A Maryland podiatrist, Larry Bernhard, was sentenced by a U.S. District Judge in Baltimore to fifty-four months in prison, plus three years’ supervised release, for a series of fraudulent bills to Medicare totaling more than $1.1 million. He pleaded guilty to charges that included health care fraud and identity theft. His scheme involved misrepresentation of podiatric services in billing statements to Medicare, and theft of nursing home patients’ names and identities in order to bill for services never actually rendered.
Bernhard operated a podiatry practice, Chesapeake Wound Care Center, out of his home in Gambrills, Maryland. He has been licensed as a podiatrist by the state of Maryland since 1981. He first came to the attention of law enforcement over allegations that, between April 2002 and October 2004, he submitted a series of fraudulent claims to Medicare. In about eighty separate claims, he claimed reimbursement for podiatric services rendered at “skilled nursing facilities” that were actually performed at hospitals. He did this allegedly in order to claim a higher rate. He and the government entered into a settlement agreement in October 2007 regarding these allegations. As part of that agreement, Bernhard agreed to a three-year period of exclusion from all federal health care programs, including Medicare and Medicaid.
According to Bernhard’s recent plea agreement, he began a new fraudulent billing scheme soon after signing the settlement agreement. Beginning in October 2007, and continuing until July 2010, he submitted fraudulent bills to Medicare Advantage plans and received upwards of $1.1 million. Prosecutors estimated that at least $1 million of the total amount was compensation for podiatry services that he never actually performed. In order to enact this scheme, Bernhard admitted, he used the personal identifying information of about two hundred nursing home patients for services that were never rendered.
Bernhard’s actions clearly violated his 2007 settlement agreement with the government. He pleaded guilty to aggravated identity theft and health care fraud. In addition to the four-and-one-half year prison sentence, he must pay restitution of $1,122,992.08.
This case illustrates some troubling vulnerabilities in the nursing home population. He used the names and other identifying information of nursing home patients as the basis for his false billing statements. The press release from the FBI describing Bernhard’s sentence does not go into detail about how the scheme affected the nursing home patients. Presumably they were simply names that Bernhard appropriated, but it could be possible, in a similar scheme, for someone to actually withhold needed treatment yet bill Medicare for the services. It is also possible that a doctor or other medical professional could order unnecessary treatments in order to pad a bill.
Nursing home patients are in a unique position of trust and dependence, placing most or all of the responsibility for their daily lives into the hands of others. This includes nursing home staff and administrators, and also the doctors and specialists who work with the nursing homes to care for the residents. This can leave them vulnerable to the unscrupulous, who may take advantage of them in a way that compromises their treatment or causes direct injury.
The Maryland nursing home lawyers at Lebowitz and Mzhen help obtain compensation for people injured due to abuse or neglect by nursing home staff, medical professionals, or fellow residents. Contact us today online or at (800) 654-1949 for a free and confidential consultation.
More Blog Posts:
Most Elder Deaths in Nursing Homes are Never Investigated, Maryland Nursing Home Blog, January 2, 2012
Drug Tampering by Nurses Reveals Problems in Regulation and Hiring, Maryland Nursing Home Blog, December 21, 2011
Maryland Home Health Care System Settles Medicaid Fraud Allegations, Maryland Nursing Home Blog, November 3, 2011
Photo credit: ‘Füsse im Sand’ by chris1961 on stock.xchng.