New Orleans, Louisiana - A Louisiana man has pleaded guilty to defrauding Medicare and Medicaid of $11.4 million by billing for unnecessary equipment.
U.S. Attorney Duane A. Evans announced that Craig L. Lovelace, 53, of Destrehan, Louisiana has pleaded guilty to defrauding Medicare and Medicaid out of about $11.4 million by billing for unnecessary durable medical equipment (“DME”).
The government has issued a formal charge against Lovelace, accusing him of healthcare fraud in violation of Section 1347 of Title 18 of the United States Code. Court documents reveal that from approximately January 2016 to June 2022, Lovelace, through his business, Advanced Medical Equipment Inc., wrongfully billed Medicare and Medicaid for expensive medical devices that weren't needed.
This unneeded equipment included equipment for breathing and nutritional support such as ventilators, tracheostomy supplies, and feeding tubes. Reality suggests these items weren't necessary, unrequested, or not provided as promised.
Some of these fraudulent cases involved patients that had already passed away. Lovelace falsely billed Medicare and Medicaid around $11.4 million related to this fraudulent scheme, and his company profited over $7.9 million.
In an attempt to conceal his fraudulent activity, Lovelace prompted the forging of documents, including medical records, order forms, and related documents, to counter Medicare inspections and document requests. These forged documents included the creation of fake provider signatures, medical notes, and dates. He also used manipulative tools like tape, white-out, and scissors to falsely suggest that the audited medical devices were ordered and supplied.
Lovelace could be sentenced to a maximum of ten years in prison. In addition to this, they could potentially receive a supervised release period of up to three years following their release from prison. Lovelace may also be fined up to $250,000 or twice the amount of their gross gains or the gross loss incurred by the victims, along with a compulsory special assessment fee of $100.
The date for the sentencing hearing has been scheduled for November 29, 2023, by U.S. District Judge Jane Triche Milazzo.
U.S. Attorney Evans commended the efforts of the Health and Human Services Office of Inspector General and the Louisiana Medicaid Fraud Control Unit. The case is being prosecuted by U.S. Department of Justice Trial Attorneys Kelly Walters and Samantha Stagias from the Criminal Division's Fraud Section, in conjunction with Assistant U.S. Attorney Nicholas Moses, who serves as the Health Care Coordinator for the Eastern District of Louisiana.