False Advertising

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13463126 - pensioner read countless papers and is very focused

False advertising is an unethical sales tactic used to encourage consumers to engage in a transaction they might otherwise pass up. As reported in the Times Ledger, today’s ”Fraud of the Day” describes how a doctor in New York used false advertising to lure senior citizens into two of his clinics and then used their Medicare numbers to fraudulently bill the program for more than $15 million.

The article states the 59-year-old doctor offered free non-medical services to seniors so they could use unsuspecting victims’ Medicare numbers to bill for services that were not medically necessary or provided. (Beware of that magic word, ” free.”) Some of the ”free” services offered were recreational massages, facials, meals, prizes and social events. (It sounds more like a senior citizens’ center to me.)

In order to receive these ”free” services, the seniors had to see a doctor first. After examining a patient, one of the doctors at the clinic would then prescribe unnecessary physical therapy and bill Medicare for services that were never provided. Over a period of four-and-a-half years, the doctor and his five co-conspirators submitted approximately $16.6 million in bogus claims to Medicare. The doctor, who was licensed in three states, received about $4.5 million.

The fraudster pleaded guilty to conspiracy to commit health care fraud and was sentenced to one year and a day in prison. He was also ordered to pay $2.2 million in restitution. (What about the other $2.3 million?)

The doctor’s fraudulent scheme was described by the prosecuting attorney as operating ”…with the relentless efficiency of an assembly line.” It looks like the doctor will be spending the next year waiting in a few lines as well, but I doubt that he will be getting any free massages or prizes for his patience.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Flushing Doc Gets Year in Fraud Case,” written by Alex Robinson and published by the Times Ledger on February 7, 2014.

A Flushing doctor was sentenced to a year in prison last week after he pleaded guilty to participating in a scheme that prosecutors said fraudulently billed Medicare for more than $15 million, the U.S. attorney in Brooklyn said.

Hoi Yat Kam, 59, was charged, along with five others, of bilking Medicare for services they were not providing and were not medically necessary, according to the indictment, filed by the office of Loretta Lynch, the U.S. attorney for the Eastern District.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.