Elderly veterans targeted in $134 million Medicare, VA medical care fraud scheme

Two men were sentenced Nov. 5 for their roles in a fraud scheme against Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) after submitting at least $134 million in fraudulent claims, according to a press release from the U.S. Attorney’s Office for the Middle Distict of Florida.

Michael Nolan, 48, of Tampa, Florida, and Richard Epstein, 29, of Aurora, Colorado, were both ordered to jointly pay $29,020,304 in restitution, as well as $2.1 million and $3 million respectively.

U.S. District Judge Virginia M. Hernandez Covington additionally sentenced Nolan to six years and six months imprisonment and Epstein to five years and three months in federal prison. Both Nolan and Epstein will also face three years of supervised release upon completion of their respective sentences.

According to court documents, in October 2016 Epstein and Nolan created and ran a telemarketing company in Tampa called REMN Management L.L.C. that targeted elderly patients by generating thousands of medically unnecessary orders for durable medical equipment — such as orthotic devices like back and knee braces — and genetic testing for cancer.

Epstein and Nolan also created and operated Comprehensive Telcare, L.L.C., a “telemedicine” company prosecutors say they used to bribe physicians to sign medical orders regardless of necessity. According to court documents, those orders were then illegally sold to client-conspirators in order to submit their own fraudulent claims to Medicare and CHAMPVA.

By April 2019 the fraud and bribery scheme had resulted in the submission of at least $134 million in fraudulent claims to both federal health benefit programs. According to the press release, the scheme also ultimately netted Epstein, Nolan and their co-conspirators $29 million in payments.

Nolan and Epstein pled guilty to charges of fraud July 31.

“The VA Office of the Inspector General’s continued oversight of VA’s multiple healthcare programs, including CHAMPVA, is one of the agency’s highest priorities. We thank our outstanding law enforcement partners for their efforts in this joint investigation,” Special Agent David Spilker of the VA’s Office of Inspector General’s Southeast Field Office said in the press release.

“They preyed on the elderly and military veterans to subject them to unnecessary medical testing and to use unnecessary medical equipment for their own financial gain,” IRS Criminal Investigation Special Agent Brian Payne also said.

Payne added that he hoped the significant prison sentences and fines would bring a sense of justice to those affected.

The case was investigated by the U.S. Department of Health and Human Services – Office of Inspector General, the FBI, the VA’s Office of Inspector General, and the IRS’s Criminal Investigation Tampa Field Office.

The case was prosecuted by Assistant U.S. Attorneys Tiffany E. Fields, Jay G. Trezevant, James A. Muench, and Department of Justice Trial Attorney Gary A. Winters.