Homeless Used in Medicare Fraud Scheme

'Red, White and Blue Man' Gets Prison Term
Homeless Used in Medicare Fraud Scheme
A California man has been sentenced to 21 months in prison for a Medicare fraud scheme that involved recruiting homeless people to receive unnecessary treatment and equipment.

James Roland Fuquay, who was known as the "Red, White and Blue Man" in reference to the colors on the Medicare card, also was ordered to pay more than $550,000 in restitution, according to the Department of Justice. Fuquay recruited Medicare beneficiaries from homeless shelters in San Diego and Los Angeles using the sales pitch, "Red, white and blue. Let's make it do what it do."

Fuquay paid the homeless to go with him to fraudulent medical clinics and durable medical equipment suppliers to request services as well as equipment, such as power wheelchairs, that they did not want, need or receive, authorities said. The scheme earned him $220,000 in illegal recruiter fees.

Detroit Medicare Fraud Case

In another Medicare fraud case involving two Detroit clinics, four defendants, including clinic owners and patient recruiters, pleaded guilty this week in a scheme that led to the payment of $6.3 million in fraudulent claims out of $8.5 million submitted. Emilio Haber, Maria Haber, Genna Yates and Darryl Nichols each face a maximum penalty of 10 years in jail and a $250,000 fine, according to the Department of Justice.

The two Detroit clinics, Ritecare and CompleteHealth, obtained patients through the payment of kickbacks to Medicare beneficiaries and patient recruiters. Recruiters told patients to feign certain symptoms to justify medically unnecessary tests.

Houston Medicare Fraud Case

And in yet another Medicare fraud case involving a patient recruiter, Sammie Wilson pleaded guilty in connection with a $5.2 million Medicare fraud scheme involving a Houston-based home health care company.

Family Healthcare Group hired Wilson and others to recruit Medicare beneficiaries to file false claims for skilled nursing services that were not medically necessary and/or not provided. Wilson, a Medicare beneficiary, faces a maximum sentence of 10 years in prison, authorities said.

About the Author

Howard Anderson

Howard Anderson

Former News Editor, ISMG

Anderson was news editor of Information Security Media Group and founding editor of HealthcareInfoSecurity and DataBreachToday. He has more than 40 years of journalism experience, with a focus on healthcare information technology issues. Before launching HealthcareInfoSecurity, he served as founding editor of Health Data Management magazine, where he worked for 17 years, and he served in leadership roles at several other healthcare magazines and newspapers.

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