Fraud roundup: Accreditation, medical necessity schemes 

Manual Delgado, 64, a former contractor for the Board of Certification/Accreditation (BOC), has pleaded guilty to accepting cash bribes and self-dealing as part of a conspiracy to impede and obstruct the lawful functions of the U.S. Department of Health and Human Services and CMS in their administration and oversight of the Medicare program. According to court documents, Delgado, who performed inspections of DME companies to determine if they complied with CMS quality standards, accepted cash bribes from numerous owners of companies to facilitate and expedite the accreditation process so those companies could be enrolled with and bill Medicare.  He also formed DME companies in the names of family members to conceal his own personal interest in the companies and then inspected these companies himself and obtained BOC accreditation and CMS approval. Delgado then sold the companies to others.  The estimated value of the fraudulently accredited DME companies that he inspected was more than $1.4 million. Delgado faces up to five years in prison. Any further proceedings will be set by the court...Shafi Abbas, 57, has been sentenced to one year and one day in prison for engaging in a conspiracy to commit health care fraud and money laundering in connection with DME businesses. Abbas, through his companies Aidmen Medical Equipment LLC and Justright Medical Equipment LLC, fraudulently billed Medicare for DME that was medically unnecessary, unwanted by patients and not prescribed by the medical providers. Abbas also transferred funds, in criminally derived property of a value greater than $10,000, which came from specified unlawful activity, specifically the health care fraud conspiracy. He has been ordered to pay restitution of more than $1.3 million.