Plea Part Of Massive Fraud Investigation That Also Led To Delray Chiropractor Richard Davidson Facing 10 Years In Prison. Parkland’s Patsy Truglia Charged.
BOCA RATON, FL (BocaNewsNow.com) — Boca Raton Chiropractor Jonathan Michael Rouffe is facing ten years in prison following a guilty plea in a $20M health care fraud conspiracy. Rouffe lives in the 5300 block of Park Place Circle in Boca Raton.
BocaNewsNow.com reported last week that Delray Beach Chiropractor Richard Davidson plead guilty to healthcare fraud and also faces ten years in prison. The United States Department of Justice Wednesday issued an advisory stating that both cases are part of the “largest enforcement action in Department of Justice History.”
“These defendants have been charged with submitting mor than $6B in false and fraudulent claims to federal health care programs and private insurers,” wrote the DOJ, “including more than $4.5 billion connected to telemedicine, more than $845 million connected to substance abuse and treatment facilities or “sober homes,” and more than $806 million connected to other health care fraud and illegal opioid distribution schemes across the country. More than 345 defendants have been charged across 51 federal districts.”
The Jonathan Rouffe Case
United States Attorney Maria Chapa Lopez announces that Jonathan Michael Rouffe (47, Boca Raton) has pleaded guilty to conspiracy to commit health care fraud. He faces a maximum penalty of 10 years in federal prison. A sentencing date has not yet been set.
According to the plea agreement, in 2018, Rouffe and his conspirators established a conglomerate of durable medical equipment (“DME”) supply companies. During the creation of the companies, they lied to Medicare to secure billing privileges. The scheme involved placing the companies in the names of straw owners. By concealing their true ownership, the conspirators secretly gained control of multiple companies, which Medicare prohibits. This enabled the conspirators to submit high volumes of illegal DME claims while attempting to evade law enforcement scrutiny. In one year, through the conglomerate, Rouffe and his conspirators submitted more than $20 million in illegal DME claims, resulting in over $10 million in payments from Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (“CHAMPVA”).
To attain such high volumes of claims, the conspirators used bribes and kickbacks. Specifically, Rouffe and his conspirators illegally purchased thousands of DME claims from so-called “marketers.” The marketers, for their part, had generated the claims under the guise of “telemedicine,” but no telemedicine had actually occurred. Instead, the “marketers” had bribed doctors to sign the DME brace orders that supported the claims. Rouffe and his conspirators paid millions to secure the illegal DME claims for submission to Medicare and CHAMPVA.
DOJ Statement, Issued Wednesday, Regarding Both Rouffe and Richard Davidson of Delray Beach:
Dr. Jonathan Michael Rouffe (47, Boca Raton, FL) and Dr. Richard Davidson (41, Delray Beach, FL) pleaded guilty in separate cases to conspiracy to commit health care fraud. Each faces a maximum penalty of 10 years in federal prison. According to court documents, Rouffe, Davidson, and other conspirators secretly controlled conglomerates of fraudulently established DME supply companies. During the conspiracies, the companies submitted more than $31 million in illegal DME claims to Medicare and the CHAMPVA, resulting in over $16 million in payments. The conspirators paid millions in kickbacks and bribes to acquire illegally signed doctors’ orders for DME from so-called “marketers,” who, for their part, had generated the signed doctors’ orders using aggressive telemarketing strategies in concert with fraudulent telemedicine involving bribed doctors. The cases are being prosecuted by Assistant United States Attorney Kristen A. Fiore
Parkland’s Patsy Truglia Charged
Patsy Truglia (52, Parkland, FL) and Ruth Bianca Fernandez (37, Lauderhill, FL) were charged in a 13-count indictment alleging a conspiracy to defraud Medicare and to commit health care fraud, submit false statements to Medicare, and violate the federal Anti-Kickback statute, as well as other related charges. The indictment was unsealed with the defendants’ arrests on September 9, 2020. According to the indictment, Truglia and Fernandez conspired to create and submit fraudulent claims to Medicare for medically unnecessary DME, using aggressive telemarketing that targeted Medicare beneficiaries, bogus telemedicine encounters, and signed doctors’ orders secured using illegal bribes and kickbacks. Through the conspiracy, Truglia and Fernandez caused the submission of approximately $25 million of fraudulent claims to Medicare and other federal health care programs, including CHAMPVA, resulting in payments of approximately $10 million from the programs. The case was charged by Assistant U.S. Attorney Kristen Fiore and is being prosecuted by Assistant U.S. Attorney Jay G. Trezevant.
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