Man bilked elderly patients

A Hayden Lake, Idaho, businessman was convicted Wednesday of more than 30 counts of defrauding Medicare and Medicaid, after repeated trial delays forced some of the charges to be dropped because the elderly witnesses had died.

A nine-woman, three-man Coeur d’Alene jury convicted Christopher Close of 30 counts of health care fraud, nine counts of money laundering, and two counts of obstruction of justice. Still pending are additional charges against the former owner of “Back ‘N Action,” a medical equipment business in Hayden Lake, including asset-forfeiture charges.

Many of the charges in the case involved billing Medicare and Medicaid for expensive, $6,000 electric wheelchairs and costly accessories, while providing elderly patients only with $2,000 scooters or nothing at all – and pocketing the difference.

Close faces maximum penalties ranging from 10 to 20 years in federal prison and maximum fines of $250,000 to $500,000 on each of the charges. A sentencing date hasn’t yet been set, in part because of a recent U.S. Supreme Court decision that affects sentencing ranges and still is being studied by courts around the country.

Shortly before the trial started, five of the 77 fraud counts against Close were dropped because the elderly witnesses had either died, become too ill to testify, or could no longer be found. In total, Close was accused of stealing more than $200,000 from the federal health programs.

As the trial began, Close tried once again to delay the trial and switch attorneys. U.S. District Judge Edward Lodge rejected the move. “This trial has already been continued four times,” the judge said.

Close, who maintained his innocence, testified in his own defense, denying the charges or attributing the discrepancies to others or to errors. He was the only defense witness in the three-week trial. But dozens of government witnesses documented the discrepancies in minute detail, according to court records and attorneys. The discrepancies included charges to the government programs for the poor and elderly for such items as $300 pressure-reducing gel positioning cushions, when patients got only cheap foam cushions.

Among the 47 witnesses called by the government in the three-week trial were a number of elderly patients and their relatives and caregivers. Some rolled into the Coeur d’Alene courtroom in wheelchairs to testify. Others made their way in with the help of walkers.

Terry Derden, first assistant U.S. Attorney for Idaho, said health care fraud cases like Close’s are a priority for prosecution.

“It helps people have confidence in the health care system, when you can take out those few bad apples that are committing fraud,” he said.

One of the first to bring authorities’ attention to the fraud scheme was a patient from Kamiah who noticed the wheelchair-scooter billing discrepancy in 2001 and reported it to Medicaid investigators. He died shortly after the case was filed.

“There were a number of complaints made at about the same time,” said Wendy Olson, the assistant U.S. Attorney who prosecuted the case.

As a way to manage the massive case, the judge asked prosecutors to split it in half, and prosecute Close first on roughly half of the 94 charges on which he originally was indicted. It’s now up to prosecutors to decide whether to have a second trial on the remaining, similar charges. The original indictment contained 77 health-care fraud charges, five of which were dismissed before the trial for lack of witnesses; plus money-laundering and forfeiture charges.

Now that the jury’s verdict on the initial charges is in, the judge will decide if the government can seize some of Close’s assets as ill-gotten gains, including cash and real estate.

The recent Supreme Court decision may require the jury to rule on various sentencing issues, so jurors were not released and can’t yet comment on the case.

Close’s Moscow, Idaho attorney, Brian Thie, said Wednesday, “Obviously I’m disappointed in the outcome. … They had to make the choice, and … they made the choice in the government’s favor.”

The jury deliberated for two days, returning its unanimous verdict late Tuesday.

Senior advocates have hailed the case as a sign that Medicare and Medicaid will go after fraud, preserving the scarce dollars the government has to spend on health care for the poor and elderly.

“We’re always hopeful that there’ll be some deterrence effect,” Olson said. Though such medical equipment fraud schemes are not uncommon around the country, she said this is the first one authorities have found in Idaho. “Hopefully, the word will go out that if they don’t bill for what they actually provide, someone may catch onto them, and they will be prosecuted.”