A Florida man was sentenced Tuesday to 12 years in prison and three years of supervised release for conspiring to defraud Medicare with false reimbursement claims for durable medical equipment.
He was also ordered to pay $21,195,540.18 in restitution and forfeiture in the amount of $2,514,040.
According to court documents, Peter Roussonicolos, 64, of Port Saint Lucie, Florida, owned and operated five DME suppliers as a silent partner. Roussonicolos hid his involvement in the companies from Medicare because he had one or more felony convictions, making him ineligible to enrol with the government program.
To further conceal his involvement, he recruited and paid co-conspirators to serve as nominee owners of the DME suppliers and caused others to falsify Medicare enrollment forms, bank records, and other documents to conceal the true ownership and control of the DME suppliers.
He also knew that a co-conspirator paid kickbacks and bribes to patient recruiters in exchange for beneficiary referrals.
As part of the scheme, the DME companies submitted approximately $61.5 million in false and fraudulent claims to Medicare for medically unnecessary DME that was ineligible for reimbursement and were paid approximately $26.7 million of these claims.
“Through lies and deceit, the defendant and his co-conspirators orchestrated a $61 million fraud on Medicare,” said Matthew R. Galeotti, Head of the Justice Department’s Criminal Division. “The defendant’s fraud drained critical government resources that could have been used to help vulnerable Americans.”
In November 2024, Roussonicolos pleaded guilty to conspiracy to commit health care fraud and wire fraud.
