The owner of two telemedicine companies was sentenced today to seven years in prison and ordered to pay $27.9 million in restitution for his role in a scheme to fraudulently bill Medicare for durable medical equipment.
According to court documents and statements made in court, Reinaldo Wilson, 57, formerly of Richmond Hill, Georgia, owned and operated two telemedicine companies located in Bayonne, New Jersey, between 2017 and 2019.
Through these companies, Wilson and others paid illegal kickbacks to medical providers to obtain orders for orthotic braces for Medicare beneficiaries, even though the beneficiaries did not need them. Wilson and others illegally sold the signed orders to purported marketing companies, which often resold them to brace companies, which in turn submitted claims to Medicare for unnecessary braces.
“Instead of connecting patients with legitimate care, Reinaldo Wilson used his telemedicine companies to exploit Medicare and line his own pockets,” said Assistant Attorney General A. Tysen Duva of the Justice Department’s Criminal Division. “He stole over $27.9 million by submitting false and fraudulent claims, robbing a program designed to provide medical care to America’s seniors. The Criminal Division will aggressively prosecute those who defraud Medicare and exploit taxpayer-funded programs meant to serve the people who have paid into the system.”
Wilson and his co-conspirators at marketing companies cajoled beneficiaries into accepting as many braces as possible. Providers working for Wilson’s telemedicine companies signed orders for four or more orthotics apiece for over 3,000 beneficiaries, and more than 40 beneficiaries received orders for 10 or more orthotics.
“Over the span of only two years, Wilson amassed over $56 million in fraudulent Medicare claims, through a cadre of crooked medical providers and co-conspirators, leveraging durable medical equipment for personal financial gain,” said Special Agent in Charge Stefanie Roddy of the FBI’s Newark Field Office. “When criminals defraud Medicare, they undermine the U.S government. The FBI will always work to apprehend these fraudsters and put an end to their schemes.”
Wilson also attempted to conceal his crimes by creating a new telemedicine company and convincing a member of his church that it was an investment opportunity. He took $20k from this member and had her open the company and bank accounts in her name, which he then took control of.
“Today's sentence underscores the serious consequences for those who exploit Medicare for personal gain,” said Acting Deputy Inspector General for Investigations Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS‑OIG). “This sentence reflects our commitment to holding individuals accountable when they manipulate providers, target vulnerable patients, and attempt to conceal fraud behind complex schemes. We will continue working with our law enforcement partners to ensure anyone who abuses federal health care programs is exposed and brought to justice.”
During the conspiracy, Wilson and others submitted over $56 million in false and fraudulent claims to Medicare, of which Medicare paid over $27.9 million.
In March 2021, Wilson pleaded guilty to conspiracy to commit wire fraud and health care fraud.
The FBI, IRS Criminal Investigations (IRS-CI), and HHS-OIG investigated the case.
Trial Attorneys Darren C. Halverson and Nicholas K. Peone of the Criminal Division’s Fraud Section prosecuted the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of eight strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion.
Editor’s Note: Do you enjoy Townhall’s conservative reporting that takes on the radical Left and woke media? Support our work so that we can continue to bring you the truth.
Join Townhall VIP and use promo code FIGHT to receive 60% off your membership.
Join the conversation as a VIP Member