Doctor And Physical Therapist Found Guilty Of 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 today that medical doctor PAUL J. MATHIEU and physical therapy doctor HATEM BEHIRY were each found guilty of participating in a $30 million scheme to defraud Medicare and the New York State Medicaid Program. The defendants were convicted following a six-week jury trial before U.S. District Judge Lorna G. Schofield.
U.S. Attorney Geoffrey S. Berman said: “These corrupt doctors betrayed their medical training, their professions, and their Medicare and Medicaid billing privileges. They chose not to heal, but to harm, the taxpaying public – the real victims of this scheme.”
According to the evidence presented during the trial and statements made in related court filings and proceedings:
Between 2007 and 2013, MATHIEU fraudulently posed as the owner of three of six medical clinics in Brooklyn (the “Clinics”), which were all in fact owned by co-conspirator Alexksandr Burman. During that time period, the Clinics fraudulently billed Medicare and Medicaid approximately $30 million for medical services and supplies that were medically unnecessary and/or not provided. Throughout this time period, MATHIEU fraudulently posed as the owner of three of those clinics, in order to satisfy a New York State law requirement that medical clinics must be owned and operated by a medical professional.
For the last three-and-a-half years of the scheme, MATHIEU also directly participated in the fraudulent billing practices of the Clinics, by visiting several of the Clinics on a weekly basis, where he would sign stacks of false and fraudulent medical charts, and issue referrals for expensive additional testing, occupational therapy, and physical therapy, including for physical therapy purportedly provided by defendant BEHIRY. During this time period, MATHIEU saw no patients at all, simply falsifying enormous stacks of phony medical records falsely stating that he had seen and treated such patients.
BEHIRY similarly participated in the fraudulent billing practices of the Clinics, by pretending to provide physical therapy to many of those same patients, most of whom were receiving cash kickbacks for coming to the Clinics. In fact, BEHIRY was engaged in an empty charade designed to create the appearance of physical therapy, while almost no therapy was actually being provided to many patients. To further the fraud, BEHIRY also prepared and oversaw the preparation of a huge quantity of phony medical and billing records. Among other things, BEHIRY completed thousands of fabricated reports, in which patients were described almost identically, and with little or no regard for actual medical conditions or needs. As with MATHIEU, many of the charts were for patients whom BEHIRY and his team had not evaluated or provided therapy to at all.
In addition to his role in the Clinics, MATHIEU also wrote unneeded prescriptions for adult diapers and other incontinence products, which were filled at Universal Supply Depot, a medical supply company also owned by Burman’s wife. MATHIEU was so prolific in this regard that, throughout the period of the fraud, he was regularly a top prescriber of adult diapers in the State of New York. MATHIEU continued to write such prescriptions, even after the Clinics were closed down because Medicare stopped paying any of the clinics’ claims.
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PAUL J. MATHIEU, 53, of Morristown, New Jersey, and HATEM BEHIRY, 51, of Brooklyn, New York, were each convicted of one count each of conspiracy to commit health care fraud, mail fraud, and wire fraud; and conspiracy to make false statements relating to a health care program; as well as the substantive offenses of health care fraud, mail fraud, and wire fraud. The conspiracy to commit health care fraud, mail fraud and wire count, and the substantive mail fraud and wire fraud counts each carry a maximum sentence of 20 years in prison. The substantive health care fraud count carries a maximum sentence of 10 years in prison, and the conspiracy to make false statements relating to health care carries a maximum sentence of five years in prison. Each count also carries a maximum fine of $250,000, or twice the gross gain or loss from the offense. The maximum potential sentences in this case are prescribed by Congress and are provided here for informational purposes only, as any sentencings of the defendants would be determined by the Court.
MATHIEU and BEHIRY bring to 15 the number of defendants convicted in this and related cases. The other defendants include: Aleksandr Burman, 57, the leader of the scheme, who was sentenced in a related case on May 8, 2017, to 120 months in prison; Marina Burman, 56, the former wife of Aleksandr Burman and the owner of Universal Supply Depot, was sentenced on May 17, 2018, to 36 months in prison; Mustak Y. Vaid, 45, a physician, was sentenced on August 1, 2018, to 18 months in prison; Ewald J. Antoine, 68, a physician, was sentenced on August 21, 2018, to 18 months in prison; Asher Oleg Kataev, 50, a Burman business partner, was sentenced on May 31, 2018, to 36 months in prison; Alla Tsirlin, 49, a Clinic office manager, was sentenced on June 5, 2018, to a year and a day in prison; and Edward Miselevich, 46, and Ivan Voychak, 39, Burman partners who jointly ran a related ambulette company, were sentenced on June 12, 2018, and July 19, 2018, respectively, to 36 months in prison each. In addition, Lina Zhitnik, 52, and Dina Cabana Rubenstein, 39, occupational therapists, Valery Volsky, 60, a bookkeeper, Olga Kharuk, 47, and Natalya Grabovskaya, 48, office managers, have each also pled guilty for their participation in this scheme and are awaiting sentencing.
Mr. Berman praised the outstanding 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.