COVID-19 Related Fraud Heating Up

Five months into the COVID-19 pandemic and the number of enforcement actions against companies and individuals who have received COVID-19 relief funds continues to grow. In the following case, investigators allege the suspect mixed it up by allegedly violating both anti-kickback laws and committing relief fund fraud.

According to the complaint, Carlos Belone of Coconut Creek, Fla., submitted claims for approximately $5 million for durable medical equipment (DME) for which Medicare paid approximately $2.3 million. In addition, R&S DME Services submitted claims for approximately $682,681 for DME between July 2019 and January 2020. Medicare paid approximately $242,741. Belone is owner of R&S Pharmacy Inc. and R&S DME Services.

He was arrested and charged with wire fraud, conspiracy to commit healthcare fraud and payment of healthcare kickbacks.

In April 2020, shortly after the emergence of the COVID-19 pandemic, Belone is alleged to have filed three separate applications for Paycheck Protection Program loans (PPP) on behalf of R&S Pharmacy using false information. The program was created to help companies cover payroll and retain employees.

According to investigators Belone was able to obtain more than $22,000 in PPP proceeds. However, instead of using the money for payroll relief and other legitimate purposes, it’s alleged he transferred at least $12,000 into a personal bank account and used at least $3,000 to pay a company known to law enforcement to provide doctors’ orders in return for kickbacks. For that, he was charged with making false statements to a financial institution.

With regard to the kickback case, Belone came to the attention of investigators after more than 100 Medicare beneficiaries contacted a Medicare fraud hotline to file complaints concerning  R&S Pharmacy and/or R&S DME Services. The complaints came in between June 2018 and March 2020.

Investigators spoke to several Medicare beneficiaries who said that they did not want or need orthotic braces, had not authorized their Medicare number to be used to submit claims for orthotic braces, and/or that they did not receive orthotic braces as represented by R&S Pharmacy in the claims that Belone and his co-conspirators submitted to Medicare. The claims totaled more than $5 million between May 2018 and December 2019, the DOJ alleged. Another company owned by Belone, R&S DME Services LLC, submitted similar fraudulent claims totaling more than $680,000 between July 2019 and January 2020, the complaint said.

Investigators determined, through interviews with a cooperating witness, that Belone paid between $150 and $325 for each doctor’s order.

The government has made it clear that fraud schemes, designed to exploit the COVID-19 crisis, is a top priority.  In March, the Department of Justice ordered every U.S. Attorney’s Office to appoint a Coronavirus Fraud Coordinator.

According to the DOJ, a variety of COVID-19-related schemes have cropped up including:

• Individuals and businesses selling fake cures for COVID-19 online and engaging in other forms of fraud.
• Phishing emails from entities posing as the World Health Organization or the Centers for Disease Control and Prevention.
• Malicious websites and apps that appear to share Coronavirus-related information to gain and lock access to your devices until payment is received.
• Seeking donations fraudulently for illegitimate or non-existent charitable organizations.
• Medical providers obtaining patient information for COVID-19 testing and then using that information to fraudulently bill for other tests and procedures.    

Our team of highly skilled attorneys and consultants are here to help you before you become the focus of an investigation, and will aggressively defend you should you become the target of one. In addition, we can assist clients in making sure any arrangements that you are considering do not violate existing laws. Give us a call at 305-358-4500 or email info@vitalehealthlaw.com.