Friday, May 31, 2013

Oklahoma City Doctor Pleads Guilty to Defrauding Medicaid

OKLAHOMA CITY—Amar Nath Bhandry, M.D., 53, of Oklahoma City, has pled guilty to committing health care fraud, announced Sanford C. Coats, United States Attorney for the Western District of Oklahoma.
According to the superseding information, Dr. Bhandry submitted claims to Medicaid claiming reimbursement for services that he had not actually provided. Specifically, he filed claims for comprehensive psychiatric examinations between 45-50 minutes in duration when he visited with patients for only 10-20 minutes. Dr. Bhandry pled guilty earlier today to the superseding information.
At sentencing, Dr. Bhandry faces up to 10 years in prison and $250,000 fine. Sentencing will take place in approximately 90 days.
These charges are the result of an investigation conducted by the Federal Bureau of Investigation and the Drug Enforcement Administration. The case was prosecuted by Assistant U.S. Attorneys Randal A. Sengel and David P. Petermann.
Reference is made to court filings for further information.

Wednesday, May 29, 2013

Two Area Women Charged with Submitting Fraudulent Bills for Home Health Services

CORPUS CHRISTI, TX—Sylvia Salinas Ramirez, of Driscoll, and Debra Jean Velasquez, of Robstown, have surrendered to authorities following the return of an indictment alleging they perpetrated a scheme to defraud the Texas Medicaid program through fraudulent home health billings, United States Attorney Kenneth Magidson announced today, along with Texas Attorney General Greg Abbott.
The 14-count indictment was returned Wednesday, May 8, 2013. Ramirez, 51, and Velasquez, 41, were taken into custody this morning and are expected to make an appearance before U.S. Magistrate Judge Janice Ellington this afternoon, at which time the issue of bond will be decided.
Ramirez and Velasquez are charged with one count of conspiracy to commit health care fraud, six counts of health care fraud, four counts of wire fraud, and three counts of aggravated identity theft.
The indictment alleges the women were employed by the Corpus Christi office of MRNG Inc. doing business as Caring Touch Home Health. During that time, Ramirez and Velasquez allegedly submitted false and fraudulent bills to Medicaid and the managed care organizations known as Evercare of Texas LLC and Superior Health Plan Inc. for home health services that had not been provided. Evercare and Superior received funds from Medicaid to manage the home health care of Medicaid beneficiaries. According to the indictment, from on or about August 1, 2009 through on or about June 15, 2010, Ramirez and Velasquez created false and fraudulent time sheets for current and former Caring Touch employees for home health services that were not provided. The indictment accuses Ramirez and Velasquez of then fraudulently billing Medicaid, Evercare, and Superior in the name of Caring Touch for those non-existent services.
The indictment also alleges that in order to personally profit from their fraudulent billings, Ramirez and Velasquez allegedly created payroll records from the fraudulent time sheet that they sent to Caring Tough’s payroll staff. According to the indictment, Ramirez and Velasquez obtained the payroll checks generated from the false and fraudulent time records, forged the signatures of the payees, and then cashed the checks and divided the money among themselves. The indictment does not accuse Caring Touch or the employees whose names were used on the false time sheets and checks of any wrongdoing.
The indictment alleges that from or about August 1, 2009 through on or about June 15, 2010, Ramirez and Velasquez submitted and or caused others to submit approximately 628 false and false and fraudulent claims in the approximate aggregate sum of $345,393.41 for home health services that were not provided. As a result, Texas Medicaid, Evercare, and Superior paid the approximate aggregate sum of $155,127.72, according to allegations.
Conspiracy to commit health care fraud and each of the six counts of health care fraud carry a maximum punishment of 10 years in federal prison without parole, upon conviction, while the four counts of wire fraud each carries a possible 20 year sentence. All of these charges also include a possible $250,000 fine. If convicted of aggravated identity theft, the defendants will serve a mandatory two-year additional prison term on each count which must be served consecutive to any other prison sentence imposed.
The charges were the result of a joint investigation conducted by officers and agents of the Corpus Christi Police Department, the FBI, Department of Health and Human Services-Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit. Special Assistant United States Attorney Rex Beasley and Assistant United States Attorney Jeffery Preston are prosecuting the case.
An indictment is an accusation of criminal conduct, not evidence. A defendant is presumed innocent unless convicted through due process of law.

Tuesday, May 28, 2013

Milwaukee Doctor Indicted on Health Care Fraud Charges

James L. Santelle, the United States Attorney for the Eastern District of Wisconsin, announced that on May 14, 2013, a federal grand jury in Milwaukee returned an indictment charging Dr. Cully R. White (age 44). Dr. White is charged with 13 counts of health care fraud in violation of Title 18, United States Code, Section 1347. Dr. White, who is a doctor of osteopathic medicine, is the owner and operator of Dr. Cully R. White, Neurosurgery & Spine, SC, located in Milwaukee, Wisconsin.
The indictment alleges that during the period from approximately November 2010 through October 2011, White carried out a scheme to defraud health insurance companies. As part of his scheme, White allegedly recruited another physician to dictate reports making it appear that the second physician had conducted interoperative nerve monitoring during surgeries performed by White. The second physician had no training or experience in, nor did he conduct interoperative nerve monitoring during White’s surgeries. The indictment further alleges White paid the second physician $150 for each report he dictated. White then used the reports prepared by the second physician to submit claims to insurance companies seeking payment for the second physician’s services.
According to the indictment, White submitted claims to insurance companies totaling more than $265,000 and ultimately received approximately $82,000. White paid the second physician a total of $14,850 for dictating the reports.
Each of the charges contained in the indictment carries a maximum possible penalty of up to 10 years in prison and a fine of up to $250,000, or both.
This matter was investigated by the Federal Bureau of Investigation and has been assigned to Assistant United States Attorney Matthew L. Jacobs for prosecution.
The public is cautioned that an indictment is merely the formal method of presenting charges in federal court and does not constitute evidence of the defendant’s guilt. The defendant is presumed innocent until such time, if ever, as the government establishes his guilt beyond a reasonable doubt.

Friday, May 24, 2013

Federal Medicare Fraud Strike Force Charges Chicago-Area Defendants with Defrauding Medicare and Other Health Insurers

