The feds unveiled charges against 243 people in 17 cities across the nation as part of the largest nationwide medical fraud bust in American history, and the alleged perps include three managers of two local medical clinics that are accused of bilking Medicare out of more than $61 million.
The charges were announced Thursday by United States Attorney General Loretta Lynch, who said the numerous schemes robbed the program of $712 million in total.
Locally, Olga Proskurovsky, Tatyana Shevchuk and Yuriy Omelchenko – all managers of both Prime Care on the Bay at 1711 Sheepshead Bay Road and Bensonhurst Best Care at 2761 Bath Avenue – are accused of conspiring with ambulette drivers to recruit patients to agree to unnecessary medical tests, with kickbacks going to both the patients and ambulette drivers.
“This action represents the largest criminal health care fraud takedown in the history of the Department of Justice and it adds to an already remarkable record of enforcement,” said Lynch in a press release. “The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners and others. They billed for equipment that wasn’t provided, for care that wasn’t needed and for services that weren’t rendered. In the days ahead, the Department of Justice will continue our 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.”
According to prosecutors, Prime Care submitted approximately $37.5 million in phony claims and Bensonhurst Best Care submitted approximately $23.6 million – all in a three year period between February 2008 and February 2011.
The two clinics were in the names of straw owners, or licensed medical practitioners whose names went on the paperwork as required by law, according to court documents. In actuality, though, they were run by the three individuals charged.
Proskurovsky, Shevchuk and Omelchenko allegedly delivered envelopes stuffed with cash to ambulette drivers and “patient recruiters” as bribes to bring them new clients. The clients themselves were coached and paid to request and submit to unnecessary medical procedures, for which the clinics billed Medicaid and Medicare.
To maximize payment while avoiding scrutiny, the accused scammers cycled through different parts of the body on the same patient, finishing a round of treatment on one body part before beginning again with a new diagnosis on another body part, say prosecutors. This way, they were able to provide the same unnecessary medical treatments and physical and occupational therapy multiple times.
In many cases, a single patient cycled through over several months, according to court documents. In one case, a patient was treated continuously between May 2008 and November 2010, all for claims of general pain in alternating parts of his body.
The clinics also allegedly billed for physical and occupational therapy sessions that were not performed by a licensed therapist, as required under program guidelines.
Prosecutors say that the clinics also billed for procedures done by physicians on dates when the physicians were out of the country.
The clinics’ straw owners were also in on the scheme, according to authorities. They were paid to sign patient charts and billing documents.
To hide the spending, Proskurovsky, Shevchuk and Omelchenko masked their outsized bonuses and salaries by drawing up phony invoices and business agreements, according to court documents.
In addition to the charges, the government is also moving to seize the accused’s properties.
The investigation into the two clinics spans back to at least February 2011, when Prime Care on the Bay was raided by authorities for allegedly colluding with Majestic Transportation to wrack up phony transportation fees. Ambulette drivers are bill for and are paid separately from the doctors through Medicaid.
That alleged racket was dismantled in the previous record-making bust, which netted 114 arrests across the nation, including 10 in Brooklyn. Last week’s busts dwarfed the prior record-hold by more than doubling the number of those arrested and, at $712 million, nearly tripling the value of the alleged fraud.