The U.S. Attorney’s Office for the District of Massachusetts announced on January 20, 2020 that Jessica Jones (“Jones”), 30, of Colorado, and Elizabeth Putulin (“Putulin”), 30, of Florida, each pleaded guilty to one count of conspiracy to commit health care fraud involving their involvement in a conspiracy to submit more than $109 million in false and fraudulent claims for durable medical equipment (DME) such as arm, back, knee, and shoulder braces.
The government charged that Jones and Putulin helped Juan Camilo Perez Buitrago (“Perez”), who pleaded guilty in October 2020 to health care fraud and paying kickbacks in connection with a federal health care program, manufacture and submit false and fraudulent Medicare claims by establishing shell companies in more than a dozen different states, including Massachusetts. Perez directed employees, including Jones and Putulin, to list his mother, wife and yacht captain as corporate directors and to use fictitious names when registering the shell companies as DME providers. At Perez’s request, Jones and Putulin purchased Medicare patient data from foreign and domestic call centers that targeted elderly patients, and instructed call centers to contact the Medicare beneficiaries with an offer of ankle, arm, back, knee and/or shoulder braces “at little to no cost.” Perez then submitted Medicare claims for those patients without obtaining a prescriber’s order to ensure that the braces were medically necessary. The government further alleged that Perez submitted blatantly fraudulent claims, including claims for deceased patients and repeat claims for the same patient and the same DME. The government alleged that Perez failed to provide any DME for more than $7.5 million in claims and that when he did provide DME to patients, Perez typically billed insurance policies more than 12 times the average price of the DME that he provided to the patient.
The government also charged that Jones and Putulin further facilitated the fraud by answering frequent phone calls from Medicare patients who received DME that they did not request, want, or need, and they responded to insurance companies’ requests for prescriber’s orders and medical records, which they were unable to provide.
The charging statute provides for a sentence of up to 10 years in prison, three years of supervised release, and a fine of $250,000. Jones and Putulin are scheduled to be sentenced on May 19, 2021. Perez is scheduled to be sentenced on March 4, 2021.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
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