A recent federal heath care fraud case alerts clinics as to how some marketers could be recruiting patients by paying those patients to go to clinics or receive DME. Before any marketer is hired, it is critical that the marketing methods be known. If a marketer pays for a patient to go to a clinic, all billing by that clinic to Medicare could be deemed a false claim. Physicians and medical providers cannot hide behind the marketer any longer and due diligence is required by the provider hiring the marketing company or individual.
In this case, James Roland Fuquay, 49, a patient recruiter who sold the personal information of Medicare beneficiaries from San Diego and Los Angeles to Los Angeles medical clinics and durable medical equipment (DME) companies was sentenced on October 26, 2010 to 21 months in prison by U.S. District Judge John F. Walter of the Central District of California. Mr. Fuquay was also ordered to pay $556,815 in restitution and serve three years of supervised release following his prison term.
The sentence follows Mr. Fuquay's guilty plea over a year ago (May 11, 2009) to conspiracy to commit health care fraud. According to court documents, Mr. Fuquay was a patient recruiter known as the “Red, White, and Blue Man,” which is a reference to the colors on a Medicare card. Mr. Fuquay admitted to recruiting Medicare beneficiaries from homeless shelters in San Diego and Los Angeles using the sales pitch, “Red, white, and blue. Let’s make it do what it do.”
Mr. Fuquay then paid the beneficiaries to go with him to fraudulent medical clinics and DME supply companies to receive medical services, power wheelchairs, hospital beds and other medical equipment the beneficiaries did not want, need or receive. Mr. Fuquay’s network of Medicare beneficiaries and fraudulent DME supply companies was large enough for him to make approximately $220,000 in illegal recruiter fees.
According to court documents, one of the fraudulent DME supply companies that paid Mr. Fuquay to recruit beneficiaries was Airport Medical Supply, whose owner, Eli Gichon, pleaded guilty on Sept. 1, 2010, to health care fraud and tax charges. According to court documents, Airport Medical Supply operated out of a dry cleaning business where Gichon directed Mr. Fuquay and others to bring beneficiaries so that Gichon could take pictures of them sitting in power wheelchairs or standing next to empty hospital bed boxes. Gichon used these pictures to try to fraudulently prove to Medicare inspectors that he had in fact provided the beneficiaries with power wheelchairs and hospital beds. Gichon’s sentencing is scheduled for Jan. 10, 2011.
