Two Doctors, Including a Psychiatrist for the U.S. Department of Veterans Affairs, and Two Others Charged in Brooklyn as Part of Nationwide Medicare Strike Force Initiative
Alleged Fraudulent Billings Exceed $17 Million; Medicare Billed For Facials and Massages
Four individuals, including two doctors, have been charged for their alleged participation in two separate schemes that falsely billed the Medicare and Medicaid programs for more than $17 million.1 The charges filed in Brooklyn, New York, are part of a nationwide takedown by the Medicare Fraud Strike Force operations that led to charges against 89 individuals for their alleged participation in schemes to collectively submit approximately $223 million in fraudulent claims.
The Brooklyn cases were announced by United States Attorney Loretta E. Lynch of the Eastern District of New York, George Venizelos, Assistant Director-in-Charge, Federal Bureau of Investigation (FBI), New York Field Office, and Thomas O’Donnell, Special Agent-in-Charge, Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations, New York. The results of the nationwide takedown were announced today by Attorney General Eric H. Holder, Health and Human Services Secretary Kathleen Sebelius, Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, FBI Assistant Director Ron Hosko, Inspector General Daniel R. Levinson of HHS-OIG, and Centers for Medicare and Medicaid Services Deputy Administrator for Program Integrity Dr. Peter Budetti.
The two schemes charged in the Eastern District of New York, detailed in an indictment and a criminal complaint, and other documents filed by the government, are as follows:
Presman. Mikhail L. Presman, 55, a psychiatrist employed by the U.S. Department of Veterans Affairs (VA), was charged in a complaint with engaging in a scheme to submit false and fraudulent medicare claims while operating a private practice when not on duty at the VA. The complaint alleges that Presman submitted fraudulent claims to the Medicare program in excess of $4,000,000 for home medical visits for patients who were never seen by Presman, for patients whom Presman claimed to have treated when he was in fact away on vacation, and for patients who were confined in a hospital at the time that Presman claimed to have treated them. Presman received over $2,800,000 in Medicare payments as a result of this scheme. A search warrant was executed at Presman’s personal residence which purported to be his medical office. The Presman case is being prosecuted by Assistant United States Attorney Patricia E. Notopoulos and Trial Attorney Bryan Fields of the Criminal Division’s Fraud Section. The defendant is scheduled to be arraigned today before United States Magistrate Judge Robert M. Levy at the federal courthouse in Brooklyn, New York.
Lee, et al. The indictment charges Chang Ho Lee, 66, a medical doctor, Michelle Lee, 58, the manager of several medical clinics, and Francis Choi, 54, a medical biller, with conspiracy to commit health care fraud, conspiracy to pay health care kickbacks, and falsification of records. Chang Ho Lee and Francis Choi are charged with health care fraud. Chang Ho Lee is separately charged with paying health care kickbacks. The charges arise from an approximately $13 million Medicare fraud scheme that took place at three clinics – two in Flushing, New York, and one in Brooklyn, New York – from approximately March 2007 to May 2012, in which patients were offered massages, facials, and other inducements and, in return, the clinic billed those patients’ Medicare numbers for physical therapy, lesion removals, and other procedures that were medically unnecessary and not provided. According to the indictment, when Medicare audited the clinics and asked for patient records in support of claims, the defendants created false patient records to submit to Medicare. The Lee case is being prosecuted by Trial Attorney Bryan Fields and Senior Trial Attorney Nicholas Acker of the Criminal Division’s Fraud Section. The defendant is scheduled to be arraigned today before United States Magistrate Judge Robert M. Levy at the federal courthouse in Brooklyn, New York.
“As alleged, these two prosecutions have exposed corrupt doctors and medical professionals who defrauded the Medicare program out of millions of dollars for their personal gain. With so many patients in desperate need of medical care, it is particularly galling that these defendants allegedly arranged Medicare-funded facials and massages and billed while on vacation,” stated United States Attorney Lynch. “Today’s arrests demonstrate our continuing commitment to vigorously prosecute all who drain taxpayer funds from the Medicare program – funds which would otherwise pay for needed care for elderly and disabled Americans.” Ms. Lynch extended her grateful appreciation to the United States Department of Veterans Affairs, Office of Inspector General, the New York State Office of the Medicaid Inspector General, the New York Attorney General’s Office, the New York State Medicaid Fraud Control Unit, the New York State Department of Financial Services, the New York City Police Department, and New York City Human Resources Administration for their assistance in the investigations in this district.
FBI Assistant Director-in-Charge Venizelos stated, “The two cases present glaring
examples of abuse of the Medicare program. As alleged in the indictment and complaint, the common thread is unscrupulous medical professionals billing this taxpayer-funded program for millions of dollars of services that were either medically unnecessary or not provided at all. Alarmingly, one doctor allegedly billed for home visits when the patients were hospitalized and therefore not home, or when he himself was on vacation and not working. Medicare fraud threatens the vitality of the program and unjustly enriches lawbreakers, and it won’t be tolerated.”
“Individuals continue to defraud the Medicare and Medicaid systems at an alarming rate, said HHS-OIG Special Agent-in-Charge O’Donnell. We will continue to aggressively investigate all heath care fraud schemes.”
Palisade Park, NJ
Palisade Park, NJ
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