Florida Medical Company Owners Charged $28M in Health Care Fraud

NEWARK, New Jersey—United States Attorney Vikas Khanna announced that two Florida men, a father and son duo, were arraigned on charges relating to their roles in a multimillion-dollar durable medical equipment (DME) and prescription drug health care fraud and kickback scheme.

Nicholas A. Alberino, 61, and his son, Nicholas P. Alberino, 34, were each charged in a seven-count indictment with conspiracy to commit health care fraud and wire fraud, committing wire fraud, conspiracy to violate the federal anti-kickback statute and four counts of violating the anti-kickback statute. The defendants were arraigned and each pleaded not guilty before Esther Salas, U.S. district judge, in Newark federal court.

From February 2018 to April 2019, the Alberino’s operated five Florida companies, each of which generated medically unnecessary prescriptions for certain medications and DME, such as orthotic braces, through a telemarketing and telemedicine scheme. The Alberino’s specifically sought to identify and target Medicare beneficiaries with these schemes. Multiple call centers contacted the beneficiaries by telephone and pressured them to accept the expensive medications and DME. Then, the Alberino’s transmitted the beneficiaries’ personal information, as well as pre-written doctor’s orders and prescriptions, to RediDoc LLC, a purported telemedicine company. The Alberino’s preselected prescription medications and DME for beneficiaries based on the potential for high reimbursement payments from insurance payers, such as Medicare, and not based on the beneficiaries’ medical needs.

RediDoc, in turn, sent the information and documents that the Alberino’s provided to doctors. The doctors typically signed the prescriptions, despite not having any contact with the patients or conducting bona fide assessments of patients’ medical needs, from which the doctors could have deemed that it was medically necessary to order the DME or medications. Once the doctors signed the prescriptions, the Alberino’s directed RediDoc to steer them to third parties with which the Alberino’s had illicit kickback and bribe arrangements. The DME suppliers and pharmacies ultimately fulfilled these fraudulent orders and submitted claims for reimbursement to health care benefit programs, including Medicare. Additionally, the Alberino’s fulfilled fraudulent orders using DME supply companies that they owned and controlled.

The Alberino’s paid over $6 million in kickbacks and bribes to RediDoc and received over $27 million in kickbacks and bribes from third parties in return for fraudulent orders. As a result, the Alberino’s received over $1.7 million from Medicare for fraudulent claims that they submitted directly to Medicare through DME supply companies they owned and controlled. Medicare ultimately paid at least $27 million to DME suppliers and pharmacies based on the fraudulent orders that originated with the Alberino’s.

The health care and wire fraud conspiracy count and wire fraud count each carry a maximum potential penalty of 20 years in prison. The charge of conspiracy to violate the anti-kickback statute carries a maximum potential penalty of five years in prison. The four counts of violating the anti-kickback statute are each punishable by 10 years in prison. Each of the seven counts in the indictment is punishable by a fine of $250,000, or twice the gain or loss from the offense, whichever is greatest.