In my research lately I’ve found story after story of Medicare or health insurance fraud. After a while, day after day, story after story, it all tends to run together. Except for the doozey I’m about to inform you all about. This one stands out and/or up.
Gary Winner, an Illinois resident and owner of Planned Eldercare, has agreed to plead guilty in Rhode Island to a five-count Information charging him with health care fraud. Same old, same old, right? Well, Winner (or as I and you will soon want to call him “Wiener”) also participated in money laundering, and the introduction of an adulterated and misbranded medical device into interstate commerce.
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What kind of adulterated and misbranded medical device, you ask? A penis pump. Ok, it’s actually called an “erectile pump.” Winner told his employees to tell their customers that this type of device was good for prostate problems and was designed to help blood circulation. Employees were instructed to tell beneficiaries that regular use of the pump increases blood flow in the urinary tract and prostate region.
Really. I couldn’t make this up if I tried.
It is alleged that Winner ordered penis enlargers from an x-rated website for $26.00 each, repackaged them, enclosing an information sheet stating that regular use of the enclosed “erectile pump” helps with bladder control, urinary flow and prostate comfort, and shipped them to recipients. Winner allegedly billed Medicare on average $284 per item, representing to Medicare that the devices sold were designed to treat erectile dysfunction. Under certain circumstances, the Medicare program covers reimbursement for products for the treatment of organic impotence and/or erectile dysfunction. Medicare regulations require that the devices be medically necessary and prescribed by a physician. It is alleged that the devices shipped to Medicare beneficiaries and billed to Medicare served no medical purpose.
Winner’s company, Planned Eldercare, is a nationwide supplier of durable medical equipment. Allegedly it’s clients were targeted through unsolicited telemarketing of arthritic and/or diabetic Medicare beneficiaries. After confirming if a potential client had arthritis or diabetes employees were then instructed to take their Medicare information and tell them that Planned Eldercare could provide them with products to help their ailments at no cost to them. Winner allegedly instructed employees to order as much as they could under a client’s benefits which resulted in thousands of products being billed for that beneficiaries did not order.
Like penis pumps.
Thus far Winner has forfeited approximately $2 million in proceeds from his operation. Health care fraud and money laundering are punishable by maximum sentences of 10 years imprisonment, a fine of $250,000, and a term of supervised release of 3 years; the introduction of an adulterated and misbranded medical device into interstate commerce is punishable by a maximum sentence of 3 years imprisonment, a fine of $10,000, a term of supervised release of 1 year. At sentencing Winner faces a maximum sentence of 33 years imprisonment, a fine of $760,000, and a term of supervised release of 4 years.
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