Minnesota couple indicted in multi-million dollar medical fraud scheme

MINNEAPOLIS (FOX 9) - A Minnesota couple has been indicted in a $15 million medical billing fraud scheme, according to the Department of Justice (DOJ). 

Medical billing fraud scheme 

The backstory:

Minnesota couple, 39-year-old Gabriel Luthor a.k.a. Alexander Langford and 40-year-old Elizabeth Brown, allegedly defrauded Medicare, Medicaid and other insurers out of a total of $15 million. 

According to the DOJ, starting in 2018, Luthor and Brown over-billed insurers for medical services they provided at Golden Victory Medical, LLC (GVM), where the couple claimed to provide neurofeedback therapy.

Neurofeedback therapy starts with a medical provider placing sensors on a patient's scalp to get pictures of the patient's brain waves, to see the effects of treatments for mental health conditions. 

The couple is accused of over-billing insurers for the neurofeedback therapy by using multiple "inapplicable" medical codes, according to the DOJ. 

False claims to insurers

Dig deeper:

Brown and Luthor, through GVM, submitted multiple claims to insurers using medical codes that don't cover nuerofeedback therapy, and codes that claimed patients received longer services than were actually provided. 

According to the DOJ, Brown and Luthor continued to submit false claims even after warnings from insurers, an outside auditor and the Center for Medicare and Medicaid Services. 

By the numbers:

The DOJ says in total, GVM submitted hundreds of thousands of false claims to insurers, which were paid out by those insurers, which authorities say resulted in a loss of about $15 million. 

Big picture view:

Luthor and Brown allegedly used the funds to buy a mansion in Eden Prairie.

Profits were also used to pay for their living expenses and the living expenses of Luthor's "other girlfriends," who reportedly lived with Luthor and Brown and helped in the fraud scheme. 

Brown and Luthor are charged with six counts of wire fraud and one count of money laundering.

What they're saying:

"Minnesota has a fraud problem," said Acting U.S. Attorney Lisa D. Kirkpatrick. "This case is yet another example of defendants defrauding government programs out of millions. This type of widespread fraud is unacceptable and will not be tolerated."

"Defrauding critical healthcare programs like Medicaid and Medicare burden systems designed to serve patients and puts them at risk," said Special Agent in Charge Alvin M. Winston Sr. of FBI Minneapolis. "The FBI and our partners will not tolerate those who abuse the healthcare system for personal gain and will pursue justice on behalf of taxpayers and patients."