United States Attorney Maria Chapa Lopez announces that Jonathan Michael Rouffe (47, Boca Raton) has pleaded guilty to conspiracy to commit health care fraud. He faces a maximum penalty of 10 years in federal prison. A sentencing date has not yet been set.
According to the plea agreement, in 2018, Rouffe and his conspirators established a conglomerate of durable medical equipment (“DME”) supply companies. During the creation of the companies, they lied to Medicare to secure billing privileges. The scheme involved placing the companies in the names of straw owners. By concealing their true ownership, the conspirators secretly gained control of multiple companies, which Medicare prohibits. This enabled the conspirators to submit high volumes of illegal DME claims while attempting to evade law enforcement scrutiny. In one year, through the conglomerate, Rouffe and his conspirators submitted more than $20 million in illegal DME claims, resulting in over $10 million in payments from Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (“CHAMPVA”).
To attain such high volumes of claims, the conspirators used bribes and kickbacks. Specifically, Rouffe and his conspirators illegally purchased thousands of DME claims from so-called “marketers.” The marketers, for their part, had generated the claims under the guise of “telemedicine,” but no telemedicine had actually occurred. Instead, the “marketers” had bribed doctors to sign the DME brace orders that supported the claims. Rouffe and his conspirators paid millions to secure the illegal DME claims for submission to Medicare and CHAMPVA.
This case was investigated by the U.S. Department of Health and Human Services – Office of Inspector General, the Federal Bureau of Investigation, and the Department of Veterans Affairs – Office of Inspector General. It is being prosecuted by Assistant United States Attorney Kristen A. Fiore.
