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Former VB businessman sentenced for $8M health care fraud scheme | #phishing | #scams | #hacking | #aihp

NORFOLK, Va. (WAVY) — A former businessman in Virginia Beach has been sentenced to 51 months in prison in connection with a multi-million dollar health care fraud scheme.

According to the U.S. Department of Justice, Frank Alosa, 49, of Kentucky, and another person operated a medical supply company that defrauded federal health care programs.

The fraud happened in 2018 and 2019 through Merchant Card Solutions LLC, which did business as Med Brace Shop. The company sold durable medical equipment supplies and submitted fraudulent claims for reimbursement to Medicare, Tricare, and Virginia Medicaid.

Alosa and his co-conspirator purchased illegal orders for unwanted and medically unnecessary durable medical equipment like orthotic braces. They then used those orders to bill Medicare nd other health care programs.

The fraudulent billing totaled more than $8 million, the DOJ said. Alosa and the co-conspirator used the proceeds for their personal benefit.

The orders for the medical equipment were made by a third party reaching out to beneficiaries and offering the unnecessary equipment. Medical providers then endorsed the unneeded medical equipment in exchange for illegal bribes.

“As a result, the equipment was issued to beneficiaries without regard for actual medical necessity and the orders were billed to their insurance programs, profiting Alosa and his co-conspirator’s company,” the DOJ said.

Alosa also hid his co-conspirator’s criminal history in Med Brace Shop because he could not serve as an owner or manager of the company.

“The methods of concealment included, among other things, creating a shell company for the purpose of making illegal payments to other entities and individuals involved in the scheme,” the DOJ said.

These agencies were defrauded:

  • Medicare of at least $3,843,922.89
  • Tricare of at least $43,370.42
  • Virginia Medicaid of at least $5,121.42.

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