Operation Brace Yourself Notches First Sentencing

Georgia DME CEO sentenced to more than three years plus fines and restitution for involvement in history-making Medicare fraud.

Roderic Bain, CEO of a string of Savannah, Ga.-based DME businesses has been sentenced to more than 40 months in prison for his part in the Medicare fraud ring that was recently brought down by Operation Brace Yourself.

Bain pled guilty to one count of False Statements Relating to Health Care Matters and in addition to his prison time, he agreed to pay more than $1.9 million in fines and restitution, said Bobby Christine, U.S. Attorney for the Southern District of Georgia.

According to court documents, Bain oversaw a multi-year scheme resulting in nearly $10 million in claims billed to Medicare. Working with others, Bain operated a network that paid kickbacks to obtain patient information, specifically that of Medicare patients. Through a third-party biller, Bain would then bill Medicare Part B and Part C for medical equipment and orthotics, including a variety of back and knee braces that were not ordered as medically necessary by a physician.

“Schemes like this put greed before need — using the identities of those who are assumed to be medically fragile to exploit programs intended for the benefit of patients,” Christine said. “Ultimately, such fraud hurts all patients by further straining the limited funding available for healthcare in an already struggling system.”

Bain’s enterprise was linked to the larger, national fraud uncovered by the multi-agency Operation Brace Yourself crackdown, which included the FBI and the Department of Health and Human Services Office of the Inspector General (HHS-OIG). That investigation broke up one of the largest healthcare fraud rings in U.S. history, which involved telemarketing companies, licensed medical professionals, and 130 HME/DME businesses that allegedly bilked $1.2 billion out of Medicare through claims for fraudulent orthopedic brace prescriptions.

In terms of scale, Operation Brace Yourself led to the execution of more than 80 search warrants in 17 federal districts with charges against 24 defendants, but that only tells part of the story. The fraud ring was extensive, according to the DOJ, which reported that some of the defendants allegedly controlled an international telemarketing network involving call centers in locations as far-flung as the Philippines and Latin America.

“Roderic Bain is only one piece of the puzzle, who for just his part in a nationwide scheme was responsible for nearly $10 million in fraudulent Medicare claims,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “That is a snapshot of how prevalent the problem of healthcare fraud is. Every tax-paying citizen is a victim when providers like Bain are driven by personal greed. We are proud of the work our agents and law enforcement partners are doing, and will continue to do, to stem this scourge on our federally-subsidized programs.”

Operation Brace Yourself investigation remains ongoing. Any doctors, medical professional, providers or beneficiaries who believe they have witnessed fraud or have been affected by it can contact the FBI hotline at 1-800-CALL-FBI. 

About the Author

David Kopf is the Executive Editor of HME Business and DME Pharmacy magazine. Follow him on Twitter at @postacutenews.

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