CHICAGO—Two area physicians and three health clinic co-owners are among seven defendants charged here with engaging in five separate, unrelated health care fraud schemes to defraud the Medicare program and/or private health insurers of millions of dollars, federal law enforcement officials announced today.
Four of the five cases here are part of a nationwide takedown by Medicare Fraud Strike Force operations in eight cities, announced today by the Departments of Justice and Health and Human Services, resulting in charges against 89 defendants, including doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud schemes collectively involving approximately $233 million in false billing.
In Chicago, the defendants were charged in two criminal complaints and two informations filed today and yesterday, and an indictment that was unsealed today following the arrest of one defendant in Miami. All seven defendants were charged with health care fraud for allegedly defrauding the Medicare program, or violating the anti-kickback statute, which makes it illegal to offer, pay, solicit, or receive payments in exchange for referrals of Medicare patients. The charges involve various medical treatments and services, as well as durable medical equipment.
“Today’s announcement marks the latest step forward in our comprehensive efforts to combat fraud and abuse in our health-care systems,” said Attorney General Eric Holder. “These significant actions build on the remarkable progress that the HEAT has enabled us to make—alongside key federal, state, and local partners—in identifying and shutting down fraud schemes. They are helping to deter would-be criminals from engaging in fraudulent activities in the first place. And they underscore our ongoing commitment to protecting the American people from all forms of health-care fraud, safeguarding taxpayer resources, and ensuring the integrity of essential health care programs,” he added.
“Today’s charges are part of our continuing efforts not only to deprive dishonest healthcare providers of their illegal profits but to demonstrate to the broader medical services community that health care fraud will be found out and prosecuted with all of our resources. In short, we will not tolerate medical professionals and providers who abuse our healthcare system,” said Gary S. Shapiro, United States Attorney for the Northern District of Illinois.
Details of the Chicago cases follow:
United States v. Ankur Roy, Akash Patel, and Dipen Desai
Ankur Roy, Akash Patel, and Dipen Desai, who owned and operated Selectcare Health Inc., which provided outpatient physical and respiratory therapy in Park Ridge and Skokie, were charged with submitting more than $4 million in false billings to Medicare between March and July 2011. Each defendant was charged with six counts of health care fraud in an indictment that was returned by a federal grand jury last Wednesday and unsealed today.
Roy, 36, of Miami was arrested today in south Florida, while Patel, 33, of Morton Grove, and Desai, 33, of Chicago, will be ordered to appear for arraignment on a later date in U.S. District Court in Chicago.
According to the indictment, the defendants submitted false claims to Medicare and Blue Cross Blue Shield on behalf of Selectcare patients for respiratory therapy services that were never provided. The alleged false billings sought reimbursement for services purportedly provided on days that Selectcare’s sole respiratory therapist was not working; for time periods in which the patients were not receiving care from Selectcare; and for treatment seven days a week for three hours per day, a schedule well in excess of any schedule prescribed for patients at Selectcare.
Roy, Patel, and Desai used a third-party billing service to forward the alleged false claims to Medicare, as well as to private insurers such as Blue Cross if the patient had supplemental private insurance, including insurance funded by labor union health and welfare plans.
Between March and July 2011, the defendants allegedly submitted $4,009,094 in false billings for services that were purportedly provided between April 2010 and April 2011, resulting in payments totaling approximately $2,214,424 from Medicare and $320,881 from Blue Cross Blue Shield. The indictment seeks forfeiture of $2,535,305 in alleged fraud proceeds, including $446,974 in funds withdrawn by cashiers’ checks that were seized by the FBI in July 2012.
The government is represented by Assistant U.S. Attorney Maureen Merin. The case was investigated by the FBI, the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), and the U.S. Department of Labor Office of Inspector General (DOL-OIG).
United States v. Cecilia Ibrahim
Dr. Cecilia Ibrahim, an internal medicine physician who operated Sunrise Medical Center in Flossmoor, was charged with one count of health care fraud for allegedly engaging in a $1.7 million Medicare and private insurance false billing scheme.
Ibrahim, 50, of Frankfort, was charged in an information filed today in U.S. District Court. She will be arraigned on a date to be determined.
Between March 2006 and August 2009, Ibrahim allegedly submitted more than 3,200 false claims to Medicare and Blue Cross Blue Shield using a billing code for spinal decompression neuroplasty, a surgical procedure that she did not perform, when she only performed intervertebral differential dynamics therapy (IDD), a non-surgical procedure. As a result, she allegedly caused a loss of at least $300,000 to Medicare and $550,000 to Blue Cross Blue Shield. The indictment seeks forfeiture of at least $882,500 in alleged fraud proceeds.
The government is represented by Assistant U.S. Attorney Samuel B. Cole. The case was investigated by the FBI, HHS-OIG, and the Railroad Retirement Board Office of Inspector General.
United States v. Ellyse Lamon
Elysse Lamon, an account executive at a company that sold durable medical equipment, including back braces and transcutaneous electrical nerve stimulation units, also known as tens units, was charged with one count of health care fraud for allegedly engaging in a $350,000 Medicare false billing scheme.
Lamon, 30, of Elmhurst, was charged in an information filed today in U.S. District Court. She will be arraigned on a date to be determined.
Between October 2010 and May 2011, Lamon allegedly caused her company to submit false claims to Medicare representing that a physician had prescribed back braces and tens units when she knew that no physician had done so and the items were not medically necessary. In order to provide written support for the false claims, Lamon allegedly obtained patient records without a physician’s permission and added false information reflecting that a physician had ordered the equipment for the patients. She allegedly forged doctors’ signatures on documents, including false treatment records she created. Lamon further used patient information she had inappropriately accessed at a pain medicine center in Chicago to set up patient meetings where she falsely told patients that doctors had prescribed the equipment for them, according to the charges.
Lamon allegedly submitted false claims to Medicare totaling $352,685, resulting in payment of at least $206,233 to her medical equipment company. She allegedly profited from these false claims by receiving increased commissions and other benefits from her company.
The government is represented by Assistant U.S. Attorney Kruti Trivedi. The case was investigated by the FBI and is not part of the Medicare Fraud Strike Force operation.
United States v. Nalini Ahluwalia
Dr. Nalini Ahluwalia was charged with one count of violating the anti-kickback law for allegedly receiving $1,000 in exchange for referring two patients to a home health care agency in August 2012.
Ahluwalia, 58, of Burr Ridge, was charged in a complaint filed today in U.S. District Court. She will be ordered to appear on a date to be determined.
According to the complaint, a confidential informant who worked at a home health care company in Chicago, told agents that the confidential informant had previously paid kickbacks to Ahluwalia of $400 to $500 per patient in exchange for her referral of Medicare patients to the home health care company.
On August 23, 2012, at the direction of agents, the confidential informant met with Ahluwalia at the doctor’s office in Chicago and paid her $1,000 for the two Medicare patient referrals in an exchange that was reflected on an audio/video recording, according to the complaint affidavit. In October 2012 and February 2013, the informant allegedly made two additional $500 payments to Ahluwalia in exchange for Medicare patient referrals.
The government is represented by Assistant U.S. Attorney Samuel B. Cole. The case was investigated by the FBI and the HHS-OIG.
United States v. Joseph Dickson
Joseph Dickson, the president and owner of JD Medical Consultants Inc., a medical marketing company, was charged with one count of violating the anti-kickback law for allegedly receiving $4,200 in exchange for referring patients to a home health care agency in October 2012.
Dickson, 65, of Lansing, was charged in a complaint filed yesterday in U.S. District Court. He will be ordered to appear on a date to be determined.
According to the complaint, a confidential informant who owned a home health care company in the Chicago area, told agents that the confidential informant had previously paid kickbacks to Dickson, among others, for referring Medicare patients to another home health care company where s/he previously worked. Dickson was described as a “middle man” who arranged the referral of patients from a physician to a home health care company, and the confidential informant told agents that the confidential informant had paid Dickson approximately $15,000 for referring about 30 patients between 2006 and 2008.
On October 3, 2012, at the direction of agents, the confidential informant met with Dickson at his office in Chicago and paid him $4,200 for seven Medicare patient referrals, at $600 each, in an exchange that was reflected on an audio/video recording, according to the complaint affidavit. In December 2012, the informant allegedly made an additional $1,800 payment to Dickson in exchange for Medicare patient referrals and re-certifications.
The government is represented by Assistant U.S. Attorney Joseph H. Thompson. The case was investigated by the FBI and the HHS-OIG.
The charges in these cases carry the following maximum penalties on each count: health care fraud—10 years in prison and a $250,000 fine, or an alternate fine totaling twice the loss or twice the gain, whichever is greater; and violating the anti-kickback statute—five years in prison and a $250,000 fine. If convicted, the court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
The Medicare Fraud Strike Force began operating in Chicago in February 2011 and consists of agents from the FBI and HHS-OIG working together with prosecutors from the U.S. Attorney’s Office and the Justice Department’s Fraud Section. The strike force is are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
Since their inception in March 2007, strike force operations in nine locations have charged more than 1,500 defendants who collectively have falsely billed the Medicare program for more than $5 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
The nationwide takedown was announced today by Attorney General Holder, HHS Secretary Kathleen Sebelius and other federal law enforcement officials. Mr. Shapiro announced the Chicago charges with Cory B. Nelson, Special Agent in Charge of the Chicago Office of the Federal Bureau of Investigation; Lamont Pugh, III, Special Agent in Charge of the Chicago Regional Office of the HHS-OIG; and James Vanderberg, Special Agent in Charge of the Labor Department Office of Inspector General in Chicago. The Railroad Retirement Board Office of Inspector General assisted in the Ibrahim investigation.
The public is reminded that indictments, informations, and complaints contain only charges and are not evidence of guilt. The defendants are presumed innocent and are entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Tuesday, May 21, 2013

