A Georgia woman was arrested yesterday in Hampton, Georgia, on criminal charges related to her alleged scheme to defraud Medicare by prescribing medically unnecessary durable medical equipment (DME), which was then billed to Medicare.
According to the indictment, Kateline Lavache, 53, of Hampton, allegedly prescribed medically unnecessary DME for Medicare beneficiaries in exchange for kickbacks and bribes from her co-conspirators. Lavache allegedly prescribed DME without conducting proper consultations with the beneficiaries. Lavache had no prior relationship with the beneficiaries, was not treating them, and failed to even conduct telemedicine consultations with them. As a result of the prescriptions, Lavache’s co-conspirators submitted to Medicare approximately $8.8 million in false and fraudulent claims for medically unnecessary DME, of which Medicare paid more than $4 million. Lavache was paid more than $123,000 in kickbacks and bribes for her participation in the scheme.
Lavache is charged with one count of conspiracy to commit health care fraud and wire fraud, as well as four counts of health care fraud. If convicted, she faces up to 20 years in prison for the conspiracy count and up to 10 years in prison for each health care fraud count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Roger Handberg for the Middle District of Florida; Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Miami Regional Office; and Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division; Special Agent in Charge David Walker of the FBI’s Tampa Field Office made the announcement.
The FBI and HHS-OIG are investigating the case.
Trial Attorney Alejandro J. Salicrup of the Criminal Division’s Fraud Section is prosecuting 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, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
An indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.