Two people from opposite ends of the countrywere among six total defendants who pled guilty recently for their roles in a Medicare fraud scam that totaled multiple millions of dollars.
Talia Alexandre, a 30-year-old from Palm Springs, Florida, and Stefanie Hirsch, a 51-year-old from Los Angeles, California, both pled guilty in the case.
Alexandre was charged with receiving kickbacks from a federal programrelated ot health care (one count). Hirsch, meanwhile, violated a Health Insurance Portability and Accountability Act (HIPPA) statute.
Both women will be sentenced before Senior Judge George A. O’Toole Jr., of U.S. district court judge, on June 24.
Alexandre conspired with Nathan LaParl, charging documents said. They allegedly sold medial and personal information from Medicare patients to Juan Camilo Perez Buitrago.
The co-conspirators worked with various call centers based in foreign countries to reach out to Medicare patients. Once the patients were on the phone, they were asked whether they would want to purchase durable medical equipment for either free or at low costs. This DME were braces offered for shoulder, knee, back or arm support.
The foreign call centers then collected insurance and demographic information from these Medicare patients and gave it to LaParl and Alexandre, who then sold that data to Perez Buitrago.
Perez Buitrago is alleged to have paid in excess of $1.4 million to Alexandre for this information. With that information in hand, he submitted fraudulent and false insurance claims in excess of $109 million for the DME the patients neither necessary, requested, prescribed or received.
LaParl and Perez Buitrago perpetuated their fraud by accessing an eligibility tool to check whether the Medicare patients were eligible for the DME through their insurance. Hirsch provided access to that eligibility tool.
Hirsch was the owner of El Medical Inc., which is a scooter and wheelchair repair company enrolled with Medicare. Because of its status, the company could access a clearinghouse database that has insurance, medical and personal information from Medicare patients.
Hirsch charged LaParlas well as Perez Buitrago 25 cents for each eligibility check that they conducted through the database. LaParlgained access to data of 350,000 Medicare patients using the credentials Hirsch provided. Perez Buitrago used the credentials to access the data for Medicare patients in excess of 150,000.
In January, LaParl plead guilty to his charge, and his sentencing hearing is scheduled for May 20. Perez Buitrago plead guilty in October of last year to charges of paying kickbacks and health care fraud in connection to a federalprogram for health care. His sentencing hearing is scheduled for May 5. Elizabeth Putulin and Jessica Jones, two additional defendants in the case, in January also plead guilty. Their sentencing hearings are scheduled for May 19.