Two Florida men pleaded guilty Thursday to taking part in a kickback scam that sent veterans to an Orlando medical provider responsible for charging more than $14 million in claims, the Justice Department revealed.
Laurent Cassagnol, 43, and Heriberto Rivera, 43, both of Orlando, have pled guilty to conspiracy to pay and receive illicit health-care kickbacks and bribes.
According to court records, the men planned to refer patients enrolled in the Department of Veterans Affairs Community Care Program to Family Integrative Medicine of Orlando, LLC. The practice offered acupuncture, chiropractic adjustments, and other holistic medical services.
The company’s CEO, Rivera, admitted to paying kickbacks and bribes to Cassagnol, who worked as an advanced medical support assistant for the VA. Prosecutors alleged that in exchange for the cash, Cassagnol steered veterans to Rivera’s office for medical care.
Cassagnol admits to accepting the payments.
The Justice Department reported that the VA and its Community Care Program received more than $14 million in claims obtained through the fraudulent referral agreement. More than $11 million in claims were paid.
Under certain conditions, qualified veterans can get medical treatments from approved clinicians outside of VA facilities under the VA Community Care Program.
The investigation began when someone filed a complaint with the VA Office of Inspector General’s fraud hotline. The FBI and the VA Inspector General’s Office are looking into the situation.
Cassagnol and Rivera are set to be sentenced on November 5. Each is facing a maximum term of five years in federal prison. A district court judge will impose their punishments after taking into account federal sentencing guidelines and other statutory criteria.
Prosecutors Angela Benoit and Jody King of the Justice Department’s Criminal Division Fraud Section are handling the case.
Since 2007, the Justice Department’s Health Care Fraud Strike Force Program has charged over 6,200 people with collectively charging federal health programs and private insurers more than $45 billion, the department reports.
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