BY: STAFF REPORT | BocaNewsNow.com
BOCA RATON, FL (BocaNewsNow.com) (Copyright © 2022 MetroDesk Media, LLC) — Self-admitted fraudster Michael Rouffe will spend four years in federal prison. The Boca Raton resident entered a guilty plea to healthcare fraud in 2020. He was sentenced on Friday. He lives in the Fairfield at Boca Raton community.
The United States Department of Justice issued this statement: U.S. District Judge Thomas P. Barber has sentenced Jonathan Michael Rouffe (49, Boca Raton) to four years in federal prison for conspiracy to commit health care fraud. The court also ordered Rouffe to forfeit assets from several bank accounts, which are traceable to proceeds of the offense. As part of his sentence, the court also entered an order of forfeiture in the amount of $3,127,290, the proceeds of the charged criminal conduct, and a restitution order in the amount of $10,725,607.15. Rouffe had pleaded guilty on June 30, 2020.
According to court documents, 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, including placing the companies in the names of straw owners. By concealing their true ownership, the conspirators gained control of more companies, which Medicare generally prohibits, enabling them to submit high volumes of illegal DME claims. Through the conglomerate, during the course of one year, 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, Rouffe and his conspirators used illegal bribes and kickbacks. Specifically, they illegally purchased thousands of DME claims from so-called “marketers.” On invoices, the parties disguised the illegal kickback transactions as marketing services and the conspirators claimed that the DME prescriptions had been generated through “telemedicine.” No telemedicine had actually occurred. Instead, doctors were bribed in exchange for DME approvals. Rouffe and his conspirators paid millions to secure the illegal DME claims for submission to Medicare and CHAMPVA.
“Today’s sentencing shows that individuals who commit Medicare fraud will be held accountable for their crimes,” said Special Agent in Charge Omar Pérez Aybar of the U.S. Department of Health and Human Services Office of Inspector General. “Our agency, working closely with our law enforcement partners, will continue to bring those who steal from federal health care programs to justice.”
“Healthcare fraud investigations require lots of patience and skill to follow the money,” said FBI Tampa Special Agent in Charge David Walker. “The FBI has a world class team of special agents, analysts, and forensic accountants determined to protect our nation’s federally funded healthcare systems and bring these heartless, greedy fraudsters to justice.”
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