Leader of $29.1 Million Medicare Fraud Scheme Pleads Guilty in Detroit

WASHINGTON—The mastermind of a $29.1 million Medicare fraud scheme involving approximately 30 purported medical clinics pleaded guilty today in Detroit for his role in the scheme.
The guilty plea was announced by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office; Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chicago Regional Office; and Special Agent in Charge Erick Martinez of the Internal Revenue Service Criminal Investigation (IRS-CI) Detroit Field Office.
Sachin Sharma, 37, of Detroit, pleaded guilty before U.S. District Judge Denise P. Hood in the Eastern District of Michigan to one count of conspiracy to commit health care fraud and one count of tax evasion.
According to court documents, Sharma oversaw and directed operations of a broad network of home health, psychotherapy, and other purported medical clinics in and around Detroit, including Reliance Home Care LLC, First Choice Home Health Care Services, Inc., and Haven Adult Day Care Center LLC. Working with co-conspirators, Sharma created and/or operated these companies for the purpose of billing Medicare for home health and psychotherapy services that Sharma knew were not provided. Court documents show that Sharma paid kickbacks to patient recruiters in order to obtain the information of Medicare beneficiaries, which he then used at these companies to bill Medicare for services that were not medically necessary and/or were not provided to these beneficiaries.
Court documents show that Sharma trained others on techniques to defraud Medicare and to conceal the fraud and directed employees to fabricate and alter medical documents to give the false impression that home health and psychotherapy services were provided when, in fact, they were not.
Sharma admitted that from 2007 through 2011, he received substantial proceeds of the fraud from these companies, but failed to report these proceeds on his individual federal income tax returns. Sharma admitted that he filed no individual income tax returns from 2007 through 2011.
Court documents allege that between 2007 and 2012, Sharma caused these companies to submit approximately $29,171,017 in claims to Medicare for services that were not medically necessary and/or not provided.
At sentencing, scheduled for August 8, 2013, Sharma faces a maximum penalty of 10 years in prison and a $250,000 fine.
Sachin Sharma’s co-defendants, Dana Sharma, Beverly Cooper, and Clarence Cooper, each previously pleaded guilty to one count of conspiracy to commit health care fraud for their roles in the scheme. Co-defendants Abdul Malik al-Jumail, aka Tony; Felicar Williams; and Jamella al-Jumail are scheduled for trial on June 10, 2013. Co-defendant Firas Alky remains a fugitive. Defendants are presumed innocent unless and until proven guilty at trial.
This case is being prosecuted by Trial Attorney William G. Kanellis and Deputy Chief Gejaa Gobena of the Criminal Division’s Fraud Section, with assistance from the Department of Justice Tax Division. It was investigated by the FBI, HHS-OIG, and IRS-CI, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

Clinic Owners Sentenced for Roles in $13.3 Million Medicare Fraud Scheme

WASHINGTON—Miami residents Raymond Arias, 42, and his wife, Emelitza Arias, 25, have been sentenced in Detroit to 100 months and 12 months in prison, respectively, for their participation in a $13.3 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley, III of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Service’s Office of Inspector General’s (OIG) Chicago Regional Office, made the announcement after sentencing by U.S. District Paul D. Borman of the Eastern District of Michigan.
The Ariases were also sentenced to two years of supervised release following their respective prison terms. At sentencing on May 7, 2013, the court ordered Raymond Arias to pay $5.4 million in restitution. Today at sentencing, the court ordered Emelitza Arias to pay $531,883 in restitution, jointly and severally. The defendants agreed to forfeit approximately $40,000 seized by federal agents during the investigation.
The Ariases pleaded guilty on October 17, 2012, to one count of conspiring to commit health care fraud. According to the plea documents, beginning in approximately 2009, Raymond Arias opened Elite Wellness where he submitted claims to Medicare for infusion therapy treatments that were never rendered. In three months, Elite Wellness submitted in excess of $10 million in claims to Medicare. Emelitza Arias joined the scheme by opening a second clinic, Carefirst Physical Therapy & Rehabilitation Center, which submitted approximately $940,000 in claims to Medicare for infusion therapy treatments that were never rendered.
The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. This case was prosecuted by Trial Attorney Catherine Dick of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan.
Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,480 individuals who collectively have falsely billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Detroit-Area Clinic Owner Sentenced to 40 Months in Prison for Role in $19 Million Health Care Fraud Scheme

WASHINGTON—A Detroit-area adult day care center owner was sentenced today to serve 40 months in prison for billing for unnecessary psychotherapy services, or services that were not provided, as part of a health care fraud conspiracy that led to more than $19 million in fraudulent Medicare billings.
The sentence was announced by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley, III of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office.
Checarol Robinson, 41, was sentenced by U.S. District Judge Nancy G. Edmunds in the Eastern District of Michigan. In addition to her prison term, Robinson was sentenced to serve two years of supervised release and was ordered to pay $599,438 in restitution, jointly and severally with her co-defendant, Louisa Thompson, who awaits sentencing following a guilty plea for her role in the scheme.
Robinson pleaded guilty on August 2, 2012, to an indictment charging her with one count of conspiracy to commit health care fraud and three counts of health care fraud.
According to Robinson’s admissions during her guilty plea proceeding, Robinson owned group homes where Medicare beneficiaries resided. In return for payments, Robinson provided these Medicare beneficiaries’ information to a fraudulent psychotherapy company—Caldwell Thompson Manor Inc.—owned by co-conspirator Thompson. That information was then used to bill Medicare for psychotherapy services that were not provided or were not medically necessary.
Robinson later owned and operated P&C Adult Day Center, which was incorporated in May 2010 and purported to provide psychotherapy services. Robinson admitted she falsely billed Medicare for individual and group therapy services that were not provided by P&C or were not medically necessary, using the Medicare beneficiaries from her group homes. Thompson, a licensed social worker and Robinson’s co-conspirator from the scheme at Caldwell Thompson, signed patient charts for psychotherapy services purportedly performed at P&C that were medically unnecessary or never performed.
According to court documents, a total of more than $19 million in false claims were submitted by the co-conspirators throughout the course of the conspiracy. Evidence presented at today’s sentencing demonstrated that Robinson was responsible for causing the submission of more than $2 million in fraudulent billings.
This case was prosecuted by Assistant Chiefs Gejaa T. Gobena and Catherine K. Dick of the Criminal Division’s Fraud Section and Assistant U.S. Attorney for the Eastern District of Michigan Philip A. Ross. It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since their inception in March 2007, strike force operations in nine locations have charged more than 1,480 defendants who collectively have falsely billed the Medicare program for more than $4.8 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

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BOSTON—A Brockton woman and three of her employees were charged with defrauding insurance companies in connection with physical therapy services.
Walkyria Massie, a/k/a Vicky Lopes, 37, of Brockton; Edward Rossi, 53, of Rochester; Deidre Chouinard, 36, of North Attleboro; and Manuela Andrade, 24, of Brockton, were charged in an indictment unsealed yesterday with conspiracy to commit mail fraud and three separate instances of mail fraud.
The indictment alleges that Massie was the owner and operator of Westgate Physical Therapy in Brockton. Patients would seek treatment at Westgate for minor injuries, generally sustained in car accidents. Massie employed Chouinard, a physical therapist; Rossi, a physical therapy assistant; and Andrade, an office manager. The indictment alleges that Massie, Rossi, Chouinard, and Andrade conspired together to falsify patient treatment charts to reflect therapy that was either never given, or was performed by unlicensed personnel, including Massie herself. Massie caused these fraudulent physical therapy claims to be submitted by mail to private insurance companies for payment. Various insurance companies paid more than $400,000 in bodily injury claims to Westgate and its patients during a two-year period, based on these fraudulent submissions.
On the charges of conspiracy to commit mail fraud and mail fraud, the defendants face a statutory maximum penalty of 20 years in prison, followed by three years of supervised release and a $250,000 fine.
United States Attorney Carmen M. Ortiz; Richard DesLauriers, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division; and Anthony DiPaolo, Vice President/Chief of Investigations of the Insurance Fraud Bureau of Massachusetts, made the announcement today. The case is being prosecuted by Assistant U.S. Attorney Shelbey Wright of Ortiz’s Health Care Fraud Unit.
The details contained in the indictment are allegations. The defendants are presumed to be innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

Detroit-Area Home Health Agency Owner Sentenced to 60 Months for Role in $13 Million Health Care Fraud Scheme

