‘No Show’ Doc From Cropsey Medical Gets Two Years In Prison & Must Pay Back $6 Million

Dr. Okon Umana, 68, the “no show” doctor at a Bensonhurst medical clinic embroiled in a $13 million health care fraud scheme, was sentenced to 24 months in prison in a federal court today. He was also ordered to fork over more than $6 million in restitution, according to the United States Attorney’s Office.

The Connecticut doctor pleaded guilty to health care fraud conspiracy in December, 2014, admitting that many medical services at Cropsey Medical Care (formerly located at 1706 Cropsey Avenue) were provided by a physician’s assistant without a doctor’s supervision, and that Cropsey Medical billed Medicare and Medicaid for the services using Umana’s provider number. Umana, who was the clinic’s medical director, also admitted to falsely certifying that transportation for patients by ambullete was medically necessary, in order for the clinic to claim reimbursements.

“Rather than using his license to practice medicine, Dr. Umana used it to fraudulently bill Medicare and Medicaid for services he did not provide,” said U.S. Attorney Kellie Currie. “Protecting taxpayer funded programs such as Medicaid and Medicare is a priority of this Office and the Department of Justice.”

As part of the sentence, the court directed Umana to pay $6,429,330 in restitution and to forfeit $6,550,036.

Between November 2009 and October 2012, Cropsey Medical submitted more than $13 million in claims to Medicare and Medicaid for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy, and diagnostic tests. Medicare and Medicaid reimbursed Cropsey more than $6 million for the claimed services and procedures.

The scam unraveled in October 2012, when the FBI busted the clinic during a large-scale investigation of $432 million worth of fraudulent Medicaid and Medicare claims nationwide.

Eight others that were charged in connection with the scheme have pleaded guilty.