Operator of Purported Durable Medical Equipment Providers Pleads Guilty to Health Care Fraud Charges for Role in Durable Medical Equipment Fraud Scheme
An operator of multiple purported durable medical equipment (DME) companies pleaded guilty today to fraud charges for her role in a scheme to defraud Healthfirst, a non-profit, New York-based health maintenance organization that administers Medicare Advantage plans and New York Medicaid Managed Care plans.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Bridget M. Rohde of the Eastern District of New York, Assistant Director in Charge William F. Sweeney Jr. of the FBI’s New York Field Office and Special Agent in Charge Scott Lampert of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Office of Investigations made the announcement.
Suzanna Meliksetyan, 28, of Gaithersburg, Maryland, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Alynne R. Ross of the Eastern District of New York. Sentencing has been scheduled for March 21, 2018 before Judge Ross.
As part of her guilty plea, Meliksetyan admitted that she operated a series of purported DME companies that did not in fact provide equipment to any beneficiaries. She further admitted that she and others called Healthfirst, falsely representing themselves as vendors in Healthfirst’s network. The companies Meliksetyan operated submitted almost $1 million in false claims to Healthfirst, and she admitted to receiving more than $300,000 in connection with those false claims.
This case was investigated by the FBI and HHS-OIG. Trial Attorney Andrew Estes of the Criminal Division’s Fraud Section is prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 3,500 defendants who have collectively billed the Medicare program for more than $12.5 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.