medicare.
Jeffrey Brooks, 40, was sentenced Wednesday to 7 1/2 years in federal prison, followed by three years of court-ordered supervised observation, after pleading guilty to one count of conspiracy to commit health care fraud, the court said. announced by the Ministry. The case was handled in U.S. District Court in Greenville, South Carolina, and Brooks sold his Western New York home in recent months.
According to the Department of Justice and court records:
Beginning in or about May 2019, Brooks operated at least eight durable medical equipment companies, all of which were registered as Medicare providers and were based in Fort Pierce, Florida. For many of the eight companies, Brooks paid someone else to put them on Medicare forms. They become owners of businesses and hide their ownership or control of those businesses from Medicare.
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Additionally, from approximately May 2020 to December 2020, Brooks was the operator and beneficial owner of Remote Solutions, a Greenville, South Carolina, company that operated a call center.
According to evidence presented in court, Mr. Brooks and his co-conspirators collected personally identifiable information and personal health information of Medicare beneficiaries so that they could order doctors to place medical braces on body parts such as knees. It is shown that the products were purchased from three different call centers. , shoulders, wrists, and back.
Around December 2020, Mr. Brooks and his co-conspirators at Remote Solutions called Medicare beneficiaries, including residents of South Carolina, and “induced” them to provide personally identifying information and personal health information, even if it was not for dental treatment. The patient was “induced” to agree to accept the treatment even though he was wearing an orthodontic device. It is not medically necessary.
From there, Brooks and his co-conspirators “paid illegal kickbacks and bribes to purported telemedicine companies” to obtain physician signatures on physician orders, regardless of medical necessity. .
Mr. Brooks then submitted false and fraudulent claims to Medicare through his durable medical equipment company using the doctor's instructions.
From May 2019 to approximately December 2020, Mr. Brooks' medical device company filed gross claims with Medicare for orthotic devices that were not medically necessary, not eligible for reimbursement, or were obtained through kickbacks or bribe payments. filed false and fraudulent claims amounting to $29.6 million; Medicare ultimately paid approximately $15.2 million for these false and fraudulent claims.
During the same period, the Department of Veterans Affairs' Civilian Health Care Program, a health care program in which the Department of Veterans Affairs shares the cost of covered medical services and supplies with eligible beneficiaries, paid $22,795 for false and fraudulent claims. .
Funds received from Medicare and the veterans health care program known as CHAMPVA were transferred to Brooks through bank accounts in the name of Remote Solutions or through another entity owned and controlled by Brooks.
In addition to the prison term, U.S. District Judge Henry M. Herlong Jr. ordered Brooks to pay more than $15.2 million in restitution to Medicare and CHAMPVA.
“By facilitating kickbacks, this defendant knowingly enabled theft from Medicare, prioritized personal profit over legitimate patient care, and ultimately cost taxpayers millions of dollars. ” said Tamara E. Miles, Special Agent in Charge of the U.S. Department of Health and Human Services. of the Inspector General.
In addition to the criminal conviction, the Justice Department said it paid $850,000 in a civil settlement last year to resolve allegations that Mr. Brooks offered kickbacks to induce false claims to be filed, a violation of the federal False Claims Act. He said it was a violation.
Joel Hirshhorn, an attorney representing Brooks in South Carolina, said in an email that Brooks sold his Clarence Center home several months ago.
Brooks sold the property, which includes a 4,844-square-foot, six-bedroom, five-bathroom home on Tonawanda Creek Road in Clarence, for $1.25 million on Nov. 16, according to Erie County records.
Contact Jon Harris at 716-849-3482 or jharris@buffnews.com. Follow him on Twitter @JonHarris.
