Kusserow’s Corner: Medical Equipment Supply Company Owner Indicted and Three Others Plead Guilty for Roles in $20 Million Medicare Fraud Scheme

On October 24, 2013, Jacob Kilgore of Fruit Heights, Utah, was indicted in the District of Utah on three counts of health care fraud, three counts of false statements relating to health care matters, and three counts of wire fraud. He was the co-owner, vice president, and regional sales manager of Orbit Medical Inc. (Orbit), a durable medical equipment supplier located in Salt Lake City specializing in power wheelchairs. He was charged with directing a scheme to defraud Medicare by submitting false and fraudulent claims to Medicare for power wheelchairs. The scheme allegedly resulted in more than $20 million in claims from Orbit to Medicare for power wheelchairs, of which Medicare paid more than $15 million. Three former company employees previously pleaded guilty for their role in the fraud scheme and are awaiting sentencing.

The indictment alleges Kilgore and others falsified medical records—including power wheelchair prescriptions and chart notes obtained from physicians—to make it appear that beneficiaries qualified to receive power wheelchairs when they did not and that the claims otherwise met all Medicare requirements. These falsified documents were used to support false and fraudulent claims from Orbit to Medicare.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2013 Strategic Management Services, LLC. Published with permission.