A Florida man who ran a group of pediatric day care facilities that provide services to special needs children has been charged with fraud. According to a press release, the 53-year-old Orlando resident has been charged with one count of Medicaid provider fraud for allegedly bilking the taxpayer-funded program out of more than $400,000. He was taken into custody on March 22. Medicaid provider fraud involving sums of more than $100,000 is a first-degree felony in Florida punishable by up to 30 years in prison and a fine of up to $10,000.
Fraud uncovered
The man’s alleged activities were discovered by the Florida Attorney General’s Medicaid Fraud Control Unit during a routine audit of daily census reports submitted by pediatric day care facilities in Lakeland, Haines City, Melbourne and Orlando. Investigators claim to have discovered that more than a third of the Medicaid claims submitted sought payment for medical services that were not provided.
Overbilling
When patients did receive treatment, the man allegedly falsified Medicaid claims by increasing the patient attendance rate to 100%. The man is said to have submitted 220 Medicaid claims per day for specialized nursing services and occupational, speech and physical therapies. He is also accused of offering parents bribes to prevent his health care fraud scheme from being discovered. In a lawsuit filed on the same day the man was arrested, the Ninth Judicial Circuit State Attorney’s Office accuses the man of filing more than 1,000 fraudulent Medicaid claims between July and December 2021.
Defrauding taxpayers
The possible prison sentence this man faces shows how severe the penalties for defrauding taxpayers can be. Programs like Medicaid provide crucial services to the community, but they also swallow up a lot of government resources. When these programs are defrauded, communities suffer and taxpayers foot the bill. This is why offenders are treated harshly.