WASHINGTON—A Detroit-area home health care agency owner was sentenced today to 60 months in prison for causing the submission of over $1 million in false and fraudulent billing to Medicare as part of a $13.8 million health care fraud conspiracy.
The sentence was announced by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley, III of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office.
According to plea documents, Rehan Khan was an owner of Moonlite Home Care Inc. As the co-owner of Moonlite, Khan paid and directed the payment of sums to doctors to refer patients for home health care services to Moonlite that were not medically necessary and/or never rendered. Khan also worked as a physical therapy assistant for several home health agencies in the Detroit area, known as Physicians Choice Home Health Care LLC and First Care Home Health Care LLC. Khan paid and directed the payment of kickbacks to beneficiaries for Physicians Choice, First Care, and Moonlite. The Medicare beneficiaries sometimes pre-signed forms and visit sheets that were later falsified to indicate that they had received home health services that they had never received. Other times, the Medicare beneficiaries’ signatures were forged on forms and visit sheets to indicate that they received home health services that they had never received.
Khan paid and directed the payment of various medical professionals, including nurses, physical therapists, and physical therapy assistants, to create fictitious patient files to document home health services purportedly provided by Moonlite that were never rendered. Khan also signed fictitious patient files purporting to have given physical therapy services at all three home health care agencies that were in fact never rendered.
From about January 2011 through about September 2011, Khan submitted or caused the submission of fraudulent claims by Moonlite, for which Medicare paid approximately $891,473. From about January 2009 through about September 2011, Medicare paid approximately $866,512 to Physicians Choice and First Care for fraudulent physical therapy claims based on falsified files and notes signed by Khan. In total, Khan was responsible for approximately $1,757,985 in false and fraudulent claims to Medicare.
This case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. The case was prosecuted by Assistant Chief Catherine K. Dick of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan.
Since their inception in March 2007, strike force operations in nine locations have charged more than 1,480 defendants who collectively have falsely billed the Medicare program for more than $4.8 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Michigan Physician Pleads Guilty to Role in Medicare Fraud Scheme

WASHINGTON—A Detroit-area physician pleaded guilty today to making fraudulent referrals for home health care as part of a $1.6 million home health care fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Robert D. Foley, III of the FBI’s Detroit Field Office, and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chicago Regional Office.
Dr. Sonjai Poonpanij, 82, of Rochester, Michigan, pleaded guilty before Senior U.S. District Judge Arthur J. Tarnow in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.
According to court documents, Dr. Poonpanij admitted that beginning in approximately July 2010, he conspired with others to commit health care fraud by referring Medicare beneficiaries for home health care that was not medically necessary and causing false and fraudulent claims to be submitted to Medicare.
Dr. Poonpanij admitted that he saw patients at a psychotherapy center in Flint, Michigan, known as New Century Adult Day Program Services LLC, and referred Medicare beneficiaries at New Century to home health care companies—including a home health care company known as Angle’s Touch Home Health Care LLC—even though he knew that those beneficiaries did not qualify for home health care. According to court documents, Dr. Poonpanij wrote prescriptions for narcotics requested by the beneficiaries in exchange for their enrollment with Angle’s Touch for home health care that they did not need or receive. In addition to referring patients that he saw at New Century, Dr. Poonpanij also referred beneficiaries whom he had never seen or treated to Angle’s Touch and other home health agencies. Dr. Poonpanij signed plans of care for these beneficiaries that were used to bill Medicare for services that were either never actually performed or were not performed in the beneficiaries’ homes as required.
Court documents allege that between September 2008 and September 2012, Dr. Poonpanij caused Angle’s Touch and two other home health agencies to submit claims to Medicare for services that were not medically necessary and/or not provided, which caused Medicare to pay these companies approximately $1,318,954.
At sentencing, scheduled for August 14, 2013, Dr. Poonpanij faces a maximum penalty of 10 years in prison and a $250,000 fine.
This case is being prosecuted by Trial Attorney Niall M. O’Donnell of the Criminal Division’s Fraud Section. It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Monday, May 20, 2013

Adrian Resident Pleads Guilty to Health Care Fraud and Filing a False Tax Return

The operator of a human resources company pleaded guilty to health care fraud and filing a false tax return, announced U.S. Attorney Barbara McQuade.
Ms. McQuade was joined in the announcement with Special Agent in Charge Erick Martinez of the Internal Revenue Service Criminal Investigation (IRS-CI) Detroit Field Office and Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office.
Jason Syrek, age 39, of Adrian, pleaded guilty before United States District Judge Paul D. Borman on May 15, 2013.
According to court records, between May 2008 and December 2010, Syrek engaged in health care fraud and tax fraud while operating CAS Resources of Adrian, Michigan. CAS Resources provided outsourcing of human resource services, such as payroll, taxes and employee benefits administration, including health care coverage.
CAS collected $1.75 million in premiums from client companies in November and December 2010, an amount due to Blue Cross Blue Shield of Michigan (BCBSM), but never paid by Syrek. He admitted diverting these funds for personal use.
According to the plea agreement, in January, 2011, Syrek as the director of CAS Resources, filed a Form 941 for 2010: Employer’s Quarterly Federal Tax return for the third quarter. The Form 941 was filed with the IRS and stated that CAS Resources paid $1,862,902 in payroll taxes. Syrek knew he had diverted these funds for his own personal use and only paid $633,332 in payroll taxes. In addition to the third quarter Form 941 for 2010, Syrek filed approximately seven other Form 941s with the IRS which he did not pay. In total, from 2010 through 2011, Syrek’s tax due is $13.4 million.
Syrek used the money to buy beachfront properties, several cars, a boat, and investment properties. In order to pay his debt, Syrek will forfeit his homes, beach properties in Florida, 2009 32.5’ Sea Ray Boat, and cars, to include a 2008 Ferrari F430 and 2008 Porsche Boxster.
“Fraud schemes like this one may involve sophisticated methods, but they are nothing more than stealing. This defendant robbed health care programs and taxpayers for his personal benefit,” McQuade said.
“Syrek’s conduct was egregious in that he effectively stole funds that were withheld on behalf of employees,” said Erick Martinez. “His actions cost the government $13.4 million dollars in tax loss alone.”
“Those who commit health care fraud and other related crimes will face severe penalties for their illegal acts,” stated FBI Special Agent in Charge Foley. “The FBI is committed to working with the IRS and other agencies to bring these individuals to justice.”
Sentencing is scheduled for August 13, 2013. Syrek faces a maximum sentence of 87 months’ imprisonment under the terms of the plea agreement, which was taken under advisement by the court, and a fine of up to $250,000. In addition, Syrek has agreed to pay restitution in the amount of $1,754,922.98 to BCBSM and $13,405,212 to the IRS.
This case is being prosecuted by Assistant United States Attorneys Sarah Resnick Cohen and Linda Aouate and investigated by special agents of the IRS Criminal Investigation and the FBI.

Friday, May 17, 2013

Grand Jury Returns Indictment Charging Manhattan Physician with Unlawfully Distributing Prescription Drugs

TOPEKA, KS—A grand jury has returned an indictment charging a physician in Manhattan, Kansas with unlawfully distributing prescription drugs, U.S. Attorney Barry Grissom said today.
Physician Michael Schuster, 53, who operates Manhattan Pain and Spine in Manhattan, Kansas, is charged with four counts: one count of conspiracy to illegally distribute controlled substances, one count of unlawful distribution of controlled substances, one count of unlawfully distributing controlled substances to a person under 21 years ol,d and one count of maintaining a premises in furtherance of unlawful drug distribution.
The indictment alleges that Schuster employed unlicensed staff members who distributed controlled substances to patients using Schuster’s signature on prescriptions while he was traveling out of the state or out of the country. Schuster was out of the office when a total of 540 patients received prescriptions for medications including oxycodone, morphine, hydromorphone, methadone, oxymorphone, tapentadol, fentanyl, amphetamine, methylphenidate, hydrocodone, alprazolam, clonazepam, diazepam, and zolpidem.
Schuster initially was charged in a criminal complaint filed April 23, 2013, in U.S. District Court in Topeka. According to an investigator’s affidavit, the investigation began early in 2012 when the Riley County Police Department received reports that Schuster was issuing prescriptions for high dosages of scheduled drugs based on minimal or cursory physical examinations.
The indictment returned today states that controlled substances may be dispensed and distributed lawfully by means of a prescription that is issued for a legitimate medical purpose by a practitioner acting in the usual course of professional practice. The practitioner must be registered with the Drug Enforcement Administration. Signing a blank prescription and having unauthorized, unlicensed individuals who are not registered with the DEA distribute controlled substances is not a lawful prescription.
The indictment alleges Schuster routinely pre-signed blank prescription forms with the intent that his unlicensed staff members would use them to issue controlled substances to patients while he was not at the clinic.
Count two of the indictment alleges Schuster caused unlicensed staff using blank prescriptions to distribute controlled substances while he was out of the clinic at various locations including Russia, South Africa, Uruguay, Canada, New York, Chile, Argentina, Brazil, and Israel.
Count three alleges that on June 16, 2010, Schuster caused oxycodone to be distributed to a person under the age of 21, who is identified in the indictment as Rex V.
Count four alleges that from April 2007 to August 2012 Schuster knowingly maintained a premises, his office at 1135 Westport Drive in Manhattan, Kansas, for the purpose of unlawfully distributing controlled substances.
The indictment also seeks the forfeiture of all the proceeds from the crimes.
Upon conviction, the crimes carry the following penalties:
Conspiracy: A maximum penalty of 20 years in federal prison and a fine up to $1 million. If death or bodily injury results from the crime, the penalty is not less than 20 years.
Unlawful distribution of controlled substances: A maximum penalty of 20 years in federal prison and a fine up to $1 million. If death or bodily injury results from the crime, the penalty is not less than 20 years.
Unlawful distribution of controlled substances to a person under 21 years old: A maximum penalty of 20 years in federal prison and a fine up to $1 million. If death or bodily injury results from the crime, the penalty is not less than 20 years.
Maintaining drug involved premises: A maximum penalty of 20 years and a fine up to $500,000.
Investigating agencies include the Riley County Police Department; the Federal Bureau of Investigation; the Department of Defense, Criminal Investigative Service (DCIS); the Department of Health and Human Services, Office of Inspector General (HHS-OIG); the Drug Enforcement Administration (DEA); the Department of Homeland Security-Homeland Security Investigations (DHS-HSI); and the Diplomatic Security Service (DSS).
In all cases, defendants are presumed innocent until and unless proven guilty. The indictments merely contain allegations of criminal conduct.

