1. Brooklyn Neurologist Dr. Leonard Langman Pleads Guilty to Medicare Fraud Scheme
Leonard Langman, MD, a neurologist from Brooklyn, N.Y., pled guilty to participating in a scheme to defraud Medicare and several other federal programs. Dr. Langman submitted claims for services that were not provided, double-billed different benefit programs for the same service to the same beneficiary and billed for services performed while he was purportedly out of the country. The fraudulent activity took place from Jan. 2006-Dec. 2009.
2. Florida Psychiatrist Pleads Guilty to Role in $200M Medicare Fraud Scheme
Alan Gumer, MD, a psychiatrist from Fort Lauderdale, Fla., pled guilty to his role in a $200 million Medicare fraud scheme dating back to 2004. Through his involvement in the scheme with American Therapeutic, Dr. Gumer alone was responsible for $19.3 million in Medicare false claims.
3. Louisiana Businesswoman, Two Employees Accused of Medicare Fraud
Sonya Lewis Williams and two of her employees are accused of defrauding Medicare of at least $349,000. Ms. Williams was allegedly based in Baton Rouge, La., but operated two Alexandria, Va.-based Medicare provider companies — Fusion Services and Grace Social Services. Employees Carla M. Clark and Lillie Lavan are accused of assisting Ms. Williams in allegedly preparing and submitting false bills to Medicare for face-to-face psychotherapy services that were never provided.
4. HealthSouth Subpoenaed Over Allegations of Improper Medicare, Medicaid Reimbursement
HealthSouth, a Birmingham, Ala.-based operator of rehabilitation hospitals, was subpoenaed by the Department of Health & Human Services for possible submission of improper claims to Medicare and Medicaid. According to the news reports, HHS is investigating data related to patient admissions, length of stay and discharge matters at HealthSouth Hospital of Houston.
5. Michigan Physician, Husband Duo Charged With Medicare Fraud
Surya Nallani, MD, a geriatrician, and her husband Srinivas Nallani have been accused of involvement in a $9 million fraud scheme. According to the indictment, which was unsealed in federal court, Dr. Nallani allegedly fraudulently billed Medicare for physician home visits on days she was either out of the country or on days it would have been impossible to travel the distance between homes. Mr. Nallani, who worked as the billing manager for Allied Geriatric Services, was also accused of filing the false claims to Medicare. According to the indictment, the scheme spanned from 2005 to last February.
6. Miami HIV Clinic Physician Found Guilty of Medicare Fraud Sentenced to 20 Years in Prison
Miami-area physician Rene De Los Rios, MD, who was convicted for his role in a $23 million HIV injection and infusion Medicare fraud scheme, has been sentenced to nearly 20 years in prison. Dr. De Los Rios practiced at Metro Med, which operated as an HIV infusion clinic for HIV-positive Medicare beneficiaries. Over the course of more than two years, Metro Med submitted nearly $23 million in claims to the Medicare program for injection and infusion treatments that were not medically necessary or were not provided.
7. Three Employees From New York Wellness Clinic Plead Guilty to Medicare Fraud
Three employees from a Brooklyn-area clinic pled guilty in connection with a $3.4 million Medicare fraud scheme. Dmitry Shteyman, Aleksey Shteyman and Maxsim Shvedkin worked at Solstice Wellness Center, a clinic that purported to specialize in providing physical therapy and various diagnostic tests. According to court documents, the employees were involved in a scheme to pay cash kickbacks to Medicare beneficiaries to induce their visits to Solstice. They admitted they paid kickbacks so Medicare could be billed for services and diagnostic tests that were not medically necessary.
8. Owners of Houston's STK Consultants Plead Guilty to $800K Medicare Fraud Scheme
Two owners of a Houston healthcare company pled guilty for their roles in a scheme to bilk Medicare of more than $800,000 by submitting claims for durable medical equipment. Kemmie Houston and Sharon Beal, owners and operators of STK Consultants, pleaded guilty to defrauding Medicare of $851,212 from Aug. 2005 to Aug. 2010. According to court documents, STK submitted claims to Medicare for DME that was medically unnecessary and/or not provided.
9. Manager of California's RL Medical Supply Sentenced for $1M Medicare Fraud Scheme
The manager of a medical supply firm in Tujunga, Calif., was sentenced in June to 51 months in federal prison for fraudulently charging Medicare more than $1 million for unnecessary durable medical equipment. Petros Odachyan, manager of RL Medical Supply, pleaded guilty in June 2010 to conspiracy to commit healthcare fraud. RL Medical Supply submitted more than $1 million in fraudulent claims for Medicare for DME patients did not need or receive. The claims were also supported by forged prescriptions. Medicare paid out approximately $600,000.
10. Owner of Detroit Medical Clinic Sentenced to 15 Months in Prison for Medicare Fraud
In June, an owner of a Detroit-area medical clinic was sentenced to 15 months in prison for involvement in a $1.12 million Medicare fraud scheme. Maria Haber, an owner of CompleteHealth in Livonia, Mich., was also sentenced to pay approximately $1 million in restitution. She pleaded guilty in Oct. 2010 to one count of conspiracy to commit healthcare fraud. Ms. Haber admitted she and her co-conspirators billed Medicare for medically unnecessary services and obtained patients by paying kickbacks to driver recruiters and directly to Medicare beneficiaries.
