El Cajon man, son plead guilty to $21 million Medicare fraud scheme [The San Diego Union-Tribune] - Insurance News | InsuranceNewsNet

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June 30, 2023 Newswires
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El Cajon man, son plead guilty to $21 million Medicare fraud scheme [The San Diego Union-Tribune]

San Diego Union-Tribune (CA)

A father and son pleaded guilty in San Diego federal court this week to running a $21 million scheme in which they paid doctors kickbacks to prescribe orthotic braces to Medicare patients, federal prosecutors said.

Anthony Duane Bell Sr., 54, of El Cajon, and Anthony Duane Bell Jr., 33, of Los Angeles, received millions of dollars by sending knee, ankle, wrist, shoulder and back braces to Medicare beneficiaries and billing the federal insurance program, according to the San Diego U.S. Attorney's Office.

Prosecutors said the patients did not need the equipment, but were contacted by marketing companies paid by the Bells because they were covered by Medicare, according to prosecutors.

The older Bell pleaded guilty to health care fraud and faces a possible sentence of 10 years in prison, according to prosecutors. He agreed to pay $21 million in restitution to Medicare, and forfeited $800,000 and a multi-million-dollar luxury house in El Cajon.

His son admitted to making a false statement to the FBI and faces a maximum of five years in prison.

A sentencing hearing for both men is scheduled for Jan. 8 in U.S. District Court.

Attorneys for both defendants — David Zugman and Keith Rutman, respectively— said their clients were glad the case was resolved.

Rutman said the younger Bell "is happy the government was willing to afford him and his father the opportunity to reach a result that was fair and took into account the totality of circumstances," and he hopes the judge will grant probation instead of time in custody.

Zugman, who represents Bell Sr., declined to comment.

According to a criminal complaint filed in 2019, the Bells ran their scheme for three years starting in May 2016. Both men worked at a company named PA Healthcare Pharmaceuticals, where they began their fraud. Later, they founded their own companies — Universal Medical Solutions 1 and Universal Medical Solutions 2, with locations in Santee and San Diego.

Prosecutors said the father and son worked with marketing companies to call Medicare beneficiaries. The telephone marketers would convince each beneficiary to get a brace, and a doctor — some of whom have been indicted as part of the scheme — would then be paid by the marketing company to write a prescription.

The orders were packaged by the marketing company, often in groups of 100 braces, and billed to Medicare.

The Bells paid significantly less for the braces than they billed Medicare, according to prosecutors. Although no exact number of individual braces sold under false pretenses was stated in the complaint, the Bells received millions of dollars from the scheme, according to prosecutors.

Bell Jr., when interviewed by the FBI, lied to investigators, saying he had never heard of PA Healthcare Pharmaceuticals, prosecutors said.

The FBI stated in a news release this week that the Bells took advantage of a government program that is designed to assist vulnerable people with getting the health care they need.

"It should not be used as a 'get rich' scheme by scammers," said FBI San Diego Acting Special Agent in Charge Thomas Ryan. "People who exploit government programs to attempt to mask their malicious acts will continue to be investigated and held accountable by the FBI and our law enforcement partners."

This story originally appeared in San Diego Union-Tribune.

©2023 The San Diego Union-Tribune. Visit sandiegouniontribune.com. Distributed by Tribune Content Agency, LLC.

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