CEO of health care software company sentenced for $1B fraud conspiracy

[exabrial]

> An Arizona man was sentenced Friday to 15 years in prison and ordered to pay more than $452 million in restitution for conspiring to defraud Medicare and other federal health care benefit programs of more than $1 billion by operating a platform that generated false doctors’ orders used to support fraudulent claims for various medical items.

I wish all headlines read like this instead of "here's why you should be scared"

[lixtra]

As you would expect from a state press release, not a tabloid publication.

[fpierfed]

Here’s why you should be scared: CEO of health care company pardoned by Trump

[burkesquires]

I think fraudsters should have to work off the money they stole at prison wages…punishments are supposed to be deterent and prevent people from commingting crime…don’t seal a billion dollars becasue IF you get caught you will have to pay back half is not a deterent…BUT if they have to pay off a billion dollars at 13-52 cents/hour…that is a deterent!

[UqWBcuFx6NV4r]

That sounds like something you’d read in a Facebook comment. This is government-sanctioned slavery, and I strongly doubt that it would serve as a deterrent. People routinely put much more on the line for much less.

[janalsncm]

At that rate you can pay back maybe $1000 per year, so if you’re only going to live 30 more years there’s no difference in punishment between 30k in fraud and a billion dollars in fraud. Punishment is the same, so might as well scam more.

[inamberclad]

I'd like to see a prison sentence for corporations.

[f1shy]

They should absolutely pay the money back. But why prison wages? Let they produce what they can, and pay back, with interest and all you want. I think it is more important that they are able to "undo" the damage, as to make they suffer.

[free_bip]

I wouldn't want to see that. That's called slavery!

And no, the severity of the crime does not (IMHO) justify it.

[tobr]

Ok, so they have to. Or else what? Back of the envelope, it would take somewhere between 200k and 1 million years of 24/7 work to pay it back at that rate.

[thayne]

That might, maybe, make it more effective as a deterrent, and possibly as retribution, but it would be less effective for restitution (since it would take much longer for those defrauded to get paid back).

[jaredklewis]

Fortunately we have a perfect justice system that never makes mistakes and never abuses their power, so let’s put all the convicts in prison for life for Mac deterrence!!

[donmcronald]

Seize the generational wealth they accumulated. Make their parents, siblings, kids, grandkids, cousins, etc. demonstrate how they earned their money and take every penny they can’t link to honest means.

The discussion around billionaires needs to move away from taxing their income and beyond taxing their wealth. We need to start talking about how much of their wealth we should be taking away. Light it on fire or delete it. The whole world will be better off.

[sharts]

I mean even at extremely high wages, cracking a billion is more than a lifetime

[burnt-resistor]

So token enforcement despite widespread corruption, collusion, racketeering, and rapacious bankrupting of ill, dying, and dead patients and their families in-lieu of a functional healthcare system that isn't obsessed with maximizing shareholder value over lives. It's literally the most expensive deathcare the market will bear.

[frinxor]

Seeing a lot of these pop up more recently, but this has been happening for a decade now apparently. Isn't this the fault of Medicare itself, of not having routine checks and better processes for preventing these fraudulent claims at the source?

If only the big scams are being caught (and we don't know what % are being caught), there's likely a lot more going undetected.

[keernan]

Why does he only have to repay 45%?

[wredcoll]

Article says medicaid only paid 300ish million on the claims.

[xnx]

Is Trump going to pardon this guy like he did Salomon Melgen, who was convicted in 2017 of defrauding Medicare out of $73 million?

[stock_toaster]

Exactly what I was wondering. I guess it depends on how much he does or doesn’t “donate”.

[vdupras]

He could pardon Mangione as well and that would make his karma even. Even Steven, just about square.

[jmyeet]

Meanwhile, we have the former governor of Florida and now Seantor from Florida Rick Scott, who was CEO of the company successfully prosecuted for the largest Medicare fraud in history ($1.7 billion) [1].

Here's what to watch: how long it takes for a donation to show up to the Trump library and how soon after that the sentence is commutted. This has erased roughly $1 billion in penalties so far since January 20. Hell, it might only take $1 million.

[1]: https://www.justice.gov/archive/opa/pr/2003/June/03_civ_386....

[AndrewKemendo]

I mean that’s pretty unabashed good news. I’m probably the most cynical person that comments regularly and I’ll take it!

It’s something at least.

[Cipater]

You're nowhere near the most cynical peron here if your first thought wasn't "how long till he gets pardoned"?

[throw-12-16]

He should run for the Senate.

[webdevver]

79 years of age!? umm... i dont understand - is this supposed to be a warning to others, or an invitation?

where was the FBI for the last 40 years? or did he really just go postal post-covid?

[shoo]

see also: Odd Lots interviewed Jetson Leder-Luis about medicare and medicaid fraud (nov 2024): https://podcasts.apple.com/us/podcast/how-fraudsters-are-bil...

[dickersnoodle]

Good. Now do (Florida Senator) Rick Scott.

[rdtsc]

It's your great chance to win big money! You should bet on it!

[rdtsc]

> The fraudulent doctors’ orders generated by DMERx falsely represented that a doctor had examined and treated the Medicare beneficiaries when, in fact, purported telemedicine companies paid doctors to sign the orders without regard to medical necessity

They'll get doctors as well? Hopefully they are part of the co-conspirators group they mentioned they convicted at the start. Criminals are going to be criminal, but it's especially disheartening when doctors engage in this. All those years going to school should be canceled and thrown into the trash immediately if they get convicted of these kinds of crimes. The path of ever being a doctor should be closed for them.

[OutOfHere]

The problem here is not the doctors. It is billing it to government insurance. Doctors should remain free to gratify patients who are willing to pay cash rather than bill to government insurance. In fact, most such gratifications never have a problem for precisely this reason.