Provider Medicare Fraud

The real medicare fraud comes from providers. In this case, the defrauder moved the operation from Detroit to the suburbs.
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Medicare scheme alleged
Mich. woman took a million, prosecutors say
September 17, 2005
BY DAVID ASHENFELTER
FREE PRESS STAFF WRITER

Rebecca Ann Sharp was a high roller.
During the past 2 1/2 years, the 40-year-old Ypsilanti woman claimed $442,536 in annual earnings, owned a fleet of luxury cars and raked in $856,298 in winnings from slot machines at casinos. …

Sharp's world came crashing down Aug. 31, when FBI agents raided her home and her Southfield health care business, seizing patient records and three vehicles -- a 2001 Chevrolet Corvette, a 2002 Lincoln LS and a 2003 Lincoln Navigator. They also froze her bank accounts and obtained a court order to prevent her from disposing of her assets.
"She's out of business," Sharp's lawyer, Frederick Bellamy of Farmington Hills, said Friday. He said he believes in Sharp's innocence and that she will try to get her property back so she can restart her business. …
Court records said Sharp did business as Continuing Senior Care of Southfield; Marketing & Assessment of Detroit, and Continuing Senior Home Care LLC of Ypsilanti.
Former employees said Sharp began operating out of the basement where she used to live in Detroit…
One former employee estimated that only 20% of the patients Sharp did business with were actually homebound and eligible for treatment. Another said only 2 in 100 were eligible.
On one day in June 2004, the government said, Sharp billed Medicare for 25.75 hours worth of service that was provided by a 66-year-old physician on her staff.
Court papers alleged that Sharp laundered money and structured bank accounts to avoid paying personal and business federal income taxes in 2003 and 2004. They said she also sold names for $900 each to five other Detroit-area home care companies and had her doctors provide phony Medicare certification for the patients.
All told, Sharp's companies billed Medicare for $2.8 million and received $1.5 million in reimbursements, the government said. Authorities say they believe she fraudulently obtained $936,465, which included $585,054 in illegal kickbacks for selling patients' names to other companies. They said companies to whom Sharp sold names billed Medicare for $4.7 million, although court papers don't indicate how much was fraudulent.