According to a press release by the Department of Justice (DOJ), on February 4, 2021 Kelly Wolfe, a Tampa, FL woman pleaded guilty to conspiracy to commit healthcare fraud and filing a false tax return. Wolfe will face up to 13 years in federal prison, though a sentencing date has not been set.
The lawsuit was brought to light by a former employee of Wolfe’s company who blew the whistle in March 2019. The former employee, along with numerous government regulators, were able to uncover the scheme which involved setting up multiple Durable Medical Equipment (DME) companies under various straw owners. With these companies, the conspirators submitted claims to Medicare and the U.S. Department of Veteran Affairs.
The scheme bribed doctors to approve orders, violating the Anti-Kickback Statutes. The former employee was incentivized to report her employer because under a qui tam lawsuit she could obtain a portion of the damages for herself. Wolfe agreed to pay $20 million in settlement to resolve the allegations of violating the False Claims Act and violating the Anti-Kickback Statute. The whistleblower will receive $4 million for assisting in the prosecution.
This prosecution was one of many under “Operation Brace Yourself”, a nationwide coordinated raid by the DOJ and other regulators targeting fraudsters filing false claims for durable medical equipment through telemedicine appointments. The name of the operation is fitting for an investigation into healthcare providers who fraudulently prescribe unnecessary orthotic braces via telemedicine. So far, Operation Brace Yourself has targeted 130 Durable Medical Equipment (DME) companies responsible for submitting $1.7 billion-worth of claims according to a DOJ press release.
