“No Show” Doctor From Cropsey Medical Care Pleads Guilty In Medicaid Fraud Scheme

A Connecticut doctor pleaded guilty Monday for his role in a massive $13 million Medicaid and Medicare fraud scheme at Cropsey Medical Care Clinic (1706 Cropsey Avenue) in Bensonhurst.

Dr. Okon Umana, 67, the last of nine defendants to be convicted in the case, pleaded guilty in a federal court on December 1 to conspiring to defraud the United States by acting as a “no show” doctor in the scheme, which provided Medicaid and Medicare patients with medically unnecessary services and testing.

From the Department of Justice (DOJ) press release:

Umana was the medical director of the Cropsey Medical Care clinic. Patients at Cropsey Medical received medically unnecessary physical therapy, diagnostic testing and other services, which were provided by a physician assistant who was acting without supervision. Such purported medical services were then fraudulently billed by Cropsey Medical to Medicare and Medicaid under Dr. Umana’s provider number. From approximately November 2009 to October 2012, Cropsey Medical submitted more than $13 million in claims to Medicare and Medicaid, seeking reimbursement for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests that were not medically necessary and often did not even occur.

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.

In 2013, we reported that Leonid Zalkind, the Philadelphia-based operator of Cropsey Health Care, pleaded guilty to laundering the funds illegally obtained from the operation. A few months later, defendant Gregory Konoplya admitted to receiving kickbacks for operating an ambulette service that recruited patients to the health clinic for bogus “treatments,” and was slapped with conspiracy charges.

Umana faces a maximum penalty of five years in prison, a fine of over $250,000, restitution of up to $6,429,330 and forfeiture of $6,550,036. He will be sentenced on April 15, 2015.

Correction (December 4, 2014): In a previous version of this article, the photo we used mistakenly identified a chiropractor’s office on Bay 16th Street as the location of Cropsey Medical Care on 1706 Cropsey Avenue. We sincerely regret the mistake and have amended to the photo to reflect this correction.