Florida Man Sentenced In Multimillion-Dollar Medicare Fraud Scheme

NEW YORK—A Florida man who allegedly sold fake prescriptions for durable medical equipment prescriptions was sentenced to 42 months in prison. 

“[Alan] Swiss defrauded Medicare through creating, purchasing and selling millions of dollars’ of false prescriptions for medical equipment,” said Jay Clayton, U.S. attorney for the southern district of New York. “Fraud of this kind not only wastes taxpayer dollars, but also drives up the cost of health care for all. Today’s sentencing sends a clear message: individuals who cheat Medicare will face justice.”

According to statements made in court and publicly filed documents in this case, from approximately 2016 through April 2019, Alan Swiss, 52, of West Palm Beach County, Florida, operated a call center named Tropical Medical Marketing, Inc., which cold-called Medicare beneficiaries and used their personal and medical information without the beneficiaries’ knowledge or consent, to prepare prescriptions for durable medical equipment (DME). Swiss then sold these DME prescriptions to co-conspirators who illegally obtained purported signatures or “authorizations” of health care providers, so that fraudulent claims could be submitted to Medicare for reimbursement.

From approximately 2017 through April 2019, Swiss also operated two DME supply companies: Modern Medical Equipment, Inc., which he used primarily to bill Medicare directly under Medicare Part B, and A&E Medical, Inc., which he then used primarily to bill private insurance companies under Medicare Part C, also known as “Medicare Advantage.”  To obtain the DME prescriptions that Swiss used to support his unlawful claims to Medicare, he used two unlawful methods: purchasing such prescriptions outright and using patient information that he had generated through his call center and purchasing the purported signatures or authorizations of health care providers. Swiss caused the two DME supply companies that he controlled to submit claims to Medicare for more than $18 million—through the billing company operated by his co-defendants, Erin Foley and Ted Albin—on which Medicare paid out nearly $6 million.

In addition to the prison term, Swiss, 52 was sentenced to three years of supervised released.  Swiss was also ordered to forfeit $6,650,929.76 and pay Medicare restitution in the amount of $6,650,929.76.