A man from Florida will not be serving time in prison for his role in a multi-million dollar Medicare fraud scheme involving the sale of patients’ personal and medical data.
Boca Raton resident, Nathan LaParl, aged 35, and his 30-year-old accomplice Talia Alexandre, of Palm Springs, worked with foreign call centers to contact Medicare patients and ask if they were interested in purchasing durable medical equipment (DME) such as arm and shoulder braces “at little to no cost.”
Demographic data and insurance information collected from the Medicare patients by the call centers was sold by LaParl and Alexandre to 32-year-old Juan Camilo Perez Buitrago of Lighthouse Beach, Florida.
Perez Buitrago used the patient data to submit false and fraudulent claims totaling more than $109m. The claims were for DME that the US attorney’s office for the District of Massachusetts said was “not prescribed, not necessary, and, in many instances, never requested or received.”
LaParl and Alexandre were paid handsomely for the data, receiving more than $1.6m from Buitrago. To facilitate the scheme, LaParl improperly accessed a patient eligibility tool and checked the insurance eligibility of more than 350,000 Medicare patients.
Access to the tool was provided by 52-year-old Stefanie Hirsch of Los Angeles, California, the owner of Medicare-enrolled wheelchair and scooter repair company, EI Medical, Inc. Hirsch shared her login credentials with LaParl and charged him $0.25 per patient eligibility check.
Hirsch pleaded guilty to violating the HIPAA statute and was sentenced in September 2021 to three years of probation and ordered to pay a fine of $2500.
Alexandre pleaded guilty to one count of receiving kickbacks in connection with a federal health care program. On December 8 2021, she was sentenced to three years of supervised release with the first year to be spent in home detention. Alexandre was fined $5000 and ordered to pay $1.47m in restitution.
On January 21 2021, LaParl pleaded guilty to one count of receiving kickbacks in connection with a federal health care program and one count of violating the HIPAA statute. He was sentenced on Thursday to three years of probation, the first year to be served subject to a curfew, and has to pay a forfeiture of $220,671.