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.
