A Florida man who supplied Medicare patient information to his co-conspirators to ultimately bill Medicare for durable medical equipment claims has been charged for his alleged participation in a kickback and telemedicine fraud scheme.
Daniel Craig Hallam, a/k/a Daniel Craig, 41, of Palm Beach Gardens, Fla., is accused of conspiring to pay kickbacks for “leads,” or patient identifications and insurance information, of persons who may need durable medical equipment, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia. According to court filings, Craig then received a percentage of the profit from a durable medical equipment company – which billed Medicare for the durable medical equipment – in exchange for supplying leads.
The financial total for orders facilitated through this scheme is alleged to be more than $6 million. Medicare beneficiaries whose patient data was brokered were located in the Southern District of Georgia and elsewhere. Hallam was charged by way of an Information, filed in the U.S. District Court for the Southern District of Georgia.
“As the number of defendants identified through this white-collar fraud investigation in the Southern District continue to grow, taxpayers should be aware that it is a priority of this office to work with our dedicated law enforcement partners to vigorously pursue those who would illegally exploit government safety-net programs for personal enrichment,” said U.S. Attorney Christine.
This prosecution, arising out of the related “Operation Brace Yourself” and “Operation Double Helix,” together with those previously announced, continue to add to the largest fraud operation prosecuted in the history of the Southern District of Georgia. Previous charges in this string of cases include eight physicians, two nurse practitioners, three operators of different telemedicine companies, two other brokers of patient data, and several owners of durable medical equipment companies. The Medicare and Medicaid beneficiaries whose identities were used as part of the scheme are located throughout the country, including in the Southern District of Georgia.
The combined total of more than $480 million in fraud charged in the Southern District of Georgia is part of nationwide operations by the Department of Justice that thus far has included allegations involving billions of dollars in fraudulent claims for genetic testing, orthotic braces, pain creams, and other items.
“The FBI is determined to protect all tax paying citizens who are affected by these kickback schemes, especially those who need government assistance for their health care needs,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. This case is just a small piece of a much larger operation that has put tremendous pressure on those seeking to take advantage of our federally subsidized health care programs.”
“Now more than ever, it’s vitally important that the health care our Medicare beneficiaries seek is based on sound medical advice, not monetary kickbacks,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta. “Together with our law enforcement partners, we will continue in the fight to ensure that government programs are only used for legitimate purposes.”
“Cases of this magnitude can only be tackled using a strategy that recognizes that the most effective way to fight these large criminal networks is by combining the strengths, resources, and expertise of our federal agencies,” said Resident Agent in Charge Glen M. Kessler of the U.S. Secret Service. “Our nation’s healthcare system cannot tolerate kickbacks to physicians and pharmacies while criminals line their pockets with taxpayer funded healthcare dollars.”
Criminal informations contain only charges; defendants are presumed innocent unless and until proven guilty.
This investigation is ongoing. As telemedicine becomes an increasing part of our healthcare system, particularly during the COVID-19 pandemic, vigilance in ensuring that fraud and kickbacks do not usurp the legitimate practice of medicine by electronic means is more important than ever. If you are aware of any fraud or kickbacks relating to telemedicine, please call the FBI hotline at 1-800-CALL-FBI.
Source: Department of Justice