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Reinaldo Wilson, 51, and Jean Wilson, 49, of Richmond Hill, Ga., are accused of using their companies to solicit kickbacks and bribes from patient recruiters, pharmacies and brace supplies – then hiring providers to order medically unnecessary braces for Medicare recipients, the U.S. Department of Justice said.
Both were arrested Wednesday morning and later brought before a U.S. District Court magistrate judge In Greensboro, NC, who ordered Jean Wilson released and her husband held pending a joint Feb. 11 bail hearing.
Each is charged with conspiracy to defraud the U.S., conspiracy to commit healthcare fraud, conspiracy to commit money laundering and receiving kickbacks.
The couple owned and operated purported telemedicine companies ACC and Tele Medcare, which had locations in Bayonne, New Jersey, Boca Raton, Florida, and Richmond Hill, Georgia, the indictment says.
“In order to obtain the orders that were transmitted in exchange for kickbacks and bribes, Reinaldo Wilson and Jean Wilson, through ACC and Tele Medcare, recruited and hired health care providers to order braces for Medicare beneficiaries,” the indictment alleges.
The couple paid kickbacks and bribes to health care providers to order braces for Medicare beneficiaries that were “medically unnecessary, ineligible for Medicare reimbursement and/or not provided as represented,” it adds.
The indictment also says they and others “transferred the brace orders to co-conspirator brace suppliers to support in excess of $56 million in false and fraudulent claims to Medicare that were submitted by brace suppliers and that Medicare paid these brace suppliers in excess of $28 million for these claims.”
This case was investigated by the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and the FBI.
Trial Attorney Darren C. Halverson of the Justice Department’s Criminal Division’s Fraud Section is prosecuting the case.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, First Assistant U.S. Attorney Rachael Honig of the District of New Jersey, Deputy Inspector General for Investigations Gary Cantrell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Director Terry Wade of the FBI’s Criminal Investigative Division made Wednesday’s announcement.
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