Patient Recruiter Melvin Young Sentenced to 40 Months in Prison for His Role in a Fraudulent Diagnostic Testing Scheme

Source- http://detroit.fbi.gov/dojpressrel/pressrel11/de012611.htm

WASHINGTON—A Detroit-area patient recruiter was sentenced today to 40 months in prison for his role in a conspiracy to defraud the Medicare program, the Departments of Justice and Health and Human Services (HHS) announced today.

Melvin Young, 57, was also sentenced by U.S. District Judge Patrick J. Duggan in the Eastern District of Michigan to three years of supervised release following his prison term and was ordered to pay restitution, joint and several with co-defendants, in the amount of $533,643. Young pleaded guilty in April 2010 to one count of conspiracy to commit health care fraud.

According to the plea documents, beginning in approximately September 2007, Young and a co-conspirator began recruiting and transporting patients to a clinic called Ritecare LLC. Ritecare was owned and operated by co-conspirators and had locations in Detroit and Livonia, Mich. Young admitted that he and this co-conspirator, Emma King, paid kickbacks to Medicare beneficiaries whom they recruited and transported to Ritecare. According to the plea documents, the owners and operators of Ritecare were the source of the funds used by Young to pay the Medicare beneficiaries he recruited. Young admitted that he would keep part of these funds as a kickback. Typically, the owners of Ritecare would provide $100-$150 per patient Young recruited, with Young retaining $50-$75 of that amount.

According to the plea documents, the patients Young recruited had to subject themselves to medically unnecessary tests to receive the money. Per instructions from the owners and operators of Ritecare, Young admitted that he instructed the patients to claim they had certain symptoms to trigger medically unnecessary tests. Consequently, the patients' medical records contained false symptoms allowing Ritecare to deceive Medicare as to the legitimacy and medical necessity of the tests it performed.

Young admitted that King and he were responsible for recruiting at least 269 patients to Ritecare. Through his recruitment efforts, Young caused the submission of approximately $940,760 in false or fraudulent billings by Ritecare. Medicare paid approximately $533,643 on those claims.

 King pleaded guilty in April 2010 to one count of conspiracy to commit health care fraud and was sentenced on Dec. 14, 2010, to 8 months in prison.


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