False Claims Counsel

So far, April has been the cruelest month for Detroit-area Medicare fraud perpetrators. The Department of Justice has announced this month several accomplishments by its Healthcare Fraud Enforcement Team (HEAT) in Detroit:

• Detroit clinic manager and patient recruiter plead guilty
  According to the guilty pleas (to a single count of conspiracy to commit healthcare fraud), the clinic manager paid patient recruiters $100 to $150 for each Medicare beneficiary to come to the clinic, and that the beneficiaries were paid $50. The patients were told to feign symptoms at the clinic, thereby receiving medically unnecessary tests. The clinic submitted a total of $2.2 million in claims for the unnecessary services.
• Detroit clinic owner sentenced to 81 months
  In addition to the sentence, the clinic owner was ordered to pay approximately $9.8 million in restitution. He had pleaded guilty in September, 2009, to billing Medicare for fictitious physical and occupational therapy services.
• Medical assistant pleads guilty in infusion and injection therapy Medicare Mill scheme
  According to the guilty plea, the medical assistant participated in a Medicare Mill scheme in which beneficiaries were recruited and paid to sign documents supporting claims for injection and infusion therapy services that were never performed.
• Detroit jury convicts doctor and patient recruiter of Medicare fraud
  On Friday, April 2, a federal jury in Detroit convicted a West Bloomfield, Michigan, physician and a patient recruiter for their roles in a Medicare Mill scheme which resulted in claims to the program of nearly $1 million. The government claimed that the clinics’ owners, who previously pleaded guilty, had moved to Detroit from Miami, due to the increased law enforcement pressure there:

  Evidence at trial established that the owners of RDM Center, Miami residents Denisse and Jose Martinez, came to Detroit to start the clinic because of heavy law enforcement scrutiny in Florida of fraudulent infusion clinics. Evidence presented at trial showed that Silber was hired to be the physician at the clinic while Reeves was hired to recruit and pay kickbacks to Medicare beneficiaries to come to the clinic. Denisse and Jose Martinez have previously pleaded guilty for their roles in the scheme.