Wednesday, May 15, 2013

The United States and the State of Vermont Enter into Global Resolution with Former Officers of Bennington School Inc. Relating to Tax and Health Care Fraud Violations

The Office of the United States Attorney for the District of Vermont and the Office of the Vermont Attorney General stated today that they have entered into global resolution of criminal and civil investigative matters concerning alleged tax and health care fraud by former officers of Bennington School Inc. (BSI). Defendant Matthew Merritt, Jr., age 81, the president and trustee of BSI; his son, defendant Matthew Merritt, III, age 54, BSI’s plant manager; and his son-in-law, defendant Raymond Crowley, age 58, who served as CFO of BSI, have agreed to plead guilty to one charge each of federal tax fraud. In addition, Matthew Merritt, Jr. will plead guilty to a federal charge of engaging in a scheme to defraud a health care program. To resolve potential civil health care fraud liability, the three Merritt family members have agreed to pay a total of $3,000,000 to the United States and the state of Vermont. Defendant Jeffrey LaBonte, age 59, the rxecutive firector of BSI, has also agreed to plead guilty to a federal tax fraud charge and will pay $1,300,000 to resolve his potential civil health care fraud liability. Of the total $4.3 million recovery, the state of Vermont will receive $2,113,708 and the United States will receive $2,186,292.
Until 2013, BSI, a for-profit, closely-held corporation, operated a residential program in Bennington, Vermont, that offered therapeutic and educational services for socially and emotionally challenged boys and girls. Over the course of the last two decades, the state of Vermont placed many students at BSI and was responsible for their tuition and other expenses. The funding for these placements came from the Vermont Medicaid program (approximately 60 percent federal funding and 40 percent state funding) and from several Vermont state agencies, including the Agency of Education, the Department of Mental Health, and the Department for Children and Families. This funding was based on a per diem rate for each student, determined on an annual basis by the Division of Rate Setting (DRS), within the Vermont Agency of Human Services. The annual rate set by DRS was determined upon a review of BSI’s application materials, including various accounting reports and budgets. In particular, the formula for the rate calculated by DRS for Medicaid and education payments to BSI was based upon the school’s reported allowable expenses. The higher the allowed expenses, the higher the per diem rate for each student. However, not all of BSI’s claimed allowable expenses were in fact allowable for the rate calculation. For example, BSI president Matthew Merritt, Jr. and executive director Jeffrey LaBonte, with the assistance of CFO Raymond Crowley and plant manager Matthew Merritt, III, implemented a system of compensating certain employees of BSI, in addition to their salary amounts, by providing personal benefits, such as cars, gasoline, oil for personal residences, payments of personal expenses on credit card accounts, salaries for family members who did not work at BSI, and reimbursements for various personal expenses. These forms of compensation were never reported on the individuals’ tax returns. In addition, these unallowable expenses were embedded in the books and records of BSI, which were used to create the reports, budgets, and other financial documents that BSI presented to DRS as accurate and allowable for rate setting.
The government’s investigation arose in 2011 following a request by BSI for a rate change due to reduced enrollment. In processing that request, DRS auditors took a close look at some of the financial information submitted and determined an on-site audit should be performed. The audit, completed in 2012, resulted in a recalculation of the rate BSI received during the years 2003-2012. DRS calculated the total amount of overpayment by the state during those years to be over $3.6 million. Under the False Claims Act, 31 U.S.C. § 3729, and potential state law remedies, should the government prevail at a trial, the defendants would be liable for treble damages as well as mandatory penalties up to $11,000 per claim. The defendants dispute DRS’s calculation, and the parties have settled to avoid further investigation and litigation.
For his federal health care fraud conviction, Matthew Merritt, Jr. faces a maximum term of imprisonment of 10 years under 18 U.S.C. § 1347. For his federal tax fraud conviction, Matthew Merritt, Jr. faces a maximum prison term of three years under 26 U.S.C. § 7206. Pursuant to a written plea agreement, the parties have agreed that Matthew Merritt, Jr.’s total term of imprisonment should not exceed 24 months.
For their federal tax fraud convictions, Matthew Merritt, III and Raymond Crowley each face a maximum prison term of three years under 26 U.S.C. § 7206. Pursuant to a written plea agreement, the parties have agreed that Matthew Merritt, III and Raymond Crowley’s prison terms should not exceed 18 months.
For his federal tax fraud conviction, Jeffrey Labonte faces a maximum prison term of three years under 26 U.S.C. § 7206. Pursuant to a written plea agreement, the government has agreed to make the nature and extent of Jeffrey Labonte’s cooperation known to the federal court and, as a result of his cooperation, request that the court sentence Jeffrey Labonte to a term of imprisonment below that recommended by the advisory sentencing guidelines.
Tristram J. Coffin, United States Attorney, noted that “schemes such as the one employed by these former BSI officials exact a significant toll on federal and state programs. Top officials at a for-profit organization that held itself out as serving an important public mission engaged in a fraud scheme involving government health care program payments. In addition, these same individuals filed false income tax returns. The prosecution of health care fraud offenses is a top priority for the Department of Justice, and coupling such fraud with tax violations makes these types of crimes even more egregious. Our office will continue to vigorously pursue and prosecute individuals who engage in such conduct. The American taxpayer deserves no less.”
The United States and the state of Vermont acknowledge that the scheme at issue here did not impact the quality of services offered to students at BSI. The school continues to operate as a fully licensed residential treatment program. However, as of January 1, 2013, management and ownership of the programs at Bennington School were transferred to Vermont Permanency Initiative Inc., which is part of the Becket Family of Services. Matthew Merritt, Jr. has resigned as president and trustee of BSI, and Jeffrey LaBonte, Matthew Merritt, III, and Raymond Crowley have left the school’s employ.
This matter was investigated by the United States Attorney’s Office, the Medicaid Fraud and Abuse Unit of the Vermont Attorney General’s Office, the Internal Revenue Service, the Federal Bureau of Investigation, and the Office of Inspector General-U.S. Department of Health and Human Services. United States Attorney Coffin commends the investigative agencies for their hard work on this criminal and civil investigation.
On the criminal matters, the United States was represented by First Assistant U.S. Attorney Paul Van de Graaf and Assistant United States Attorney Timothy C. Doherty, Jr. The civil investigation was handled by Civil Chief Carol L. Shea. The state of Vermont was represented by Assistant Attorney General Edward Baker. Matthew Merritt, Jr. is represented by David V. Kirby of O’Connor and Kirby in Burlington, Vermont. Jeffrey LaBonte is represented by John Pucci of Buckley Richardson in Springfield, Massachusetts. Matthew Merritt, III is represented by Richard Berne in Portland, Maine. Raymond Crowley is represented by Maryanne E. Kampmann of Stetler, Allen, & Kampmann in Burlington, Vermont.

