Guilty Defendant in $39 Million Medicare Fraud Case is a 22-Year-Old

Medicare is a program aimed at providing healthcare to elderly Americans, but you don’t have to be 65 in order to commit Medicare fraud. In fact, a Florida man was recently convicted of bilking nearly $40 million out of the government program despite the fact that he is only a few years removed from high school. 

Christopher Spellman, 22, was found guilty of defrauding Medicare out of $39.5 million. Prosecutors had charged him with submitting false claims in a number of states. Spellman set up multiple shell companies that posed as legitimate healthcare providers and submitted thousands of claims to Medicare, seeking reimbursement for equipment that was either unnecessary or never provided

The company owned by Spellman and his co-conspirators, Dimon Business Solution, LLC, was portrayed as an operation to manage durable medical equipment, such as blood sugar meters, oxygen-providing equipment, wheelchairs and CPAP machines. Dimon’s owners also controlled medical equipment supply companies, but used figureheads to hide their connection to these firms. 

As part of their scheme to commit Medicare fraud, Spellman and the other owners used various methods, including bribes and kickbacks, to convince doctors to provide unnecessary prescriptions for orthotic braces. In turn, the companies controlled by Spellman and the others billed Medicare and were reimbursed for tens of millions of dollars. 

Sometimes, reimbursement requests for relatively low-cost items or services do not receive a great deal of scrutiny from Medicare. However, as the Dimon case shows, submitting a heavy volume of claims for equipment such as orthotic braces can amount to substantial revenue in just a few years. 

Through initiatives such as the Health Care Fraud Prevention and Enforcement Action Team (HEAT), the U.S. Department of Justice and the Department of Health and Human Services have been working together to crack down on illegal Medicare claims. However, no government effort has the ability to catch every instance of wrongdoing. Nurses, home health aides, medical device technicians and others on the frontlines of medical care are often the first to know when a company is billing for unnecessary items or services. 

If you’re aware of a situation that might involve healthcare fraud, a consultation with the attorneys of Kardell Law Group will help you understand what protections apply, and how you could be compensated if you report what you know.