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BROOKLYN, N.Y. – The owner of two medical clinics in Brooklyn, New York, was sentenced today to seven years in prison for her role in a $55 million health care fraud scheme.
Acting U.S. Attorney Bridget M. Rohde of the Eastern District of New York, Acting Assistant Attorney General Kenneth A. Blanco of the Department of Justice Criminal Division, Special Agent-in-Charge Scott Lampert of the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) Office of Investigations New York Region, Special Agent-in-Charge James D. Robnett of the IRS Criminal Investigation (IRS-CI) New York Field Office, and Inspector General Dennis Rosen of the New York State Office of the Medicaid Inspector General (OMIG) made the announcement.
Valentina Kovalienko, 47, the owner of Prime Care on the Bay LLC and Bensonhurst Mega Medical Care P.C., was sentenced by U.S. District Judge Roslynn R. Mauskopf of the Eastern District of New York, who also ordered Kovalienko to pay $29,336,497.27 in restitution and to forfeit $29,336,497.27. Kovalienko pleaded guilty in October 2015 to one count of conspiracy to commit health care fraud and one count of conspiracy to commit money laundering.
As part of her guilty plea, Kovalienko acknowledged that her co-conspirators paid cash kickbacks to patients to induce them to attend her two clinics. Kovalienko also admitted that she submitted false and fraudulent claims to Medicare and Medicaid for services that were induced by prohibited kickback payments to patients or that were unlawfully rendered by unlicensed staff. Kovalienko also wrote checks from the clinics’ bank accounts to third-party companies, which purported to provide services to the clinics, but which in fact were not providing services, and the payments were instead used to generate the cash needed to pay the illegal kickbacks to patients, she admitted.
“The defendant made stealing from Medicare and Medicaid her full time business by agreeing with others to pay cash kickbacks to patients, submit fraudulent claims to Medicare and Medicaid, and write checks to sham companies to disburse the proceeds of the illegal scheme,” stated Acting United States Attorney Rohde. “This Office and our law enforcement partners are committed to protecting precious taxpayer dollars from unscrupulous providers seeking to defraud federal health care programs.”
“The fraud scheme that Ms. Kovalienko and others engaged in was motivated by nothing more than personal greed,” said HHS OIG Special Agent-in-Charge Lampert. “This sentencing should serve as a warning to any health care provider that dares to put personal profit ahead of proper patient care. HHS OIG, along with our law enforcement partners, will continue to aggressively pursue those who seek to undermine the federally funded health care programs intended for our most vulnerable Americans.”
“Affordable Healthcare is a phrase the American people have heard over and over for the past decade,” said IRS-CI Special Agent-in-Charge Robnett. “It is schemes such as this that keep costs high for all American citizens. As Criminal Investigators for the IRS, we are happy to lend our financial expertise in uncovering fraud that hurts all of us.”
“Individuals who commit Medicaid fraud prey on the most vulnerable New Yorkers, and the impacts - fewer health care resources and waste of taxpayer dollars - affect all of us,” stated OMIG Inspector General Rosen. “My office will continue to work closely with our state and federal partners to hold wrongdoers fully accountable.”
Twenty other individuals have pleaded guilty in connection with this case, including the former medical directors of Prime Care on the Bay LLC and Bensonhurst Mega Medical Care P.C., six physical and occupational therapists, three ambulette drivers, the owner of several of the sham companies used to launder the money and a former patient who received illegal kickbacks.
HHS OIG, IRS-CI and OMIG investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. Assistant Chief A. Brendan Stewart of the Fraud Section and Assistant U.S. Attorney F. Turner Buford of the Eastern District of New York, formerly a Fraud Section trial attorney, are prosecuting the case.
The Criminal Division’s 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 the HHS-OIG, are 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.
Residence: Brooklyn, New York
E.D.N.Y. Docket No. 11-CR-106 (RRM)
United States Attorney’s Office