West Palm Beach’s new golf resort, Banyon Cay, appears to be heading for more delays as the developer in charge of the project has been hit with fraud charges by the federal government. 46-year-old Dominic Gatto has been charged along with five others in a scheme to generate money and kickbacks from medically unnecessary orthotic braces. The scheme targeted those with Medicare and other public insurance plans. The government claims that the health care practitioners that ordered the braces knew that they were medically unnecessary and the scheme’s one purpose was to generate kickbacks for fraudsters.
Also charged was a former mob boss affiliated with the Columbo crime family. As of yet, no one has been indicted. It is believed that the charges could halt the development of the Banyon Cay project.
Understanding health care fraud and theft of public services
Typically, health care fraud occurs in the same manner that you see above. Someone is in league with doctors or an unscrupulous clinic on behalf of a medical equipment company. Doctors take a look at a patient and then they determine that the patient needs whatever the company is supplying based on whatever diagnosis requires their products. So the doctor is paid by the medical supply company to fabricate diagnoses. The medical supply company gets extra money by selling their equipment to patients who don’t really need it. The patient goes along with the whole thing because they don’t understand medicine, the practice of medicine, and when specific remedies are required for specific conditions. Plus, they don’t have to pay for it—their insurance picks up the bill.
So health care fraud is generally a type of insurance fraud. Many of these schemes target public insurance because public insurance is a lot less likely to question aggressive medical remedies than a private insurance company. However, Medicare and Medicaid do have doctors on staff to go over the ledger. If they see that a rare type of niche remedy which is far costlier than well-known remedies is being over-prescribed, they will eventually catch up with the fraudsters. It’s not really a matter of if, but when.
The fraud is costly not only to the federal government but the taxpayers who fund the federal government. Every year, waste from fraud costs taxpayers billions in dollars. While many insurance companies would balk at providing orthotic braces on a regular basis to the majority of clients who enter a doctor’s office, Medicare will let fraudsters get away with it for a time and then catch up with them when they have enough evidence to prosecute. So by the time the feds are breathing down the fraudster’s neck, they’ve already built a strong case just by going over the data provided to them by the clinic.
Talk to a West Palm Beach Criminal Defense Attorney
The federal government aggressively prosecutes Medicare fraud. If you’ve been charged with health care fraud by the federal government, you need a West Palm Beach criminal attorney who can argue in federal court. Call The Skier Law Firm, P.A. today to discuss your situation and allow us to begin preparing your defense today.