Saturday, June 29, 2024

Madison Man Charged in $12 Million Medicare Attack

 The Justice Department issued the following statement Thursday. 

Today, United States Attorney Todd Gee announced criminal charges against a defendant in connection with an alleged conspiracy to defraud the United States. The charges filed in federal court are part of the Department of Justice’s 2024 National Health Care Fraud Enforcement Action. The charges stem from a scheme to pay kickbacks to a marketer in exchange for completed doctors’ orders so the defendant could cause his durable medical equipment companies to bill Medicare and Medicare Advantage plans for orthotic braces that were medically unnecessary and/or ineligible for reimbursement. 

“This defendant engaged in a scheme that cost taxpayers in Mississippi and throughout the nation millions of dollars,” said U.S. Attorney Todd Gee. “The Department of Justice is committed to investigating and prosecuting fraud in Mississippi, and I encourage doctors, patients, and others that are aware of such schemes to report them to federal authorities.”

The charges announced today are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.

The Health Care Fraud Unit’s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys’ Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals’ Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit’s Data Analytics Team. Descriptions of each case involved in today’s enforcement action are available on the Department’s website here.

During the enforcement period, the Southern District of Mississippi worked with the Department’s Criminal Division, the U.S. Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation to investigate and prosecute this case.

The defendant charged in the Southern District of Mississippi as part of this enforcement action is Reginald Fullwood, Jr., 59, of Madison, Mississippi.  Fullwood was charged by information with conspiracy to defraud the United States in connection with a scheme to pay kickbacks to a marketer in exchange for completed doctors’ orders so that he could cause his durable medical equipment company, Jackson Medical Supply, to bill Medicare and Medicare Advantage plans for orthotic braces that were medically unnecessary and/or ineligible for reimbursement. When Medicare initiated an investigation of Jackson Medical Supply, the defendant opened another entity in the name of a nominee owner and again paid kickbacks to a marketer in exchange for doctors’ orders so that the new entity could continue to bill Medicare and Medicare Advantage plans for orthotic braces. Overall, Fullwood caused these entities to bill Medicare and Medicare Advantage approximately $12,441,625.30 and the entities were reimbursed approximately $6,448,092.61 for durable medical equipment that was medically unnecessary and/or ineligible for reimbursement.

The case is being prosecuted by Trial Attorney Sara Porter of the Gulf Coast Strike Force and Assistant United States Attorney Kimberly Purdie.

An information is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

26 comments:

Anonymous said...

You manage to mention the name of the local defendant after roughly 500 words.

Bravo. Great journalisming.

Anonymous said...

Einstein, it’s a statement from the Justice Department.

Anonymous said...

The first sentence of the post is "The Justice Department issued the following statement Thursday." It's a news release, not a KF-authored post.

Great reading comprehension-ing.

Anonymous said...

After scanning the descriptions of many of the cases in the link, these acts are incredibly widespread and diverse. Hopefully real-time AI analysis of prescriptions may stop this in the future before these levels of thievery are detected.

Anonymous said...

Convert part of Parchman prison to a federal facility and dump every one of them in there. It is my understanding that it is somewhat uncomfortable, particularly in the heat of summer.

Anonymous said...

Attn 3:00 pm. Remedial reading courses are readily available at various stations around the state.

Nice digs said...

Tip of the iceberg.

Anonymous said...

Kingfish chooses his own headlines, you fucktards, and decided to put “Madison man” in this one, before his copy & paste job. He’s not a trained journalist, or else he wouldn’t have “BURIED THE LEDE” as he did here.

Want to grab clicks with a “Madison Man” headline? Fine. Just don’t leave the local dude’s name out of the story till you’re 500 words deep.

It’s fucking lazy.

Anonymous said...

I would challenge any medical doctor (who sees patients) to swear (on his/her child's soul) that he is not cheating Medicare.

Anonymous said...

He ought to have to go to prison.

Kingfish said...

Well, dummy, here is the headline the JUSTICE DEPARTMENT gave the press release. It's on its website.

"Madison Man Charged with Conspiracy to Defraud the United States as Part of Department of Justice’s 2024 National Health Care Fraud Enforcement Action"

You don't like how the press release was phrased, take it up with DOJ.

Anonymous said...

Crime in Madison County is obviously out of control. Stay in Jackson! Don't move here. Chowke will protect you. Danger, danger.

Anonymous said...

Then why did you change the headline to include the word 'attack'? What 'attack'?

Y'all have beat that poster up quite enough.

Anonymous said...

I tried to post that most if not all medical doctors who see patients on a daily basis have and do defraud the Medicare and Medicaid programs. If they say they don't, they're lying. In their hearts they think it's justified since reimbursements are so minimal.

But, since that post didn't criticize the former poster, my post was shit-canned.

Louis LeFleur said...

Is this the same Reggie Fullwood who attended Westpoint and played football for the Golden Knights? Inquiring minds want to know.

Anonymous said...

Copy. Paste. Copy. Paste.

Anonymous said...

Them Dang Madison fokes.

Anonymous said...

@8:26

Though this particular scammer isn’t a doctor, you are 100% correct on the overwhelming majority of docs scamming CMS, all under the rubric that they are so overworked and underpaid, plus the government doesn’t reimburse them at the rate each of them value their respective “genius.” Billing for non-performed or unneeded tests is as common as the value billing schemes at all the big law firms.

Looks like this guy, like Cain, Langston, and fine former Ole Miss Rebels like Rufus French & Logan Power, wanted to join the government handout gravy train that the docs/pharmacists has kept to themselves for so long.

Anonymous said...

Louis, yes, that is the same Reggie.

Anonymous said...

The biggest defraud of healthcare is the Medicare annual wellness visit where Medicare pays doctors $250 dollars to collect all kinds of personal information about patient under the guise of a physical exam and then turn it into the government for them to do whatever the hell they want to with, with patient consent without the real knowledge of what’s happening. They collect some sort of multi phasic personality inventory, some sort of audit of all sort of things in their home, including guns and alcohol, test to see if you have dementia, also test to see if you’re frequently falling, and then force vaccinations. This is the biggest abuse that I’ve ever seen in my career as a physician. Half of my Medicare patients despise this and opt out, and God forbid you have Humana healthcare, they have Medicare wellness nurses call the patients and get in the middle of all of their business. And no, the doctor who’s working their ass off is not defrauding Medicare, they’re Getting audited by Medicare for ordering more than two lipid profiles in one years time because they identified someone with hyperlipidemia on a Medicare wellness visit, follow them them up per the standard of care. You are damned if you do and damned if you don’t when you’re a physician in primary care taken care of anything that’s has anything to do with the centers Sheely come here for Medicare and Medicaid services.

Anonymous said...

They gave him time to get a head start. He is probably in Mexico now. I hope he like tacos.

Anonymous said...

10:22 You need your mouth washed out with soap, like our parents did when we used curse words!

Anonymous said...

7:04 PM is correct.
We tell patients they don't have to answer any questions they don't feel comfortable answering on the questionnaire.

Anonymous said...

Kingfish, is this tied to the sealed indictments discussed earlier (24-198 to 24-202)?

Anonymous said...

The same Reginald Fullwood who was kicked out of the FL State Legislature for tax fraud, too. You'd think one would learn...

Anonymous said...

@4:09

Different, but equally-crooked, Reggie Fullwood. This is Mississippi, former West Point cadet, casino Reggie, not Florida politico Reggie.


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