Former Kentucky businessman faces $6 million repayment in Medicare fraud case
A former Kentucky resident who admitted filing fraudulent bills with Medicare has been sentenced to two years and nine months in federal prison.
Pedro Reyes also owes $6,004,916 in restitution to the government health plan.
Reyes, 54, a former resident of Elizabethtown who later moved to Florida, pleaded guilty to conspiracy to commit health care fraud, according to the court record.
Reyes admitted that between February 2019 and April 2021, he billed Medicare through companies he owned for durable medical equipment, such as knee braces, for beneficiaries that was unnecessary, that they didn’t want, and which hadn’t been prescribed for them.
Reyes and others obtained orders for the equipment through improper telephone solicitations and they contained forged or fraudulent approvals from providers, the prosecutor, Assistant U.S Attorney Christopher C. Tieke, said in a sentencing memorandum.
The orders also were tainted by kickbacks paid to marketers who used “unauthorized” methods to get lists of patients, the memo said.
It did not explain what those methods were.
“The bottom line is that Reyes and his co-conspirators engaged in a criminal and fraudulent billing scheme in which they targeted a vulnerable population of Medicare recipients as a means to unlawfully line their pockets with government funds,” the prosecutor said.
U.S. District Judge Claria Horn Boom sentenced Reyes May 22 in federal court in Louisville.
The case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General.
