Doctor And Occupational Therapist Sentenced To Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced that physician PAUL J. MATHIEU was sentenced yesterday evening by U.S. District Judge Lorna G. Schofield to 48 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program. Between 2007 and 2013, MATHIEU falsely posed as the owner of three medical clinics, which were actually owned a by corrupt businessman, and falsely claimed that he had examined and treated thousands of patients whom he had not in fact seen. In addition, occupational therapist LINA ZHITNIK was sentenced by Judge Schofield on December 3, 2019, to 14 months in prison for her role in the same scheme, which included falsifying medical records in order to claim that she had provided therapy services that she had not in fact provided. MATHIEU was convicted in May 2019, following a six-week trial, on charges of health care fraud, wire fraud, mail fraud, conspiracy to commit those offenses, and conspiracy to make false statements in connection with a federal health care program. ZHITNIK pled guilty to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud in April 2019, during jury selection for trial.
U.S. Attorney Geoffrey S. Berman said: “Corrupt doctors and therapists who defraud Medicare and Medicaid betray their medical training, their professions, their patients, and the taxpayers. These taxpayer-funded programs are designed to provide essential medical services to the elderly and the needy, not to enrich corrupt doctors and other fraudsters. Paul Mathieu’s sentence sends a clear message that those who cheat Medicare and Medicaid will be held accountable.”
According to the evidence presented at trial and other public documents, including Zhitnik’s guilty plea transcript:
Between 2007 and 2013, Aleksandr Burman – who is currently serving a 10-year prison term for his participation in this scheme – owned and operated six medical clinics in Brooklyn (the “Clinics”) that fraudulently billed Medicare and Medicaid approximately $30 million for medical services and supplies that were not provided, were provided without regard to medical necessity, or were otherwise fraudulently billed. Under New York State law, professional medical corporations must be owned by a medical professional. To circumvent this requirement, Burman and MATHIEU agreed to have MATHIEU pose as the true owner of a succession of three different clinics, which Burman owned and operated for more than five years, from 2007 through 2013. Throughout those years, MATHIEU signed a variety of fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that MATHIEU was the sole owner of The Medical Office of Paul J. Mathieu, P.C.; Sunlight Medical, P.C.; and Ocean View Medical of Brooklyn, P.C. Burman also hired two other doctors, Ewald J. Antoine and Mustak Y. Vaid, to pose fraudulently as the owners of three additional, related clinics.
MATHIEU also came weekly to several of the clinics, where he signed stacks of false and fraudulent medical charts, and issued referrals for expensive additional testing, occupational therapy, and physical therapy. For the last 3½ years of the scheme, MATHIEU saw no patients at all, simply falsifying enormous stacks of phony medical records falsely stating that he had seen and treated such patients.
In addition to his role in the clinics, MATHIEU also wrote unneeded prescriptions for adult diapers and other incontinence products, which prescriptions were filled at Universal Supply Depot, a medical supply company also owned by Aleksandr Burman. MATHIEU was so prolific in this regard that, throughout the period of the fraud, he was the No. 1 top prescriber of adult diapers in the State of New York. The only year MATHIEU ranked second, he ranked behind another member of the same criminal scheme. MATHIEU continued to write such prescriptions, even after the medical clinics closed after Medicare stopped paying any of the clinics’ claims.
ZHITNIK participated in the scheme for more than a year, from mid-2011 through mid-2012. ZHITNIK was paid to come to one of the clinics for a portion of each day. While there, ZHITNIK signed large numbers of medical records to be used in fraudulent billing, falsely claiming to have provided occupational therapy services that she did not in fact provide. Indeed, ZHITNIK signed such fraudulent paperwork, backdated, even for weeks when she was on family vacations in New Orleans and Miami, as well as when she was on shorter trips or out of town taking private flying lessons.
MATHIEU is the tenth defendant, and the third physician, who has been sentenced in this case and a related case. The other defendants, each of whom pled guilty, include: Aleksandr Burman, who was sentenced in a related case on May 8, 2017, to 10 years in prison; Marina Burman, the former wife of Aleksandr Burman and the owner of a related medical supply company, sentenced on May 17, 2018, to three years in prison; Mustak Y. Vaid, a physician sentenced on August 1, 2018, to 18 months in prison; Ewald J. Antoine, a physician sentenced on August 21, 2018, to a year and a day in prison; Asher Oleg Kataev, a Burman business partner, sentenced on May 31, 2018, to three years in prison; Alla Tsirlin, a Clinic office manager, sentenced on June 5, 2018, to a year and a day in prison; and Edward Miselevich and Ivan Voychak, Burman partners who jointly ran a related ambulette company, sentenced on June 12 and July 19, 2018, to three years in prison each.
One additional defendant awaits sentencing, physical therapist Hatem Behiry, who was convicted at trial with MATHIEU.
In addition to the prison term, MATHIEU, 54, of Morristown, New Jersey, was sentenced to three years of supervised release. Judge Schofield also ordered MATHIEU to pay restitution and forfeiture. ZHITNIK, 52, of Brooklyn, New York, was also sentenced to three years of supervised release, ordered to pay restitution of $1,369,554, and to forfeit $89,682.
Mr. Berman praised the outstanding investigative work of the Federal Bureau of Investigation, the Office of the Inspector General of the U.S. Department of Health and Human Services, and the New York State Office of the Medicaid Inspector General (“OMIG”).