Related Articles on Medicare Fraud:
CMS to Adopt Predictive Fraud-Fighting Technology July 1
OIG: Medicaid and Medicare Fraud Investigations May Net $3.4B
Court Uses "One Purpose Test" to Convict Illinois Physician of Medicare Fraud, Kickbacks
Leonard Langman, MD, a neurologist from Brooklyn, N.Y., pled guilty to participating in a scheme to defraud Medicare and several other federal programs. Dr. Langman submitted claims for services that were not provided, double-billed different benefit programs for the same service to the same beneficiary and billed for services performed while he was purportedly out of the country. The fraudulent activity took place from Jan. 2006-Dec. 2009.
2. Florida Psychiatrist Pleads Guilty to Role in $200M Medicare Fraud Scheme
Alan Gumer, MD, a psychiatrist from Fort Lauderdale, Fla., pled guilty to his role in a $200 million Medicare fraud scheme dating back to 2004. Through his involvement in the scheme with American Therapeutic, Dr. Gumer alone was responsible for $19.3 million in Medicare false claims.
3. Louisiana Businesswoman, Two Employees Accused of Medicare Fraud
Sonya Lewis Williams and two of her employees are accused of defrauding Medicare of at least $349,000. Ms. Williams was allegedly based in Baton Rouge, La., but operated two Alexandria, Va.-based Medicare provider companies — Fusion Services and Grace Social Services. Employees Carla M. Clark and Lillie Lavan are accused of assisting Ms. Williams in allegedly preparing and submitting false bills to Medicare for face-to-face psychotherapy services that were never provided.
4. HealthSouth Subpoenaed Over Allegations of Improper Medicare, Medicaid Reimbursement
HealthSouth, a Birmingham, Ala.-based operator of rehabilitation hospitals, was subpoenaed by the Department of Health & Human Services for possible submission of improper claims to Medicare and Medicaid. According to the news reports, HHS is investigating data related to patient admissions, length of stay and discharge matters at HealthSouth Hospital of Houston.
5. Michigan Physician, Husband Duo Charged With Medicare Fraud
Surya Nallani, MD, a geriatrician, and her husband Srinivas Nallani have been accused of involvement in a $9 million fraud scheme. According to the indictment, which was unsealed in federal court, Dr. Nallani allegedly fraudulently billed Medicare for physician home visits on days she was either out of the country or on days it would have been impossible to travel the distance between homes. Mr. Nallani, who worked as the billing manager for Allied Geriatric Services, was also accused of filing the false claims to Medicare. According to the indictment, the scheme spanned from 2005 to last February.
6. Miami HIV Clinic Physician Found Guilty of Medicare Fraud Sentenced to 20 Years in Prison
Miami-area physician Rene De Los Rios, MD, who was convicted for his role in a $23 million HIV injection and infusion Medicare fraud scheme, has been sentenced to nearly 20 years in prison. Dr. De Los Rios practiced at Metro Med, which operated as an HIV infusion clinic for HIV-positive Medicare beneficiaries. Over the course of more than two years, Metro Med submitted nearly $23 million in claims to the Medicare program for injection and infusion treatments that were not medically necessary or were not provided.
7. Three Employees From New York Wellness Clinic Plead Guilty to Medicare Fraud
Three employees from a Brooklyn-area clinic pled guilty in connection with a $3.4 million Medicare fraud scheme. Dmitry Shteyman, Aleksey Shteyman and Maxsim Shvedkin worked at Solstice Wellness Center, a clinic that purported to specialize in providing physical therapy and various diagnostic tests. According to court documents, the employees were involved in a scheme to pay cash kickbacks to Medicare beneficiaries to induce their visits to Solstice. They admitted they paid kickbacks so Medicare could be billed for services and diagnostic tests that were not medically necessary.
8. Owners of Houston's STK Consultants Plead Guilty to $800K Medicare Fraud Scheme
Two owners of a Houston healthcare company pled guilty for their roles in a scheme to bilk Medicare of more than $800,000 by submitting claims for durable medical equipment. Kemmie Houston and Sharon Beal, owners and operators of STK Consultants, pleaded guilty to defrauding Medicare of $851,212 from Aug. 2005 to Aug. 2010. According to court documents, STK submitted claims to Medicare for DME that was medically unnecessary and/or not provided.
9. Manager of California's RL Medical Supply Sentenced for $1M Medicare Fraud Scheme
The manager of a medical supply firm in Tujunga, Calif., was sentenced in June to 51 months in federal prison for fraudulently charging Medicare more than $1 million for unnecessary durable medical equipment. Petros Odachyan, manager of RL Medical Supply, pleaded guilty in June 2010 to conspiracy to commit healthcare fraud. RL Medical Supply submitted more than $1 million in fraudulent claims for Medicare for DME patients did not need or receive. The claims were also supported by forged prescriptions. Medicare paid out approximately $600,000.
10. Owner of Detroit Medical Clinic Sentenced to 15 Months in Prison for Medicare Fraud
In June, an owner of a Detroit-area medical clinic was sentenced to 15 months in prison for involvement in a $1.12 million Medicare fraud scheme. Maria Haber, an owner of CompleteHealth in Livonia, Mich., was also sentenced to pay approximately $1 million in restitution. She pleaded guilty in Oct. 2010 to one count of conspiracy to commit healthcare fraud. Ms. Haber admitted she and her co-conspirators billed Medicare for medically unnecessary services and obtained patients by paying kickbacks to driver recruiters and directly to Medicare beneficiaries.
Related Articles on Medicare Fraud:
CMS to Adopt Predictive Fraud-Fighting Technology July 1
OIG: Medicaid and Medicare Fraud Investigations May Net $3.4B
Court Uses "One Purpose Test" to Convict Illinois Physician of Medicare Fraud, Kickbacks