A Clarence Center man allegedly defrauded Medicare of millions

Jeffrey Brooks, 40, was sentenced Wednesday to 7 1/2 years in prison, followed by three years of court-ordered probation, after he pleaded guilty to one count of conspiracy to commit health care fraud, the Justice Department announced. That case was handled in U.S. District Court in Greenville, South Carolina, and Brooks sold his home in western New York within the past few months.

According to the Department of Justice and court records:

Beginning on or about May 2019, Brooks operated at least eight durable medical equipment businesses, all of which were registered Medicare providers and located in Fort Pierce, Florida. For many of the eight companies, Brooks paid someone else to appear on Medicare paperwork as the owner of the company, thus concealing his ownership or control of those companies from Medicare.

Additionally, from approximately May 2020 through December 2020, Brooks was also the operator and beneficial owner of Remote Solutions, a Greenville, South Carolina, company that operated a call center.

Evidence presented to the court showed that Brooks “and his co-conspirators” purchased Medicare beneficiaries’ personally identifiable information and personal health information from third-party call centers so they could issue doctors orders for medical braces for body areas such as the knee. Shoulder, wrist and back.

In or around December 2020, Brooks and Remote Solutions co-conspirators contacted Medicare beneficiaries, including those in South Carolina, and “induced” them to provide their personally identifiable information and personal health information and also agree to accept brackets, even if They weren’t. It is not medically necessary.

From there, Brooks and his co-conspirators paid “illegal kickbacks and kickbacks to a purported telemedicine company” to obtain a medical practitioner’s signature on doctors’ orders — again, regardless of medical need.

Then, through durable medical equipment companies he controlled, Brooks used doctors’ orders to submit false and fraudulent claims to the Medicare program.

From approximately May 2019 to December 2020, Brooks’ medical equipment companies submitted false and fraudulent claims to Medicare totaling $29.6 million — for aligners that were not medically necessary, ineligible for reimbursement or were obtained through the payment of kickbacks and kickbacks. Medicare ended up paying about $15.2 million on those false and fraudulent claims.

During the same time period, the VA Civilian Health and Medical Program — a health care program in which the VA shares the cost of covered health care services and supplies with eligible beneficiaries — paid $22,795 on false and fraudulent claims.

The funds from Medicare and the VA health program, known as CHAMPVA, were then transferred to Brooks through bank accounts in the name of Remote Solutions or another entity owned and controlled by Brooks.

In addition to the prison sentence, U.S. District Judge Henry M. Herlong Jr. ordered Brooks to pay more than $15.2 million in restitution to Medicare and CHAMPVA.

“By facilitating kickbacks, this defendant intentionally enabled theft from the Medicare program, put personal profit before legitimate patient care, and ultimately cost taxpayers millions,” said Tamala E. Miles, Special Agent in Charge of the U.S. Department of Health and Human Services. Dollars. To the Inspector General.

In addition to the criminal conviction, the Justice Department said Brooks last year paid $850,000 in a civil settlement to settle allegations that he made bribes and caused false claims to be filed, in violation of the federal False Claims Act.

Joel Hirschhorn, an attorney who represented Brooks in South Carolina, said in an email that Brooks sold his home in Clarence Center several months ago.

Erie County records show Brooks sold a property on Tonawanda Creek Road in Clarence, which included a 4,844-square-foot, six-bedroom, five-bathroom home, on Nov. 16 for $1.25 million.