Fairfield Man Pleads Guilty In $7.8M Health Care Fraud Scheme: Feds

FAIRFIELD, CT — A 58-year-old Fairfield man pleaded guilty last week in federal court in connection with $7.8 million health care fraud and kickback scheme, New Jersey United States Attorney Vikas Khanna announced.

Jesse Foote pleaded guilty before U.S. District Judge Esther Salas in Newark federal court to a two-count information charging him with conspiracy to violate the Federal Anti-Kickback statute and conspiracy to commit health care fraud.

At his sentencing in January, Foote faces a possible maximum prison term of 15 years, and fines totaling $500,000, or twice the gross gain or loss from the offense, whichever is greater.

According to statements and documents filed in court, Foote conspired with overseas telemarking call centers, durable medical equipment suppliers, telemedicine companies, and doctors to submit fraudulent claims to health care benefit programs.

The scheme ran from December 2017 to March 2021, and among those scammed included Medicare and TRICARE, through a circular scheme of kickbacks and bribes.

Foote controlled a marketing company through which he purchased patient "leads" from overseas telemarking companies, which consisted of information about Medicare and other beneficiaries and pre-written doctors' orders for durable medical equipment. The telemarketing call centers targeted Medicare beneficiaries and others with health insurance to persuade them to accept equipment, including orthotic braces, without regard to medical necessity. Foote paid bribes and kickbacks to telemedicine companies, which in turn paid bribes and kickbacks to doctors, to obtain doctors’ orders for durable medical equipment based on the leads.

The doctors often approved the equipment orders without having had any contact with the beneficiary and without making a bona fide assessment that such equipment was medically necessary.

Prosecutors said that Foote then sold the signed doctors' orders to others with whom he had kickback arrangements. The doctors' orders were ultimately submitted to durable medical equipment suppliers, including equipment suppliers controlled by Foote, which submitted fraudulent claims for reimbursement to health care benefit programs including Medicare, TRICARE, and private insurance companies.

In total, Foote and his conspirators caused the submission of false and fraudulent claims to health care benefit programs, totaling more than $7.8 million for the equipment.

Attorney for the United States Khanna credited special agents of the FBI, under the direction of Special Agent in Charge James E. Dennehy in Newark, U.S. Department of Health and Human Services Office of Inspector General, under the direction of Special Agent in Charge Naomi Gruchacz, and U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Northeast Field Office, under the direction of Special Agent in Charge Brian J. Solecki, with the investigation.

The government is represented by Assistant U.S. Attorney Katherine M. Romano of the Health Care Fraud Unit and Senior Trial Counsel Barbara Ward of the Asset Recovery and Money Laundering Unit in Newark.

Read the Foote case.