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Date: 03-11-2024
Case Style:
Case Number: 20CR2887-WQ
Judge: William Q. Hayes
Court: The United States Court for the Southern District of California
Plaintiff's Attorney: The United States Attorney’s Office for San Diego
The case is being prosecuted by Assistant U.S. Attorneys Valerie H. Chu and Christopher M. Alexander of the Southern District of California.
Defendant's Attorney:
Description:
Father and Son Duo Sentenced to Prison in $21 Million Dollar Medicare Scheme
Anthony Duane Bell Sr. and his son, Anthony Duane Bell Jr., were sentenced in federal court today to 65 months and 12 months and one day, respectively, for their roles in fraudulently receiving more than $21 million in Medicare payments and lying to cover it up.
The pair, along with others, conspired to commit Medicare fraud by billing for medically-unnecessary durable medical equipment such as knee, ankle, shoulder, wrist and back braces. Bell Sr. pleaded guilty to Medicare fraud while Bell Jr. pleaded guilty to making false statements to a federal officer.
U.S. District Court Judge William Q. Hayes also ordered Bell Sr. to pay $21,725,604.56 in restitution to Medicare and forfeit $806,375.12 and a luxury house in El Cajon. The forfeited property was purchased using money obtained from the fraud. In arriving at the sentence, Judge Hayes found that Bell Sr. intended to defraud Medicare of over $46 million dollars and received over $21 million dollars.
“This brazen scheme exploited elderly and disabled Medicare beneficiaries so these defendants could line their own pockets,” said U.S. Attorney Tara K. McGrath. “Together with our law enforcement partners, this office will continue to vigorously investigate and prosecute fraud that diverts Medicare funds from some of our nation’s most vulnerable citizens.”
“Those who game the system to take advantage of federal health care programs for personal financial gain do so at the expense of those who rely on these programs and American taxpayers,” said Special Agent in Charge Timothy B. DeFrancesca of the Department of Health and Human Services Office of the Inspector General (HHS-OIG). “Together with our law enforcement partners, HHS-OIG will continue working diligently to hold these individuals accountable.”
“The Bells using their business as a front to defraud the U.S. government and Medicare program is unacceptable,” said FBI San Diego Acting Special Agent in Charge Tom Ryan. “The FBI and its law enforcement partners will continue to dedicate their resources to make sure individuals who try to illegally profit from the U.S. government will be prosecuted.”
According to court records, the Bells created companies known as Universal Medical Solutions 1 and Universal Medical Solutions 2, which supplied durable medical equipment. In order to find customers for their businesses, the Bells entered into sham agreements with “marketing” companies that, instead of marketing, provided packets of information about Medicare beneficiaries for $125 to $350 each. These packets of information included a Medicare beneficiary’s personal information, medical history, Medicare number, and an audio recording between a call center and the patient, in which the patient supposedly agreed to accept a brace. The packet also included a signed prescription from a doctor, obtained via telemedicine, claiming that the brace was medically necessary for the patient – although in almost all cases the prescription was signed by a physician who had no previous doctor-patient relationship with the patient, was often in another state, and at most had conducted an audio call with the patient. In all cases the doctor had not conducted any kind of physical examination of the patient.
The Bells bought thousands of these patient packets, each time indirectly paying the telemedicine doctors through the “marketing” companies. The packets were referred to in the industry as “Doctor’s Orders” or “D.O.s.” The Bells purchased the “D.O.s” for a variety of braces, paying the most (up to $350) for a back brace prescription, the type of medical equipment for which Medicare offered the highest reimbursement. The Bells could then, after shipping the brace to the patient, bill Medicare around $1,359.89 for each back brace, through their companies. The Bells also bought other braces, including wrist, knee, and shoulder braces, and billed Medicare at much higher prices than they paid for them.
When Bell Jr. was interviewed by the FBI, he lied about his knowledge of the scheme.
Outcome:
Plaintiff's Experts:
Defendant's Experts:
Comments: