FWA- Eastern District of Louisiana | Destrehan Man Pleads Guilty to $11.4 Million Medicare and Medicaid Fraud Scheme

MM Curator summary

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[MM Curator Summary]: Craig Lovelace stole $11.4M using a broad-reaching DME scheme.



Clipped from: https://www.justice.gov/usao-edla/pr/destrehan-man-pleads-guilty-114-million-medicare-and-medicaid-fraud-scheme

NEW ORLEANS, LOUISIANA –  CRAIG L. LOVELACE, age 53, a resident of Destrehan, pled guilty to defrauding Medicare and Medicaid of approximately $11.4 million in medically unnecessary durable medical equipment (“DME”), announced U.S. Attorney Duane A. Evans.

The government filed a bill of information charging LOVELACE with healthcare fraud, in violation of Title 18, United States Code, Section 1347. According to court documents, from approximately January 2016 through June 2022, LOVELACE, through his company Advanced Medical Equipment Inc., billed Medicare and Medicaid for durable medical equipment (“DME”) that was medically unnecessary. That included equipment for respiratory support and nutritional support, including ventilators, tracheostomy supplies, and feeding tubes. In reality, those items were medically unnecessary, not ordered, or not provided as represented.  In some instances, the patients had already died. LOVELACE billed Medicare and Medicaid approximately $11.4 million in connection with this scheme, and his company was reimbursed over $7.9 million. To cover up his scheme, LOVELACE directed the falsification of documents, including medical records, order forms, and supporting documentation, in response to Medicare audits and record requests. The falsification of documents included forging provider signatures, medical notes, and dates, as well as using tape, white-out, and scissors, to make it falsely appear that the audited DME was ordered and delivered.

LOVELACE faces up to ten years in prison. LOVELACE also faces up to three years of supervised release after release from prison, a fine of up to $250,000 or twice the gross gain to LOVELACE or the gross loss to any victims, and a mandatory $100 special assessment fee.

U.S. District Judge Jane Triche Milazzo set the sentencing hearing for November 29, 2023.

U.S. Attorney Evans praised the work of the Health and Human Services Office of Inspector General and the Louisiana Medicaid Fraud Control Unit. U.S. Department of Justice Trial Attorneys Kelly Walters and Samantha Stagias of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Nicholas Moses, Health Care Coordinator for the Eastern District of Louisiana, are prosecuting the case.