Doctor Sentenced 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 EWALD J. ANTOINE was sentenced today by U.S. District Judge Lorna G. Schofield to one year and one day in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program. ANTOINE falsely posed as the owner of two medical clinics, which were actually owned by a corrupt businessman, and falsely claimed that he had examined and treated hundreds of patients whom he had not in fact seen. ANTOINE pled guilty on January 11, 2018, to health care fraud and conspiracy to commit health care fraud, mail fraud, and wire fraud.
U.S. Attorney Geoffrey S. Berman said: “The Medicare and Medicaid programs are intended to provide essential medical services to the elderly and the needy, not to enrich corrupt doctors and other fraudsters. The real victims in this case are U.S. taxpayers and needy patients with legitimate medical needs. Today’s sentence sends a strong message that those who cheat Medicare and Medicaid, including physicians who abuse their licenses and professional oaths, will be held accountable.”
According to the Indictment and other documents filed in federal court, as well as statements made during ANTOINE’s plea proceeding and sentencing:
Between 2007 and 2013, Aleksandr Burman 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, medical clinics must be owned and operated by a medical professional. To circumvent this requirement, Burman, who was not a medical professional, hired doctors to pose as the nominal owners of each of the Clinics. ANTOINE was one of those doctors, agreeing to sign a variety of fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that ANTOINE was the sole owner of Sunlight Medical and Psychiatric Services, P.C., and Coney Island Medical Services, P.C., two of the six Clinics. ANTOINE and his co-conspirators also helped prepare false medical records to support fraudulent reimbursement claims submitted to Medicare and Medicaid. ANTOINE signed medical charts falsely stating that he had examined patients, and wrote prescriptions and referrals for medically unnecessary and/or non-existent tests and supplies.
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In addition to the prison term, ANTOINE, 67, of Valley Stream, New York, was sentenced to three years of supervised release. Judge Schofield also ordered ANTOINE to pay restitution of $1,825,544 and to forfeit $269,412 in ill-gotten gains.
ANTOINE is the eighth defendant, and the second physician, who has been sentenced after pleading guilty in this case and a related case. The other defendants include: Aleksandr Burman, the leader of the scheme, 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; 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 one year and one day in prison; and Edward Miselevich and Ivan Voychak, Burman’s partners who jointly ran a related ambulette company, sentenced on June 12 and July 19, 2018, respectively, to three years in prison each.
Three additional defendants – a doctor (Paul J. Mathieu), a physical therapist (Hatem Behiry), and an occupational therapist (Lina Zhitnik) – are scheduled to go to trial before Judge Schofield on November 26, 2018. These three remaining defendants are presumed innocent unless and until proven guilty.
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”).
The prosecution of this case is being handled by the Office’s Complex Frauds and Cybercrime Unit. Assistant U.S. Attorney David Raymond Lewis is in charge of the prosecution.