Clinic Owner And Respiratory Therapist Accused Of Medicaid Fraud
Healthcare billing in the United States is anything but a straightforward matter. Just try to make sense of a bill that you have received from a doctor’s office or hospital. When you call your insurance company to try to figure out why your bill is so expensive, you end up still responsible for paying much more than you anticipated, but you also find out that a portion of what the treatment you received has vanished into thin air. With Medicaid billing, patients do not pay anything (except the income tax that the employers of the patients or their parents withhold from their paychecks), so all of the fancy math goes on behind the scenes. Medicaid receives and pays numerous claims every day, and it would take a very extensive audit to find out the true frequency of errors on Medicaid claims and instances in which healthcare providers intentionally inflate the costs of the services for which they bill or intentionally make false statements on the claims. If you or your employer is under investigation for Medicaid fraud, contact a West Palm Beach white collar crime lawyer.
Therapy Clinic Allegedly Paid Kickbacks in Exchange for the Use of the Medicaid Provider Numbers
Until recently, Clive McIntosh operated a clinic called Dynamiks Health Care in Orlando. The clinic provided physical, occupational, and respiratory therapy to patients, most of whom were Medicaid beneficiaries. He is accused of engaging in a kickback scheme in which he allegedly used the Medicaid Provider Numbers (MPNs) of two respiratory therapists to file false claims with Medicaid. In exchange for the use of their MPNs, McIntosh allegedly paid kickbacks to the respiratory therapists.
The MPN of respiratory therapist James Tenpenny appears on a series of Medicaid claims filed by Dynamiks between 2014 and 2019. Prosecutors allege that Tenpenny never actually provided respiratory therapy services to any Dynamiks patients. Tenpenny was arrested in 2022 in connection with the Medicaid fraud scheme, and his case is currently pending.
Between 2018 and 2020, Tymeka Hester’s MPN appears on Dynamiks Medicaid claims that prosecutors also believe are fraudulent. They allege that there is only evidence of Hester treating one patient for Dynamiks. During this time, Hester’s MPN appears on approximately $3.5 million worth of false claims.
This month, McIntosh and Hester were arrested. McIntosh is facing charges for racketeering, money laundering, and Medicaid fraud. If convicted, he could face a maximum sentence of 90 years in prison. Hester is facing charges for Medicaid fraud and scheming to defraud. If convicted, she could face a maximum sentence of 60 years in prison. Like all defendants in criminal cases, McIntosh and Hester are presumed innocent until proven guilty. News sources have not indicated whether either defendant has entered a plea.
Contact a West Palm Beach Criminal Defense Lawyer Today
Attorney William Wallshein has more than 39 years of experience, including five years as a prosecutor in Palm Beach County. Contact William Wallshein P.A. in West Palm Beach, Florida to discuss your case.
Sources:
clickorlando.com/news/florida/2023/05/03/shut-it-down-2-arrested-in-35m-florida-medicaid-fraud-ring-crackdown/
myfloridalegal.com/newsrelease/ag-moodys-mfcu-shuts-down-fraud-ring-stealing-more-3-million-taxpayer-funded-program