Two Doctors, Including a Psychiatrist for the U.S. Department of Veterans Affairs, and Two Others Charged in Brooklyn as Part of Nationwide Medicare Strike Force Initiative

Four individuals, including two doctors, have been charged for their alleged participation in two separate schemes that falsely billed the Medicare and Medicaid programs for more than $17 million. The charges filed in Brooklyn, New York, are part of a nationwide takedown by the Medicare Fraud Strike Force operations that led to charges against 89 individuals for their alleged participation in schemes to collectively submit approximately $223 million in fraudulent claims.
The Brooklyn cases were announced by United States Attorney Loretta E. Lynch of the Eastern District of New York; George Venizelos, Assistant Director in Charge, Federal Bureau of Investigation (FBI), New York Field Office; and Thomas O’Donnell, Special Agent in Charge, Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations, New York. The results of the nationwide takedown were announced today by Attorney General Eric H. Holder, Health and Human Services Secretary Kathleen Sebelius, Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, FBI Assistant Director Ron Hosko, Inspector General Daniel R. Levinson of HHS-OIG, and Centers for Medicare and Medicaid Services Deputy Administrator for Program Integrity Dr. Peter Budetti.
The two schemes charged in the Eastern District of New York, detailed in an indictment and a criminal complaint, and other documents filed by the government, are as follows:
Presman
Mikhail L. Presman, 55, a psychiatrist employed by the U.S. Department of Veterans Affairs (VA), was charged in a complaint with engaging in a scheme to submit false and fraudulent medicare claims while operating a private practice when not on duty at the VA. The complaint alleges that Presman submitted fraudulent claims to the Medicare program in excess of $4,000,000 for home medical visits for patients who were never seen by Presman, for patients whom Presman claimed to have treated when he was in fact away on vacation, and for patients who were confined in a hospital at the time that Presman claimed to have treated them. Presman received more than $2,800,000 in Medicare payments as a result of this scheme. A search warrant was executed at Presman’s personal residence, which he purported to be his medical office. The Presman case is being prosecuted by Assistant United States Attorney Patricia E. Notopoulos and Trial Attorney Bryan Fields of the Criminal Division’s Fraud Section. The defendant is scheduled to be arraigned today before United States Magistrate Judge Robert M. Levy at the federal courthouse in Brooklyn, New York.
Lee, et al.
The indictment charges Chang Ho Lee, 66, a medical doctor; Michelle Lee, 58, the manager of several medical clinics; and Francis Choi, 54, a medical biller, with conspiracy to commit health care fraud, conspiracy to pay health care kickbacks, and falsification of records. Chang Ho Lee and Francis Choi are charged with health care fraud. Chang Ho Lee is separately charged with paying health care kickbacks. The charges arise from an approximately $13 million Medicare fraud scheme that took place at three clinics—two in Flushing, New York, and one in Brooklyn, New York—from approximately March 2007 to May 2012, in which patients were offered massages, facials, and other inducements and, in return, the clinic billed those patients’ Medicare numbers for physical therapy, lesion removals, and other procedures that were medically unnecessary and not provided. According to the indictment, when Medicare audited the clinics and asked for patient records in support of claims, the defendants created false patient records to submit to Medicare. The Lee case is being prosecuted by Trial Attorney Bryan Fields and Senior Trial Attorney Nicholas Acker of the Criminal Division’s Fraud Section. The defendant is scheduled to be arraigned today before United States Magistrate Judge Robert M. Levy at the federal courthouse in Brooklyn, New York.
“As alleged, these two prosecutions have exposed corrupt doctors and medical professionals who defrauded the Medicare program out of millions of dollars for their personal gain. With so many patients in desperate need of medical care, it is particularly galling that these defendants allegedly arranged Medicare-funded facials and massages and billed while on vacation,” stated United States Attorney Lynch. “Today’s arrests demonstrate our continuing commitment to vigorously prosecute all who drain taxpayer funds from the Medicare program—funds which would otherwise pay for needed care for elderly and disabled Americans.” Ms. Lynch extended her grateful appreciation to the United States Department of Veterans Affairs, Office of Inspector General; the New York State Office of the Medicaid Inspector General; the New York Attorney General’s Office; the New York State Medicaid Fraud Control Unit; the New York State Department of Financial Services; the New York City Police Department; and New York City Human Resources Administration for their assistance in the investigations in this district.
FBI Assistant Director in Charge Venizelos stated, “The two cases present glaring examples of abuse of the Medicare program. As alleged in the indictment and complaint, the common thread is unscrupulous medical professionals billing this taxpayer-funded program for millions of dollars of services that were either medically unnecessary or not provided at all. Alarmingly, one doctor allegedly billed for home visits when the patients were hospitalized and therefore not home or when he himself was on vacation and not working. Medicare fraud threatens the vitality of the program and unjustly enriches lawbreakers, and it won’t be tolerated.”
“Individuals continue to defraud the Medicare and Medicaid systems at an alarming rate,” said HHS-OIG Special Agent in Charge O’Donnell. We will continue to aggressively investigate all heath care fraud schemes.”
The charges are merely allegations, and the defendants are presumed innocent unless and until proven guilty.
Defendants:
Mikhail Presman, Brooklyn, New York
Francis Choi, Blauvelt, New York
Chang Lee, Palisade Park, New Jersey
Michelle Lee, Palisade Park, New Jersey

Tuesday, May 14, 2013

Employee Arrested at Premier Internal Medicine

MOBILE, AL—Madonna Lynette Reed, 28, of Fairhope, Alabama, was arrested on April 25, 2013, at her place of employment, Premier Internal Medicine, in Fairhope, on a federal criminal complaint charging conspiracy to possess with intent to distribute hydrocodone acetaminophen and possession with intent to distribute hydrocodone acetaminophen. That substance is a Schedule III controlled substance. Reed’s initial appearance was scheduled today for 11:00 a.m. before United States Magistrate Judge William E. Cassady. The judge will determine whether there is probable cause to bind her over for consideration by a grand jury and whether there are conditions that can be set to reasonably assure the safety of the community and her appearance at subsequent court proceedings. The judge will also take up the matter of her legal representation.
The case was investigated by the FBI, assisted by the Baldwin County Sheriff’s Office and supported by the Fairhope Police Department. It is being prosecuted by Gloria Bedwell in the United States Attorney’s Office.
A defendant is presumed innocent unless and until she is convicted as the result of a jury trial or a guilty plea.

Daphne Man Sentenced in Health Care Fraud Billing Case

Kenyen Brown, U.S. Attorney for the Southern District of Alabama, announces that defendant Nehal Bodalia, who pled guilty to health care fraud information in February, was sentenced to four years in prison, followed by three years of supervised release, and ordered to pay a $20,000 fine. From at least January 2010 through January 2013, Bodalia owned and operated the Rehab in Motion physical therapy practice, which had locations in Mobile and Robertsdale, Alabama. While operating his clinic, Bodalia devised and executed a scheme to defraud Blue Cross & Blue Shield (BC/BS) of Alabama by seeking reimbursement for medical procedures that had not been performed.
Bodalia’s scheme operated like this: physical therapists working at Rehab in Motion would input the procedures performed on a particular patient into an office computer program, which would generate billing tickets that were then sent to the patient’s insurance company. Bodalia directed the physical therapists to not close out the billing tickets after they entered the performed procedures. It was explained the reason the billing tickets should not be closed out by the therapists was so that Bill Jones of Affordable Billing in New Jersey, who supposedly handled billing for Rehab in Motion, could make any necessary changes to the tickets. However, Bill Jones does not exist, and Affordable Billing does not have a New Jersey office. Rather, after the therapists had entered the information into the computer system, Bodalia altered the billing tickets to make it appear as if certain medical procedures were performed, when, in fact, they had not been performed. Bodalia knew these fraudulently altered tickets would be submitted to an insurance company for reimbursement.
BC/BS Alabama confronted Bodalia with billing discrepancy, and he quickly paid back the insurance company. However, this was not Bodalia’s first experience with a health care fraud. In 2008, Bodalia was convicted of health care fraud in U.S. District Court for the Northern District of Georgia for a nearly identical billing fraud scheme.
This case was investigated by the Federal Bureau of Investigation in Mobile and Blue Cross & Blue Shield of Alabama in Birmingham. The case was prosecuted by the U.S. Attorney’s Office for the Southern District of Alabama.

