Tuesday, January 28, 2025

Medicare Fraud Yields Prison Time

 The Justice Department issued the following statement. 

A Madison man was sentenced to 37 months in federal prison for conspiracy to defraud the United States.

According to court documents and statements made in court, Reginald Fullwood, Jr., 59, of Madison, participated in 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.

Fullwood pleaded guilty to conspiracy to defraud the United States on August 28, 2024.

Acting U.S. Attorney Patrick A. Lemon of the Southern District of Mississippi, Special Agent in Charge Robert A. Eikhoff of the Federal Bureau of Investigation, and Special Agent in Charge Tamala Miles of the Department of Health and Human Services Office of Inspector General made the announcement.

The U.S. Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation are investigating the case.

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

19 comments:

Anonymous said...

Stupid ain't got no limits.

anon said...

I think these cases and amounts, $6.5 million!, are duplicated all over this country. If our national Shad, Elon can root aout all of these we may well prosper.

Anonymous said...

The AG's office has a Medicaid Fraud Division that I believe focuses on provider fraud.

When's the last time they arrested anyone (or helped the Feds do it)?

David said...

10:23 If Lynn could sign on to a class action with other AGs she would be all over it including a press release

Reggi, Reggi, Reggi said...

One of Reunion's finest.

Anonymous said...

I just did an image search. Is this the same guy who was in trouble, in Florida?

Anonymous said...

@10:23, that's a great question, and I'm glad you asked! I'm wondering the same thing. I haven't heard anything out of the AG's Medicaid Fraud Control Unit in a long time!! Now, it may be that they really did do something and the feds didn't mention it. I've seen that happen before, but somehow I doubt it.

Anonymous said...

If you are referencing a former Florida elected official with a similar name that had some problems with his campaign funds, they probably are two ddifferent people.

Anonymous said...

Fairly rare to see a sentenced perp in the 'Sip with a residence worth a million. How much is owed on it would be a question.

David said...

We could always go to www.attorneygenerallynnfitch.com to find out details.. That self serving website

Anonymous said...

Pretty strong start to a run in politics. With a fraud record like that, he’s an up and coming star in the Republican field.

Anonymous said...

How much have they recovered from him?

Anonymous said...

Good. This doesn’t happen often enough.

Anonymous said...

Sold our company to as part of his JMS acquisition when he got into this business back in 2014. We always did everything the right way and made for damn sure we stayed in compliance with all things Medicare. Its a shame to see what he ended up doing with it.

Anonymous said...

The turnover rates for directors of Medicaid, Medicare and Department of Rehabilitation Services are considerable. These rates are directly correlated with staff competency.

Anonymous said...

Where are the indictments of the doctors who received the kickbacks? Were these prescriptions filed without the knowledge of the physician whose name is on the order?

Anonymous said...

As a lawyer who has filed and files federal whistleblower claims….nobody files in MS because nobody in the US attys office looks at the cases in MS. The large fraud occurs where you have lots of elderly people. MS is a drop in the bucket.

Anonymous said...

They had real lawyers

Anonymous said...

Our tax dollars at work



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