2 brothers plead guilty to roles in $67M Medicare fraud scheme

Two Florida brothers are staring down lengthy prison sentences after pleading guilty to playing a role in a fraud scheme that raked in $67 million from Medicare.

Daniel M. Carver, 36, of Boca Raton faces a maximum of 25 years in prison, and his brother Louis, of Delray Beach, could receive a 10-year sentence, according to an announcement from the Department of Justice (DOJ).

“Medicare fraud affects patients and taxpayers nationwide, and HHS-OIG is committed to holding accountable those who attempt to steal from federal health care programs,” Christian Schrank, the deputy inspector general for investigations for the Department of Health and Human Services Office of Inspector General, told Fierce Healthcare in an email. “By remaining vigilant, protecting personal and medical information, and reporting suspicious claims, patients and providers alike can play a pivotal role in combatting Medicare fraud.”

Schrank OIG
Christian Schrank (Office of Inspector General)

Daniel M. Carver owned and managed call centers that he used to target Medicare beneficiaries, talking the individuals into paying for unnecessary genetic testing and durable medical equipment, the DOJ said. Meanwhile, his brother, Louis, worked the phones at the call centers and pretended to own a laboratory where false genetic testing claims were submitted, according to the release.

The Carvers and other co-conspirators offered bribes and kickbacks to telemedicine companies to secure completed doctors’ orders, the DOJ said, then sold those orders to laboratories and durable medical equipment companies. The conspirators in the scheme also forged physicians’ and patients’ signatures and “tricked” providers into ordering genetic tests that weren’t necessary, the DOJ said.

The scheme operated between January 2020 and July 2021, according to the announcement.

The pleas followed a four-day trial in the Southern District of Florida. They’re both scheduled to be sentenced on Dec. 5 by a federal district court judge who will base the punishment on the U.S. Sentencing Guidelines and other legal factors, the DOJ said.

The Carvers aren’t the only ones being charged in the case, according to the release. Five other defendants pleaded guilty in the case and await sentencing. A trial for three of the defendants is set to begin Sept. 26.

Attorneys with the Fraud Section of the DOJ’s Criminal Division are prosecuting the case. The Fraud Section’s Health Care Fraud Strike Force program, created in 2007 and comprising 15 strike forces in 25 federal districts, have charged more than 5,000 individuals who’ve collectively bilked public and private healthcare payers out of about $24 billion.