The patients received kickbacks for visiting the clinics where they took sleep and stress tests that were administered by unlicensed and unsupervised personnel. (So people who didn’t know what they were doing gave tests that were not needed. That’s a bit scary.)
The two medical clinics turned out to be owned by two non-physicians who paid a real doctor to pretend that he owned the offices. The patients were coached by the defendants to fill out their forms to make it look like they needed the testing. Fraudulent claims were submitted to the two federal health care programs and the money collected from Medicare and Medicaid was then laundered through shell companies owned by the two non-physicians. (The scheme that lasted around nine years, cost the government health care programs $70 million.)
The 54-year-old recruiter pleaded guilty to conspiracy to commit mail fraud, wire fraud and health care fraud. (Here’s where he gets his lucky break.) He was looking at up to 10 years in prison, but because prosecutors recognized him as the smallest offender, they recommended a below-guidelines sentence.
The judge was swayed by a statement from a witness in the Probation Department who cited the recruiter’s tremendous success in a year-and-a-half in-patient drug treatment program. (Apparently, the fraudster overcame his long-time heroin and cocaine addiction while participating in the program.) The judge took that information into consideration and sentenced the man to time served and three years of supervised release. He must also pay $4 million in forfeiture and restitution.
While the judge recognized the man for the tremendous progress he had made since he committed the illegal acts, she also reiterated that he had participated in a massive scheme that victimized vulnerable people. Let’s hope this poster child for rehab success doesn’t blow his second chance at redefining his life.
Today’s “Fraud of the Day” is based on an article entitled, “No Jail For Recruiter In $70M Medicare Fraud,” posted by Law360.com on April 21, 2017.
Source: Law360, New York (April 21, 2017, 7:33 PM EDT) — A New York federal judge on Friday sentenced the “least culpable” participant in a $70 million Medicare and Medicaid fraud scheme to time served, citing his tremendous success in an in-patient drug treatment program.
Jonathan Oliver, 54, pled guilty last year to conspiracy to commit mail fraud, wire fraud and health care fraud for acting as a runner and recruiter in the scheme in which unnecessary medical tests were conducted on homeless and indigent people and billed to Medicare or Medicaid. Oliver was heard on wiretaps saying, “Stress test, stress test, get paid, got your Medicaid, gets paid,” according to the government’s sentencing memo.