Medicare Fraud Conspirator Sentenced to Over Seven Years in Prison for Bogus Doctors’ Orders Scheme

GREENVILLE, S.C. — A New York man was sentenced to more than seven years in federal prison after pleading guilty to one count of conspiracy to commit health care fraud, the office of Adair Ford Boroughs, the U.S. Attorney for South Carolina, announced Thursday. Jeffrey Brooks, 40, was found to have created bogus doctors’ orders using medical information bought from call centers to bilk Medicare for millions.

Brooks also paid $850,000 last year in a civil settlement to resolve allegations that he provided kickbacks and caused false claims to be submitted in violation of the federal False Claims Act. As the owner of a call center in Greenville, South Carolina, Brooks and his co-conspirators purchased personally identifiable information of Medicare patients and used it to generate signed doctors’ orders, which were then used to submit false and fraudulent claims to Medicare and The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).

In addition to the call center, Brooks operated at least eight durable medical equipment (DME) companies located in Fort Pierce, Florida. Through these companies, Brooks was charged with conspiring to submit or cause to be submitted false and fraudulent claims to Medicare and CHAMPVA for braces that were not medically necessary and eligible for reimbursement.

The evidence presented to the court showed that the DME companies controlled by Brooks caused Medicare to be billed over $29 million in false and fraudulent claims. The civil settlement resolves a lawsuit originally brought by two individuals under the “qui tam” or whistleblower provisions of the False Claims Act. As part of the civil resolution, the whistleblowers received approximately $144,500 of the settlement amount.

Boroughs, the U.S. Attorney for South Carolina, stated, “As we put an end to Brooks’ fraudulent scheme, he faces both accountability and justice.”
Tamala E. Miles, Special Agent in Charge at the U.S. Department of Health and Human Services, added, “By facilitating kickbacks, this defendant knowingly enabled theft from Medicare, putting personal profit before legitimate patient care and ultimately costing taxpayers millions of dollars.”

The case serves as a reminder of the ongoing efforts to combat healthcare fraud and hold those accountable who defraud federal healthcare programs.