A Center City medical-supply company and the couple who own it were charged by a federal grand jury yesterday with bilking Medicare and other benefit programs out of more than $1.2 million.
Authorities said R&V Medical Supplies and its owners, Robert Saul, 36, and Sheila Saul, 51, both of Philadelphia, submitted bogus claims for reimbursement for durable medical equipment such as power wheelchairs and scooters.
Also charged yesterday were two former employees of a Philadelphia-based nonprofit, Carol Mason, 57, of Norristown, and Lisa Burnett, 40, of Philadelphia, who allegedly received kickbacks for Medicare referrals.
Mason was allegedly paid almost $15,000 and Burnett more than $2,000 in kickbacks from the Sauls, the indictment said.
Two Philadelphia women, Susan Landolf, 27, a former R&V employee, and Debra Stallings, 43, who worked at a medical practice, were charged separately in the case - Landolf with receiving kickbacks for Medicare referrals and health-care fraud, and Stallings with health-care fraud.
U.S. Attorney Michael Levy said that the defendants "used the Medicare Trust Fund as their personal ATM."
The indictment alleged that R&V and the Sauls paid kickbacks - based on the amount and types of medical supplies ordered - for referrals in order to provide medical equipment to Medicare beneficiaries and others.
A referral for a power wheelchair, for example, was worth a $100 kickback.
The referrals came from individuals who worked for doctors or nonprofits and had access to the names, Social Security numbers and health-care providers of beneficiaries, authorities said.
The indictment alleged that the scheme began in March 2007 and lasted until yesterday.
Authorities said that information obtained through kickbacks was verified by the Sauls to make sure that beneficiaries were covered by health insurance and to determine the scope of their coverage.
The Sauls then determined the type of medical equipment to order for each beneficiary, the indictment alleged.
The charging document also said that R&V and the Sauls requested that employees write up the necessary approvals, such as doctor's orders, product descriptions, letters of medical necessity and personal examinations based on the type of medical equipment ordered for each beneficiary and that person's insurance program.
The indictment said that Robert Saul forged (or directed others to forge) doctor signatures on the supporting documents. R&V and the Sauls allegedly submitted hundreds of bogus claims for reimbursement to health-care providers, including Medicare and Independence Blue Cross.
It is unknown how much profit R&V actually made on the bogus claims, authorities said.
Robert Saul allegedly tried to cover up the scheme by, among other things, lying to beneficiaries.
Authorities said that most of the patients received equipment they didn't need and that their doctors hadn't authorized.
The indictment said that Saul told them that the city of Philadelphia was giving out free medical supplies, or that their doctors had approved the equipment at no cost to them.
Saul also allegedly instructed employees to lie to federal agents if questioned about the illegal kickbacks and forgeries.