Daphne Man Sentenced in Health Care Fraud Billing Case

Kenyen Brown, U.S. Attorney for the Southern District of Alabama, announces that defendant Nehal Bodalia, who pled guilty to health care fraud information in February, was sentenced to four years in prison, followed by three years of supervised release, and ordered to pay a $20,000 fine. From at least January 2010 through January 2013, Bodalia owned and operated the Rehab in Motion physical therapy practice, which had locations in Mobile and Robertsdale, Alabama. While operating his clinic, Bodalia devised and executed a scheme to defraud Blue Cross & Blue Shield (BC/BS) of Alabama by seeking reimbursement for medical procedures that had not been performed.
Bodalia’s scheme operated like this: physical therapists working at Rehab in Motion would input the procedures performed on a particular patient into an office computer program, which would generate billing tickets that were then sent to the patient’s insurance company. Bodalia directed the physical therapists to not close out the billing tickets after they entered the performed procedures. It was explained the reason the billing tickets should not be closed out by the therapists was so that Bill Jones of Affordable Billing in New Jersey, who supposedly handled billing for Rehab in Motion, could make any necessary changes to the tickets. However, Bill Jones does not exist, and Affordable Billing does not have a New Jersey office. Rather, after the therapists had entered the information into the computer system, Bodalia altered the billing tickets to make it appear as if certain medical procedures were performed, when, in fact, they had not been performed. Bodalia knew these fraudulently altered tickets would be submitted to an insurance company for reimbursement.
BC/BS Alabama confronted Bodalia with billing discrepancy, and he quickly paid back the insurance company. However, this was not Bodalia’s first experience with a health care fraud. In 2008, Bodalia was convicted of health care fraud in U.S. District Court for the Northern District of Georgia for a nearly identical billing fraud scheme.
This case was investigated by the Federal Bureau of Investigation in Mobile and Blue Cross & Blue Shield of Alabama in Birmingham. The case was prosecuted by the U.S. Attorney’s Office for the Southern District of Alabama.

Wednesday, May 8, 2013

Former Owner of Wilksboro Clincial Laboratory Pleads Guilty to Criminal Health Care Fraud and Tax Fraud Charges and Agrees to Pay $300,000 to Settle Civil Fraud Allegations

CHARLOTTE, NC—The former owner of Wilkesboro Clinical Laboratory (WCL) pleaded guilty today in U.S. District Court for his involvement in a health care fraud scheme in which he and his company billed Medicare for services which were not rendered, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Louis Francis Curte, 49, also admitted he filed false tax returns from 2007 to 2010.
In a separate civil settlement with the U.S. Attorney’s Office, Curte also agreed to pay $300,000 to resolve civil fraud allegations that he and his company violated the Physician Self-Referral Act or “Stark Law.”
U.S. Attorney Tompkins is joined in making today’s announcement by Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Office of Investigations, Atlanta Region; Jeannine A. Hammett, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation Division (IRS-CI); and John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division.
Curte appeared before U.S. Magistrate Judge David C. Keesler today and pleaded guilty to four counts of health care fraud and one count of filing a false tax return. According to court documents and today’s plea hearing, Curte was the owner and operator of WCL, which was enrolled with the Medicare program and provided microbiology and other laboratory services. Court records show that from at least 2007 to in or about 2009, Curte defrauded Medicare by submitting false and fraudulent claims for microbiology services that were never rendered.
Court documents indicate that Curte and WCL used another company (“Company #1”) for certain types of microbiology testing that could not be performed by WCL in-house. Court records show that WCL generally submitted specimens to Company #1 to test for the presence of infection-causing bacteria. If an infection was present in a specimen, Company #1 then typically performed one or two additional tests to identify the type of pathogen present (“identification test”) and the type of antibiotic to which the pathogen was susceptible (“susceptibility test”). Pursuant to the scheme to defraud, Curte routinely billed Medicare for identification and susceptibility tests, when, in fact, no such tests were performed and even when the initial testing indicated that no pathogen was actually present in the specimen. According to the plea agreement, the intended loss to Medicare by the defendant was between $10,000 and $30,000.
At today’s hearing, Curte also pleaded guilty to filing false tax returns for the years 2007 through 2010. According to filed documents and court proceedings, Curte filed false tax returns which substantially understated his gross income, and therefore, the tax owed to the United States. Court records indicate that Curte maintained false books in an attempt to mask a prohibited business relationship with a physician, identified in court documents as Dr. T.M. According to the plea agreement, the amount of tax loss was more than $30,000 but less than $50,000.
At sentencing, Curte faces a maximum term of 10 years in prison and a $250,000 fine for the health care fraud charges and a maximum term of three years in prison and a $250,000 fine for the tax fraud charge. In his plea agreement, Curte agreed to pay full restitution to Medicare and to IRS for any losses. The final restitution amount will be determined by the court at Curte’s sentencing hearing, which has not been scheduled yet. Curte has been released on bond pending sentencing.
Curte’s prohibited relationship with Dr. T. M. forms the basis for Curte’s civil settlement agreement. According to the civil settlement agreement, from January 1, 2006 through April 30, 2009, Curte and WCL violated the Stark Law by knowingly having a prohibited financial relationship with Dr. T.M.
Dr. T.M. owned and operated a billing company, now defunct, which submitted all of WCL’s reimbursement claims to Medicare. Dr. T.M.’s billing company was paid on a “per claim” basis for the reimbursement claims submitted to Medicare on behalf of WCL. As an owner of the billing company, Dr. T.M. benefitted directly from WCL’s payments to his billing company. Investigators also found that Dr. T.M. referred blood and tissue specimens to WCL for pathology testing.
The Stark Law forbids a medical provider from billing Medicare and Medicaid for certain services referred by physicians who have a financial relationship with the medical provider. A prohibited financial relationship includes an agreement between the medical provider and a physician to compensate the physician based on the volume of the physician’s referrals or the revenue realized through those referrals.
Under the terms of the settlement agreement, Curte is required to reimburse the government for the amount he wrongfully received from Medicare in violation of the Stark Law and to pay penalties back to the program, for a total of $300,000.
The investigation into Curte was handled by HHS-OIG and IRS, with the assistance of the FBI. The criminal prosecution was handled by Assistant U.S. Attorney Kelli Ferry.
Assistant U.S. Attorney Don Caldwell handled the civil settlement.
The investigation and charges are the work of the Western District’s joint Health Care Fraud Task Force. The task force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system and reducing the potential for health care fraud in the future. The task force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing of all whistle blower complaints, and the creation of investigative teams so that individual agencies may focus their unique areas of expertise on investigations. The task force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 (1-800-HHS-TIPS) or e-mail at HHSTips@oig.hhs.gov. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.

Tuesday, May 7, 2013

Harrisburg Ambulance Company Pleads Guilty to Submitting False Statements to Medicare

The United States Attorney’s Office for the Middle District of Pennsylvania announced today that a Harrisburg-based ambulance company has pleaded guilty to multiple false statement charges related to Medicare fraud.
Advantage Medical Transport Inc., headquartered at 733 Fire House Lane, Harrisburg, pleaded guilty before U.S. District Court Judge Christopher C. Conner today to 14 counts of false statements in health care matters, 18 USC 1035. Each count is punishable by up to as much as a $500,000 fine. Serge Sivchuk, age 27, the sole owner of Advantage, appeared in court and entered the guilty pleas on behalf of the corporation. The government estimated the total loss to Medicare as a result of the fraud was approximately $740,000.
According to U.S. Attorney Peter J. Smith, Sivchuk and Advantage were indicted in January 2012 on multiple false statement and Medicare fraud charges. The indictment alleged that between January 2009 and June 2011 Sivchuk, and Advantage perpetrated a scheme to defraud Medicare by submitting hundreds of claims for the nonemergency transport of Medicare beneficiaries to and from dialysis treatment centers. The indictment alleged the claims were fraudulent because the patients were ambulatory and the ambulance transports were not medically necessary.
The indictment focused on an August 2010 audit conducted by Medicare, and a June 2, 2011 search of Advantage’s business premises by federal law enforcement officers. In response to the audit Sivchuk submitted 14 ambulance trip sheets to Medicare that were prepared by emergency medical technicians (EMTs) at the time of each ambulance transport. The trip sheets contained a narrative section that described the patient’s physical condition and ability to ambulate and serve as the primary support document for each Medicare billed, ambulance transport claim. The June 2, 2011 search by the FBI and investigators from the Health and Human Services (HHS) Inspector General’s Office revealed Sivchuk did not submit the original trip sheets to the auditors but instead submitted copies that had been re- written and forged to conceal the fact the beneficiaries were ambulatory and capable of walking and standing.
During a February 22, 2013 court appearance before Judge Connor, Sivchuk pled guilty to one of the 14 false statement counts for which he was indicted, admitting he directed a subordinate to re-write and forge the signatures of two EMTs on a trip sheet pertaining to the ambulance transport of a dialysis treatment beneficiary on August 19, 2010. Sivchuk is currently awaiting sentencing and the completion of a pre-sentence report.
Medicare paid Advantage approximately $166 for each leg of a transport to and from a dialysis treatment center, plus $5.49 per mile. Many dialysis patients underwent three treatments per week. Thus, one week’s transport of just one dialysis patient would yield Advantage more than $1,000.
Under the terms of Advantage’s plea agreement Judge Conner will determine the overall loss to Medicare. During the guilty plea proceeding Assistant U.S. Attorney Kim Douglas Daniel told the court the government intends to show during the loss hearing that the total loss to Medicare was approximately $740,000. Daniel also noted that at the time the investigators executed the June 2, 2011 search warrant, the U.S. Attorney’s Office filed a civil action in federal court that froze more than $936,000 in Advantage and Sivchuk controlled bank accounts.
The case is part of a priority program within the U.S. Department of Justice and the U.S. Attorney’s Office focusing on Health Care Fraud and a joint investigation by the FBI and the HHS-Office of Inspector General. Anyone with information concerning suspected health care fraud should contact the FBI at 717-232-8686.

