American Airlines workers were targets of alleged $17 million hearing aid scam.
A federal grand jury indicted a Texas father and son duo this week in an alleged hearing aid scam that targeted American Airlines workers and netted nearly $17 million.
Terry Anderson, 66, and Rocky Anderson, 36, were each charged on 15 federal counts by the U.S. attorney for the Northern District of Texas. The charges include conspiracy to commit health care fraud, health care fraud and aiding and abetting, and identity theft and aiding and abetting.
The indictment accuses the pair of submitting fraudulent claims for hearing aids to Blue Cross Blue Shield of Texas starting in 2011, many of which were submitted on behalf of American Airlines’ employees. The indictment alleges that the hearing aids were not needed by the patients and in many cases were not delivered.
According to the indictment, the pair, who operated Anderson Optical and Hearing Aid Center, offered a free pair of high-end sunglasses or prescription eyeglasses in exchange for taking a free hearing test. Patients were also offered $100 gift cards for referring family members or co-workers.
At the end of the test, patients were told they had slight to mild hearing loss and were required to sign an order for hearing aids in order to receive the free glasses, according to the indictment. The patients were told the hearing aids would be provided at no cost and there would be no co-payments or deductibles due.
The plan appeared to specifically target American Airlines employees, whose Blue Cross Blue Shield insurance plans at the time did not have a maximum limit on the cost of hearing aids and allowed subscribers to obtain new hearing aids annually.
The indictment said the hearing tests did not meet Blue Cross Blue Shield’s medical standards and that many were conducted in less than five minutes in an employee break room at DFW International Airport.
The Andersons allegedly told some American employees that even though they did not have hearing loss, they would likely develop it in the future and should order hearing aids in case their benefits were reduced or they were laid off due to bankruptcy proceedings American was going through at the time.
In 2013, 84.6 percent of Anderson Optical and Hearing’s revenue came from Blue Cross Blue Shield, with 99.7 percent of those payments based on claims submitted by American Airlines employees or their dependents, the indictment said.
The indictment pegs the total amount of hearing aid claims submitted on behalf of American Airlines employees at $27 million, with $16.7 million going to Anderson Optical and Hearing.
It further alleges that the Andersons falsified patient records, forged patient signatures and attempted to collect deductibles and co-insurances for the hearing aids from patients years after conducting the hearing test and promising free hearing aids.
American changed its insurance policy in 2014, with a new cap of $3,500 per hearing aid and a limit of replacement hearing aids every 36 months.
The indictment alleges that the Andersons submitted claims for as much as $13,990 on behalf of patients.
The Andersons were scheduled to make their first court appearance on Thursday.
If convicted, the indictment includes a notice that would require the Andersons to forfeit a 300-acre ranch in Bosque County, three vehicles and more than $3.1 million seized from nine financial accounts in December 2015.
The health care fraud counts carry a maximum penalty of 10 years in federal prison and a $250,000 fine, while the identity theft counts carry a mandatory penalty of two years in federal prison and a $250,000 fine, according to the U.S. attorney’s office for the Northern District of Texas.
Source: Dallas News
Image credit: Conor Shine
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