Miami inspector pleads guilty to fraud in Medicare accreditation scheme
Key Points(5)
- A Florida contractor has admitted to accepting bribes and engaging in fraudulent self-dealing to manipulate the Medicare accreditation process, federal prosecutors announced.
- Manuel Delgado, 64, pleaded guilty to conspiring to impede and obstruct the U.S.
- Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) in their oversight of the Medicare program.
- According to court documents, Delgado worked as a contractor for the Board of Certification/Accreditation, International (BOC), which inspects durable medical equipment (DME) companies to ensure compliance with CMS quality standards.
- Accreditation from BOC is a prerequisite for companies to bill Medicare for supplying medical equipment to patients.
A Florida contractor has admitted to accepting bribes and engaging in fraudulent self-dealing to manipulate the Medicare accreditation process, federal prosecutors announced.
Manuel Delgado, 64, pleaded guilty to conspiring to impede and obstruct the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) in their oversight of the Medicare program.
According to court documents, Delgado worked as a contractor for the Board of Certification/Accreditation, International (BOC), which inspects durable medical equipment (DME) companies to ensure compliance with CMS quality standards. Accreditation from BOC is a prerequisite for companies to bill Medicare for supplying medical equipment to patients.
Delgado admitted to accepting cash bribes from multiple DME company owners in exchange for expediting and facilitating their accreditation, allowing them to bill Medicare. Additionally, he secretly formed DME companies under the names of family members, conducted their inspections himself, and fraudulently obtained accreditation and CMS approval. Delgado then sold these companies to others, making them valuable as Medicare-approved suppliers.
Prosecutors estimate the total value of the fraudulently accredited DME companies at over $1.4 million.
Legal proceedings and potential sentence
Delgado pleaded guilty before U.S. Magistrate Judge Ellen D’Angelo, who will submit a report and recommendation to U.S. District Judge K. Michael Moore. He faces up to five years in prison, with further court proceedings to be scheduled.
The case was investigated by the FBI’s Miami Field Office and the Department of Health and Human Services Office of Inspector General (HHS-OIG). The announcement was made by U.S. Attorney Hayden P. O’Byrne for the Southern District of Florida, Supervisory Official Antoinette T. Bacon of the Justice Department’s Criminal Division, Acting Special Agent in Charge Ryan P. Lynch of HHS-OIG Miami, and Acting Special Agent in Charge Brett Skiles of FBI Miami.
The prosecution is being handled by Assistant U.S. Attorney Aimee C. Jimenez and Trial Attorney Jacqueline DerOvanesian of the Justice Department’s Fraud Section, with Assistant U.S. Attorney Daren Grove overseeing asset forfeiture.
