Medicare-Payment-Methods-1024x768The federal Department of Justice and the Department of Health and Human Services Medicare Fraud Strike Force announced their largest-ever national Medicare fraud takedown today, which included 12 individuals from Kentucky’s Western District, most of whom are from the Louisville area.

The national sweep resulted in charges against 243 individuals for allegedly participating in Medicare fraud schemes totaling $712 million in false billings. The individuals charged in the Western District of Kentucky — including three physicians and the staff of various clinics — involved $7.8 million in fraudulent billings.

“Losses caused by health care fraud are staggering, amounting to tens of billions of dollars every year,” U.S. Attorney John Kuhn of Kentucky’s Western District said in a press release. “Sadly, these fraud losses are passed along to the rest of us in the form of increased health care costs. For that reason, investigating and prosecuting health care fraud is one of the Department of Justice’s highest priorities.”

Jaime Guerrero, formerly a physician with offices in Louisville and Jeffersonville, Ind., was charged with prescribing powerful pain medications without a legitimate medical purpose that resulted in the deaths of five patients. He also was charged with unlawful distribution of controlled substances, health care fraud, conspiracy and money laundering. Guerrero could face up to life in prison, if convicted.

“Kentucky is facing an epidemic of prescription drug abuse,” said Derrick L. Jackson, a special agent at the U.S. Department of Health and Human Services. “Physicians who overprescribe narcotics not only waste valuable taxpayer dollars and defraud Medicare and Medicaid, they also threaten the health and safety of their patients.”

Kelly Lenning, a former medical office manager in Louisville, was charged with health care fraud and aggravated identity theft, accused of using the DEA numbers of former nurse practitioners to prescribe Hydrocodone to two individuals, who gave the pills back to her for her own personal use. Lenning could face 36 years in prison and a $1.5 million fine, if convicted.

Five defendants who worked at Louisville chiropractic clinics were charged with health care fraud and identity theft, accused of scheming to fraudulently bill insurance companies $5 million for services never performed. The Justice Department says the defendants billed that amount for muscle relaxant injections using patient information without their knowledge, while never providing the injections. Each of the defendants could face 10 years in prison.

A Louisville rehab specialist and two co-conspirators also were charged with health care fraud for allegedly staging an automobile accident in order to obtain insurance money and receive controlled substances. Each of the defendants could receive 20 years in prison and a $500,000 fine, if convicted.

Joe Sonka is a staff writer at Insider Louisville focusing on government, politics, education and public safety. He is a former news editor and staff writer at LEO Weekly and has also freelanced for The Nation and ThinkProgress. He has won first place awards from the Louisville Metro chapter of the Society of Professional Journalists in the categories of Health Reporting, Enterprise Reporting, Government/Politics, Minority/Women’s Affairs Reporting, Continuing Coverage and Best Blog. Email him at [email protected]


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