Thursday, May 07, 2009

A contributor to high health care costs

Tuesday, May 5, 2009, 4:44pm EDT
Amador gets jail time Medicare fraud
Atlanta Business Chronicle

A man who set up a series of fake medical clinics in and around Atlanta to support a Medicare fraud ring is headed to federal prison.

Alain Amador, 31, of Miami, was sentenced Tuesday to serve more than four years in prison for conspiracy to commit health care fraud. He also must pay $3.9 million in restitution. Amador pleaded guilty to the charges on March 3.

Amador and his conspirators set up fake medical clinics in metro Atlanta. They leased space in the names of the companies, opened bank accounts, filed corporate documents in the names of the companies, and ultimately applied for and received Medicare billing numbers. However, the companies existed in name only. They maintained no operations, employees, or equipment. Using improperly obtained identity information of actual doctors and Medicare patients, the conspirators filed more than $12 million in Medicare claims for phony services in less than a year.

Of the amount billed, Medicare paid about $3 million before the scheme was uncovered and the payments were halted. The federal government seized about $2 million of the money, some of which was still present in bank accounts when the scheme was identified, and some of which was in the form of checks that were sitting in the fake offices waiting to be picked up and deposited. Most of the remainder of the money was transferred to or deposited in foreign bank accounts.

Amador, who has a nursing degree, helped set up and maintain the fake companies. He assisted in incorporating the companies and opening the bank accounts. He periodically traveled from Miami, where most of the conspirators were based, to Atlanta, to keep up appearances at the office space, check the mail and pay rent.

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