Friday, May 3, 2013

Montana Hospitals Agree to Pay $3.95 Million to Resolve Alleged False Claims Act and Stark Law Violations

St. Vincent Healthcare, a hospital located in Billings, Montana, and Holy Rosary Healthcare, a hospital located in Miles City, Montana, have agreed to pay $3,950,000 plus interest to resolve allegations that they violated the Stark Law and the False Claims Act by improperly providing incentive pay to physicians that made referrals to the hospitals, the Justice Department announced today. The Stark Law forbids a hospital from billing Medicare for certain services referred by physicians who have a financial relationship with the hospital unless that relationship falls within certain exceptions. A prohibited financial relationship includes a hospital’s agreement to compensate a physician in a manner that takes into account the volume of the physician’s referrals or the revenue realized through those referrals.
The settlement announced today resolves allegations that the hospitals paid several physicians incentive compensation that took into account the value or volume of their referrals by improperly including certain designated health services in the formula for calculating physician incentive compensation. These issues were disclosed by the hospitals to the government.
“The resolution of this matter underscores our commitment to ensure that services reimbursable by federal health care programs are based on the best interests of patients rather than the personal financial interests of referring physicians,” said Stuart F. Delery, Acting Assistant Attorney General for the Department’s Civil Division.
“Combating health care fraud is a top priority of the Department of Justice and the Montana U.S. Attorney’s Office. St. Vincent Healthcare and Holy Rosary Healthcare allegedly put their financial interest ahead of their responsibility to provide cost effective health care. The United States recovered $3,950,000 of taxpayers’ dollars from the hospitals. The U.S. Attorney’s Office is committed to enforcing the Stark Law and False Claims Act, as well as other health care laws and regulations against wrongdoers. This case also demonstrates how the Department of Justice will work with those health care providers who disclose their misconduct,” said Michael W. Cotter, U.S. Attorney for the District of Montana.
“There is an expectation that corporations providing services to Medicare and Medicaid beneficiaries adhere to the provision of the Stark Law. I applaud St. Vincent Healthcare and Holy Rosary Healthcare for recognizing their potential liability in this matter and making a disclosure,” said Gerry Roy, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services region, including Montana. “Working closely with our partners at the Department of Justice, we will vigilantly protect federal health care programs against violations of the Stark Law.”
This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services, in May 2009. The partnership between the two departments has focused on efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover $10.3 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $14.2 billion.
This case was handled by Assistant U.S. Attorney Jessica T. Fehr and Assistant U.S. Attorney Michael Shin with the U.S. Attorney’s Office for the District of Montana, the Department of Justice’s Civil Division, the Office of Inspector General of the U.S. Department of Health and Human Services, and the Federal Bureau of Investigation. The claims settled by this agreement are allegations only, and there has been no determination of liability.

Wednesday, May 1, 2013

Florida Man Sentenced to 55 Months’ Imprisonment for Role in Health Care Fraud and Money Remitting Ring

Wifredo A. Ferrer, United States Attorney of the Southern District of Florida; Addy Villanueva, Special Agent in Charge, Florida Department of Law Enforcement (FDLE); Michael B. Steinbach, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), announced that Oscar Sanchez, 47, of Naples, was sentenced to 55 months’ imprisonment, 20 months’ home confinement, and three years of supervised release for his role in a money laundering conspiracy, in violation of Title 18, United States Code, Section 1956(h). In addition, U.S. District Judge Paul Huck entered a forfeiture order that consisted of a personal money judgment against Sanchez in the amount of $10,000,000. In partial satisfaction of that judgment, Sanchez will be forfeiting to the United States four properties worth about $635,000 and $63,196 in cash. Sanchez also must perform 1,600 hours of community service during his first year after his term of imprisonment.
On August 30, 2012, Sanchez pled guilty to conspiring to launder the proceeds of health care fraud. According to court documents, Sanchez acted as a middleman between individuals engaging in health care fraud and Caribbean Transfers, a company that remitted money from the United States to Cuba. Sanchez admitted to providing approximately $10 million in cash to individuals who defrauded the Medicare program.
Mr. Ferrer commended the investigative efforts of FDLE, FBI, and HHS-OIG in coordination with the Medicare Fraud Strike Force for their work on this case. The case was prosecuted by Assistant U.S. Attorneys H. Ron Davidson and Eloisa Fernandez.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Supervisor of $63 Million Health Care Fraud Scheme Convicted

WASHINGTON—A federal jury today convicted a Miami-area supervisor of a mental health care company, Health Care Solutions Network (HCSN), for helping to orchestrate a fraud scheme that crossed state lines and that resulted in the submission of more than $63 million in fraudulent claims to Medicare and Florida Medicaid.
The announcement was made by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Special Agent in Charge of the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigation’s Miami office.
After a five-day trial, a jury in the Southern District of Florida found Wondera Eason, 51, guilty of conspiracy to commit health care fraud. Sentencing is scheduled for July 8, 2013.
Eason was employed as the director of Medical Records at HCSN’s Partial Hospitalization Program (PHP). A PHP is a form of intensive treatment for severe mental illness. In Florida, HCSN operated community mental health centers at two locations. After stealing millions from Medicare and Medicaid in Florida, HCSN’s owner, Armando Gonzalez, exported the scheme to North Carolina, opening a third HCSN location in Hendersonville.
Evidence at trial showed that at all three locations, Eason, a certified medical records technician, oversaw the alteration, fabrication, and forgery of thousands of documents, which purported to support the fraudulent claims HCSN submitted to Medicare and Florida Medicaid. Many of these medical records were created weeks or months after the patients were admitted to HCSN facilities in Florida for purported PHP treatment and were utilized to support false and fraudulent billing to government sponsored health care benefit programs, including Medicare and Florida Medicaid. Eason directed therapists to fabricate documents, and she also forged the signature of therapists and others on documents that she was in charge of maintaining. Eason interacted with Medicare and Medicaid auditors, providing them with false and fraudulent documents, while certifying the documents were accurate.
The “therapy” at HCSN often consisted of nothing more than patients watching Disney movies, playing bingo, and having barbeques. Eason directed therapists to remove any references to these recreational activities in the medical records.
According to evidence at trial, Eason was aware that HCSN in Florida paid illegal kickbacks to owners and operators of Miami-Dade County Assisted Living Facilities (ALF) in exchange for patient referral information to be used to submit false and fraudulent claims to Medicare and Medicaid. Eason also knew that many of the ALF referral patients were ineligible for PHP services because many patients suffered from mental retardation, dementia, and Alzheimer’s disease.
From 2004 through 2011, HCSN billed Medicare and the Florida Medicaid program approximately $63 million for purported mental health services.
Fifteen defendants have been charged for their alleged roles in the HCSN health care fraud scheme, and 12 defendants have pleaded guilty. On Monday, February 25, 2013, Gonzalez was sentenced to serve 168 months in prison for his role in the scheme. Alleged co-conspirators Alina Feas and Lisset Palmero are scheduled for trial on June 3, 2013. Defendants are presumed innocent until proven guilty at trial.
This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorneys Allan J. Medina and Steven Kim, former Special Trial Attorney William Parente, and Deputy Chief Benjamin D. Singer of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.