NEWARK, New Jersey—A Connecticut man has admitted his role in a multimillion-dollar durable medical equipment (DME) health care fraud and kickback scheme, announced U.S. Attorney Vikas Khanna.
Jesse Foote of Fairfield, Connecticut, pleaded guilty before U.S. District Judge Esther Salas in Newark federal court to a two-count information, charging him with conspiracy to violate the federal Anti-Kickback Statute and conspiracy to commit health care fraud. Foote and his conspirators caused the submission of false and fraudulent claims totaling more than $7.8 million for DME.
According to documentation filed in the case and statements made in court, Foote conspired with overseas telemarketing call centers, DME suppliers, telemedicine companies and doctors to submit fraudulent claims to health care benefit programs, including Medicare and TRICARE, through a circular scheme of kickbacks and bribes. Additionally, Foote controlled a marketing company through which he purchased patient “leads” from overseas telemarketing companies, which consisted of information about Medicare, other beneficiaries and pre-written doctors’ orders for DME. The telemarketing call centers targeted Medicare beneficiaries and others with health insurance, in efforts to persuade them to accept DME, such as orthotic braces, without regard for medical necessity.
Foote paid bribes and kickbacks to telemedicine companies to obtain doctors’ orders for DME based on the leads he purchased. The doctors often approved the DME orders without having any contact with the beneficiary or making a bona fide assessment that the DME was medically necessary. In turn, Foote sold the signed doctors’ orders to others with whom he had kickback arrangements. The doctors’ orders were ultimately submitted to DME suppliers, including suppliers controlled by Foote. These suppliers then submitted fraudulent claims for reimbursement to health care benefit programs including Medicare, TRICARE and private insurance companies.
The kickback conspiracy charge is punishable by a maximum of five years in prison, and the health care fraud conspiracy charge is punishable by a maximum of 10 years in prison. Both charges are punishable by a fine of $250,000, or twice the gross gain or loss from the offense, whichever is greatest. Foote’s sentencing is scheduled for Jan. 21, 2025.
