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Multi-Million Dollar Medicare Fraud Scheme Exposed in Massachusetts
Talia Alexandre, 30, of Palm Springs, Fla., and Stefanie Hirsch, 51, of Los Angeles, Calif., have admitted to their roles in a massive Medicare fraud scheme that spanned years and defrauded the program out of over $109 million.
According to court documents, Alexandre and co-conspirator Nathan LaParl sold Medicare patients’ personal and medical data to Juan Camilo Perez Buitrago, who used it to submit false and fraudulent claims. Alexandre received over $1.4 million from Perez Buitrago for the patient data.
Perez Buitrago and LaParl accessed a patient eligibility tool provided by Hirsch, who owned EI Medical, Inc., a Medicare-enrolled wheelchair and scooter repair company. Hirsch improperly gave LaParl and Perez Buitrago access to the tool, charging them about $0.25 per patient eligibility check.
The scheme was perpetrated through foreign call centers that contacted Medicare patients to ask if they were interested in durable medical equipment. The patients’ demographic and insurance information was collected and sold to Perez Buitrago, who used it to submit false claims for DME that was not prescribed, not necessary, and often never requested or received.
LaParl pleaded guilty in January 2021 and is scheduled to be sentenced on May 20, 2021. Perez Buitrago pleaded guilty in October 2020 and is scheduled to be sentenced on May 5, 2021. Two other defendants, Jessica Jones and Elizabeth Putulin, pleaded guilty in January 2021 and are scheduled to be sentenced on May 19, 2021.
Talia Alexandre pleaded guilty to one count of receiving kickbacks in connection with a federal health care program. Stefanie Hirsch pleaded guilty to violating the HIPAA statute. U.S. Senior District Court Judge George A. O’Toole Jr. scheduled the sentencing hearings for June 24, 2021.
The case was investigated by the Federal Bureau of Investigation, the Department of Health and Human Services, Office of the Inspector General, and the U.S. Postal Inspection Service.
Key Facts
- State: Massachusetts
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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