9 Arrested in Brooklyn in Largest Medicare Fraud Bust in U.S. History

9 Arrested in Brooklyn in Largest Medicare Fraud Bust in U.S. History

9 Arrested in Brooklyn in Largest Medicare Fraud Bust in U.S. History

On June 18, 2015, Attorney General Loretta E. Lynch publicly announced the biggest Medicare fraud takedown in the history of the United States.  The sweep tops the scales for both number of defendants charged and dollar value lost, netting 243 suspects for a grand total of $712 million in false billings.  Nine were arrested in Brooklyn, New York amongst eight additional cities.  The Department of Justice has vowed to “continue [its] focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives.”

DOJ: 243 Suspects Charged with $712 Million in Medicare Fraud

The Medicare Fraud Strike Force has led fraud investigations in the past, but nothing comes close to approaching the scale of its most recent sweep.  Nearly 900 law enforcement officers across 17 districts collaborated on the unprecedented bust, bolstered by a recent influx of $350 million in additional funding from the Affordable Care Act.

Among the 243 individuals now facing criminal fraud charges, 46 were described by the DOJ as “doctors, nurses and other licensed medical professionals,” including home health care providers and pharmacy owners.

The alleged methods of committing fraud were as varied as the defendants’ professions.  A DOJ spokesperson stated that some of the defendants – called “patient recruiters” by federal investigators – operated by visiting shelters and soup kitchens, where they allegedly offered money to homeless individuals in exchange for their Medicare patient numbers.

In other instances, defendants were charged for marketing unnecessary medical devices to patients who never requested them – like the four New Orleans residents charged with billing Medicare over $22 million to pay for unsolicited talking glucose monitors.

In other cases still, healthcare facility owners allegedly billed for services which were either minimal or simply never rendered – like the Miami mental health center that billed for nearly $64 million from 2006 to 2012, incentivizing “patient recruiters” with kickbacks along the way.

In yet other instances, physicians allegedly lied about the duration of their doctor-patient sessions in order to over-bill for time – like the Dallas doctors who billed for 90-minute sessions when the sessions actually lasted closer to 15 or 20 minutes.

Medicare Fraud Bust

Brooklyn Criminal Defendants Named in Court Documents

According to the DOJ, the nine defendants apprehended in New York were collectively involved in two different schemes.  Six of the nine Brooklyn defendants were arrested for their suspected involvement in an $8 million occupational and physical therapy scheme, while the remaining three were charged in connection to a separate physical therapy scheme totaling $50 million.

According to unsealed court documents, the three defendants being charged in the $50 million scheme are Olga Proskurovsky, Tatyana Shevchuk, and Yuriy Omelchenko, all of whom are managers at Prime Care on the Bay, LLC and Bensonhurst Mega Medical P.C.  The other Medicare fraud indictment names as defendants Jeffrey Suh, Kang Young Chung, Sophia Lin, Richelle Munoz (a Brooklyn resident), Dorothy Pana, and Emily Shim.  Businesses involved include Plaza Medi Group, Inc., New Plaza Group, Inc., 37th Ave. Medical PC, My Wellness Health Center, and First Health Marketing Center, LLC.

Other cities targeted in the bust included Houston, Los Angeles, Tampa, Detroit, and McAllen, Texas.

Given the diversity of the alleged scams involved, the wide array of criminal charges resulting from the bust comes as little surprise.  From pharmacy fraud to conspiracy to commit health care fraud to money laundering to kickback violations to aggravated identity theft, the charges seem to run the gamut of fraud offenses.  Yet, for their many differences, all of these fraud-related allegations share one trait in common: the potential to lead to incredibly harsh penalties if the defendants are convicted.

While the recent bust sets news records for size and scope, the DOJ hasn’t given any indication of relaxing its efforts in the future.

“Every day,” said Assistant Attorney General Caldwell, “the Criminal Division is more strategic in our approach to prosecuting Medicare Fraud.  We obtain and analyze billing data in real-time.  We target hot spots… and we are speeding up our investigations.  By doing this, we are increasingly able to stop schemes at the developmental stage, and to prevent them from spreading to other parts of the country.”

If you’ve been charged with Medicare fraud in New York, or if one of your loved ones was arrested on fraud charges, the experienced criminal defense lawyers of Sullivan & Galleshaw may be able to help.  Our legal team brings more than 30 years of combined experience to every case we handle, and our attorneys have been featured in FOX News, MSNBC, and ESPN.  We defend clients charged with a wide range of misdemeanor and felony offenses, including white collar crimes, and are proud to offer free initial consultations.

To set up your free legal consultation with our fraud attorneys, call our law offices today at (800) 730-0135.  Your information will be kept confidential.