Physical Therapist Sentenced To 2 Years In Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid
Audrey Strauss, the Acting United States Attorney for the Southern District of New York, announced that physical therapist HATEM BEHIRY was sentenced today by U.S. District Judge Lorna G. Schofield to 24 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program (“Medicaid”). Between 2007 and late 2012, on a regular basis, BEHIRY falsely pretended to provide physical therapy services to patients, and falsified medical records in a fraudulent scheme to bill Medicare and Medicaid for non-existent services. BEHIRY and a co-defendant physician, Paul J. Mathieu, were 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.
Acting U.S. Attorney Audrey Strauss said: “At a time when our medical system may be more important than ever, today’s sentence sends an unambiguous message that those who cheat Medicare and Medicaid will be held accountable. Corrupt health care professionals 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 therapists and other fraudsters.”
According to the evidence presented at trial and other public documents:
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. As part of this scheme, three medical doctors – Mathieu, Mustak Y. Vaid, and Ewald J. Antone, all of whom have been convicted and sentenced in this case – falsely posed as the owners of the Clinics. The doctors did so by, among other things, signing various fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that they were the owners of the clinics.
Mathieu, Vaid, and Antoine also came weekly to the clinics, where they signed stacks of false and fraudulent medical charts and billing documents for patients that they had not seen, and issued referrals for unnecessary testing, occupational therapy, and physical therapy.
BEHIRY participated in the scheme almost from its inception, in 2007, until late 2012. BEHIRY regularly signed medical records to be used in fraudulent billing, in which he falsely claimed to have provided physical therapy services that he did not in fact provide. Generally, BEHIRY provided no physical therapy services at all to patients, engaging instead in brief pro forma conversations with the patients, and then completing paperwork that was used to bill Medicare and Medicaid for roughly an hour of physical therapy services. Typically, patients were told that they had to remain in the clinic for nearly an hour – which they often did by simply watching television in a waiting room for much of that time, and sometimes receiving massages or making unsupervised use of exercise machines (activities that are not billable to Medicare or Medicaid as physical therapy).
In addition, BEHIRY oversaw a group of other physical therapists, whom he arranged to bring to the Clinics to bill fraudulently for physical therapy services that were not in fact provided.
All told, Medicare and Medicaid paid more than $5 million for purported physical therapy services billed under BEHIRY’s name. As part of the scheme, more than $800,000 was transferred from the Clinics to BEHIRY’s own company.
BEHIRY is the eleventh defendant to be sentenced in this and Burman’s related case. Mathieu, who was convicted at trial with BEHIRY, was sentenced on December 11, 2019, to four years in prison. 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.
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In addition to the prison term, BEHIRY, 52, of Brooklyn, New York, was sentenced to three years of supervised release. Judge Schofield also ordered BEHIRY to pay restitution of $5,757,661 and forfeiture of $808.975.
Ms. Strauss 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”).