A Brooklyn, N.Y., resident pleaded guilty today for his role as a patient recruiter in a $13 million kickback and health care fraud scheme, the fourth defendant to plead guilty in the scheme based at the Cropsey Medical Care PLLC clinic in Brooklyn.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Loretta E. Lynch of the Eastern District of New York; Assistant Director in Charge George Venizelos of the FBI’s New York Field Office; and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG) made the announcement.
Gregory Konoplya, 57, pleaded guilty before U.S. Magistrate Judge Roanne Mann of the Eastern District of New York to one count of conspiracy to pay and receive illegal health care kickbacks. At sentencing before U.S. District Judge Nina Gershon, scheduled for Dec. 4, 2013, Konoplya faces a maximum penalty of five years in prison.
Court documents state that Konoplya, working through an ambulette company in Brooklyn, recruited patients to attend Cropsey Medical. An ambulette is a vehicle that is licensed by New York State’s Medicaid program to transport beneficiaries to and from medical facilities when such transportation is medically necessary. From 2009 to 2012, Konoplya paid employees of Cropsey Medical a per beneficiary cash kickback so that Cropsey Medical would accept Konoplya’s beneficiaries as patients and so that Konoplya’s ambulette company could bill Medicaid for the transportation of beneficiaries to and from Cropsey Medical. Once Konoplya’s beneficiaries were transported to Cropsey Medical, they were paid cash kickbacks to induce them to continue to attend the clinic and to receive medically unnecessary physical therapy, diagnostic testing and other services. Such purported medical services were then billed by Cropsey Medical to Medicare and Medicaid.
According to court documents, 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.
The case was investigated by the FBI and HHS-OIG and brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case is being prosecuted by Fraud Section Trial Attorney Sarah M. Hall and Assistant U.S. Attorneys Shannon Jones and Ilene Jaroslaw of the Eastern District of New York.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.