Corporate Compliance

Detroit clinic owner sentenced for Medicare fraud scheme

Compliance Monitor, August 18, 2010

The owner of a Detroit-area medical clinic will serve 56 months in prison and pay $2 million in restitution for defrauding Medicare, according to a Department of Justice (DOJ) press release.

Carlos Grana, 36, admitted to operating Careplus LLC, a medical clinic that generated nearly all of its patients through illegal kickbacks, according to the DOJ. Grana paid patient recruiters $100–$150 for each Medicare beneficiary they brought to Careplus to receive illegitimate medical testing. Per Grana’s instructions, recruiters told patients to fake symptoms for the purpose of deceiving Medicare about the medical necessity of tests performed, according to the DOJ.

Between February 2008 and October 2009, Careplus submitted approximately $2.2 million in false claims. Medicare paid $2 million of those claims.

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