Medicare Fraud Scam Leads to Physician’s Indictment

We read today in the news that a Dr. Michael D. Kim in Houston, Texas had been indicted by a Federal Grand Jury in yet another “motorized wheelchair fraud scheme.” According to the government’s indictment, Dr. Kim fraudulently approved thousands of Medicare beneficiaries for motorized wheelchairs in return for cash payments of $200.00 per beneficiary. According to the indictment, thousands of Medicare beneficiaries were brought by paid recruiters to Dr. Kim’s medical clinic in Houston between April of 2002 and October of 2003 for the purpose of securing a false or fraudulent Certificate of Medical Necessity. A CMN as it is called in the industry is necessary to bill Medicare for a physician approved motorized wheelchair. Dr. Kim allegedly assisted others in filing false and fraudulent claims for motorized wheelchairs at a cost of $4,200.00 a piece. The indictment seeks to forfeit approximately $13 million from Dr. Kim. Allegedly, Dr. Kim routinely approved wheelchairs for 20 to 60 patients a day who clearly did not meet the Medicare guidelines to receive such a device.

When it comes to government programs which depend upon the honesty of those providing services thereunder, there appears to be no end in sight with respect to the imagination of those willing to defraud the government of taxpayer money. Claims are filed under false pretenses and monies are paid based on certifications provided to the government. While the government’s audit function obviously is a problem and a cause for concern for all tax payers, the good news is that occasionally the government does get it right and does indict those who would defraud their government. Here, however, the proverbial horse is “already out of the barn” since taxpayers paid $29 million in fraudulent charges under the Medicare program. It appears that it is simply too easy (and too attractive to criminals) to rip off the Medicare program. Obviously, payment guidelines need to be tightened otherwise we can expect to read similar headlines in the future with respect to the Medicare and Medicaid programs.

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