MIAMI--A well-known Florida attorney who specialized in sales of durable medical equipment companies pleaded guilty on Thursday to Medicare fraud conspiracy and now faces a sentence of up to 10 years in prison, according to the U.S. Attorney's Office, Southern District of Florida.
According to court documents, Benjamin R. Metsch and an unnamed co-conspirator schemed to facilitate the fraudulent sales of 67 south Florida DME companies from October 2002 through August 2004.
Authorities said that Metsch and his co-conspirator attempted to conceal the names of the true purchasers of the companies by preparing "fraudulent sales documents, including stock transfer agreements and operational agreements concerning DME companies that previously had received authorization from Medicare to bill Medicare Part B to receive reimbursement for DME-related items and services." The documents also often greatly understated the true sales prices, authorities said.
The scheme involved "straw" purchasers who, with the knowledge of Metsch and his co-conspirator, acted in the place of the true buyers. That is a violation of both federal law and Medicare rules that require "truthful, complete information concerning the ownership and control of Medicare providers, including DME companies," authorities said.
Once the sales had closed, the purchasers failed to notify Medicare of the changes in ownership in a timely fashion, the court records indicated. Under Medicare rules, DME companies have 30 days after a change or update in ownership in which to report the changes.
"This impaired Medicare's ability to properly oversee the activities of those companies," the court documents said.
The companies then submitted fraudulent Medicare claims for DME items and services as though they were still owned by the prior owners.
The scheme netted Metsch's law firm $103,000, according to authorities; in a plea agreement, Metsch has agreed to pay that amount in restitution. Metsch could get up to 10 years in prison and be fined a maximum of $250,000. He is scheduled to be sentenced on May 18.
To report suspected Medicare fraud, contact the Office of Inspector General by calling (800) HHS-TIPS; e-mailing HHSTips@oig.hhs.gov; faxing (800) 223-2164 (no more than 10 pages) or mailing Office of Inspector General, HHS TIPS Hotline, P.O. Box 23489, Washington, D.C. 20026. For more details, see "Medicare Fraud: How to Report" at www.medicare.gov/FraudAbuse/HowToReport.asp.