California Medical Equipment Company Owner Found Guilty in $24 Million Medicare Scam

California Medical Equipment Company Owner Found Guilty in $24 Million Medicare Scam
A file photograph of a judge's gavel. (Joe Raedle/Getty Images)
City News Service
6/28/2023
Updated:
6/28/2023
0:00

LOS ANGELES—A Redondo Beach woman was found guilty on June 27 of nearly two dozen felonies for billing Medicare more than $24 million by submitting fraudulent claims for medically unnecessary durable medical equipment—mostly power wheelchairs—and repairs, many of which were never performed.

Tamara Motley, 54, was found guilty by a federal jury in downtown Los Angeles of 20 counts of healthcare fraud, two counts of aggravated identity theft, and one count of conspiracy to commit money laundering, according to the U.S. Attorney’s Office.

Following the reading of the guilty verdicts, U.S. District Judge Stanley Blumenfeld Jr. remanded Motley into custody.

According to evidence presented at her five-day trial, from July 2006 to August 2014, Motley was the de facto owner of Hawthorne-based Action Medical Equipment and Supplies. From January 2013 to November 2016, she was the de facto owner of Ventura-based Kaja Medical Equipment & Supply. Both companies were enrolled with Medicare in the names of Motley’s out-of-state relatives.

Motley orchestrated a scheme in which she paid marketers for patient referrals and then directed them to take patients to corrupt physicians, who prescribed medically unnecessary durable medical equipment, such as power wheelchairs, that her companies used to submit fraudulent bills to Medicare, evidence showed.

In January 2011, when Medicare changed the reimbursement rules for power wheelchairs to make the upfront payments less lucrative to suppliers, Action switched to billing Medicare for power wheelchair repairs, and continued that scheme at Kaja once Action was shut down.

The repairs were not medically necessary because the patients did not need the chairs to begin with, were not needed to make the wheelchairs serviceable in any event, and often simply were not performed. These repairs were expensive—often billed for $3,000–$4,000—and accounted for nearly half of Action’s billings and almost all of Kaja’s.

Over an eight-year period, Action billed Medicare more than $18.2 million for durable medical equipment—most for power wheelchairs, but also for accessories, knee braces, and back braces—and repair or replacement. Medicare paid Action nearly $10.3 million.

Between July 2013 and November 2016, Kaja billed Medicare $6.3 million, primarily for repairs. Medicare paid Kaja about $2.8 million for those claims.

Blumenfeld scheduled an Oct. 3 sentencing hearing, at which time Motley will face up to 10 years in federal prison for each health care fraud count, up to 20 years in federal prison for the money laundering conspiracy count, and a mandatory sentence of two years in federal prison consecutive to the other sentences for the aggravated identity theft counts, prosecutors noted.