Two Managers of a Brooklyn Medical Clinic Indicted for Roles in $2.1 Million Fraud Scheme
Two managers of a Brooklyn, New York medical clinic were charged in an indictment unsealed today related to their alleged participation in a $2.1 million fraud scheme involving medically unnecessary occupational therapy services.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, U.S. Attorney Robert L. Capers of the Eastern District of New York, 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, Special Agent in Charge Kathy A. Enstrom of Internal Revenue Service Criminal Investigation’s (IRS-CI) New York Office and New York State Medicaid Inspector General Dennis Rosen of the Office of the Medicaid Inspector General (OMIG) made the announcement.
Iezabel Zeltser, 52, of Brooklyn, was charged in an indictment filed yesterday in the Eastern District of New York with one count of conspiracy to commit health care fraud, one count of conspiracy to commit money laundering and three counts of money laundering. Rafael Gilkarov, 51, of Brooklyn, was charged in the indictment with one count of conspiracy to commit money laundering and three counts of money laundering. The defendants made initial appearances today, Feb. 15, at 2:30 p.m. EST before U.S. Magistrate Judge Cheryl L. Pollack of the Eastern District of New York.
According to allegations in the indictment, Zeltser and Gilkarov operated Evercare Occupational Therapy LLC, a Brooklyn medical clinic purported to provide medically necessary occupational therapy services to Medicare and Medicaid beneficiaries. The defendants allegedly paid patients to submit themselves to medically unnecessary therapy services provided by unlicensed aides. To conceal the scheme, Zeltser and Gilkarov allegedly used a skeleton crew of licensed occupational therapists to create fake medical charts. The defendants in turn laundered a substantial portion of the proceeds through shell companies, using the cash to enrich themselves and to pay kickbacks to the beneficiaries, the indictment alleges.
According to the indictment, Evercare submitted approximately $2.1 million in fraudulent claims to the Medicare and Medicaid programs for services which were not medically necessary or not provided and was paid approximately $1 million on those claims.
The charges and allegations contained in an indictment are merely accusations. The defendants are presumed innocent unless and until proven guilty.
HHS-OIG, IRS-CI and the New York State OMIG investigated the case, which was 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 Trial Attorneys Debra Jaroslawicz and Richard A. Powers of the Criminal Division’s Fraud Section.
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 more than 3,000 defendants who have collectively billed the Medicare program for more than $11 billion. In addition, HHS Centers for Medicare and 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.