Motley

I. BACKGROUND

A. Factual Background Tamara Motley operated Action Medical Equipment and Supply, Inc. (Action) and Kaja Medical Equipment & Supply, Inc. (Kaja), two durable medical equipment (DME) companies enrolled as Medicare providers. Action was incorporated in the name of her mother, Beverly Muntz, while Kaja was incorporated in the name of her nephew, Bryant Brown. Neither played an active role in the management of the companies, nor was either implicated in the fraudulent scheme we describe below. Medicare permits DME supply companies, physicians, and other healthcare providers to seek reimbursement for covered services provided to eligible beneficiaries, typically individuals aged 65 or older or those with disabilities. To receive reimbursement, a DME supplier must enroll in Medicare and certify that it will comply with all rules and regulations, including not submitting false or fraudulent claims. Once enrolled, Electronic Data Interchange (EDI) and Electronic Funds Transfer (EFT) agreements allow suppliers to submit claims electronically and to receive payment directly to their business bank account. Electronic claims include, among other things, the beneficiary’s name…