Two Florida men were arrested earlier this month and are facing federal charges related to an alleged kickback scheme involving clinical laboratory testing. David Brock Lovelace, 44, and Dale B. DuBois, 61, were arrested by federal agents and charged with conspiracy to defraud the Medicare program. Lovelace was previously indicted on charges that he submitted $5.9 million in false radiology, audiology, neurology, and cardiology claims to Medicare in connection with his company, Summit Health, which operated health care clinics. Lovelace was one of 50 Floridian health care providers or executives caught up in a federal sting earlier this year. According to the U.S. Justice Department, Lovelace and DuBois are accused of paying kickbacks to medical clinics in Miami in exchange for DNA samples and patient information. They would then sell the samples and patient data to medical laboratories, which would then use them as a pretext for billing Medicare. According to Justice, Lovelace has received at least $675,000 from just one lab over the past 14 months. The labs have not been named by investigators or prosecutors. The case is being handled by the Federal Bureau of Investigation (FBI) and the Office of Inspector General of the U.S. Department of […]
Two Florida men were arrested earlier this month and are facing federal charges related to an alleged kickback scheme involving clinical laboratory testing.
David Brock Lovelace, 44, and Dale B. DuBois, 61, were arrested by federal agents and charged with conspiracy to defraud the Medicare program.
Lovelace was previously indicted on charges that he submitted $5.9 million in false radiology, audiology, neurology, and cardiology claims to Medicare in connection with his company, Summit Health, which operated health care clinics. Lovelace was one of 50 Floridian health care providers or executives caught up in a federal sting earlier this year.
According to the U.S. Justice Department, Lovelace and DuBois are accused of paying kickbacks to medical clinics in Miami in exchange for DNA samples and patient information. They would then sell the samples and patient data to medical laboratories, which would then use them as a pretext for billing Medicare. According to Justice, Lovelace has received at least $675,000 from just one lab over the past 14 months. The labs have not been named by investigators or prosecutors.
The case is being handled by the Federal Bureau of Investigation (FBI) and the Office of Inspector General of the U.S. Department of Health and Human Services (HHS). It is one of many Medicare fraud cases that have been brought in recent years, as the Obama administration has made Medicare fraud prevention a priority among its law enforcement policies.
HHS has created special media events throughout the country to discuss the issue and has set up special task forces in nine U.S. cities, although officials have indicated that the bulk of fraudulent activities have been occurring in Southern California and South Florida. A joint FBI-HHS strike force focused on Medicare and Medicaid fraud has charged some 2,000 defendants since 2007 and accused them of defrauding the program of more than $6 billion.
In an unrelated California case, state prosecutors earlier this month filed 31 charges of felony grand theft, conspiracy, false impersonation, and insurance fraud against Douglas J. Abeles, M.D., an orthopedic surgeon who practices in the Castro Valley, east of San Francisco. Abeles’s office manager, Gabriela Cuevas, was also charged.
According to an indictment, Abeles operated several medical-related businesses, including one that performed urinlaysis tests for drug compliance purposes, primarily in workers’ compensation cases. However, prosecutors say the work was never performed, even though insurance claims were routinely submitted by Abeles’s businesses. Insurers Liberty Mutual, Travelers Insurance Co., Zenith Insurance Co., and Fireman’s Fund Insurance Co. are among those payers to have alleged they received false claims.
“Large insurance fraud schemes are often highly sophisticated,” said Alameda County District Attorney Nancy E. O’Malley in a statement issued by the California Department of Insurance. “This investigation required extensive and diligent investigative work, entailing the meticulous collection of evidence.”
Takeaway: The federal crackdown on health care fraud in Florida is continuing, with laboratories likely to be targets in the not-too-distant future.
