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HomenewsIndictment for over $140 million in Medicare and Medicaid fraud

Indictment for over $140 million in Medicare and Medicaid fraud

The Justice Department stated Thursday that a New Jersey man and his business were indicted for allegedly cheating Medicare and Medicaid out of more than $140 million.

Kevin Breslin, 56, and KBWB Operations LLC, doing business as Atrium Health, are accused of diverting payments from Wisconsin nursing facilities to Atrium owners between January 2015 and September 2018. As a result, several facilities were forced to reduce care quality and staffing levels.

“Additionally, the indictment alleges that Breslin and Atrium deducted insurance premiums from employees’ paychecks, but failed to pay those funds to the third-party administrator for use in settling health claims,” the Justice Department stated Thursday. “The indictment further alleges that the defendants deducted 401(k) contributions from employees’ paychecks but neglected to transfer those funds to a third-party pension administrator.”

Atrium billed Medicare for more than $189 million and received more than $49 million, while billing Medicaid for more than $218 million and receiving more than $93 million. There was a dearth of clean diapers, inadequate wound care materials, insufficient cleaning supplies, and a lack of durable medical equipment and breathing supplies at the nursing facilities.

“The diversion of funds resulted in nonpayment to vendors, resulting in the termination of numerous services, including physical therapy for residents, fire alarm monitoring services, phone and internet services, which prevented staff from obtaining prescription orders and accessing electronic medical records systems,” the Justice Department said.

Breslin and Atrium have been charged with healthcare fraud, six charges of wire fraud, three counts of mail fraud, tax fraud and money laundering conspiracy.

If convicted, Breslin faces five years in federal prison on the tax fraud conspiracy charge and twenty years on each of the health-care fraud, wire fraud, mail fraud, and money-laundering conspiracy charges.

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