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Imagine this scenario. Doctors, “cappers” and board-and-care administrators cooperate to make elderly, infirm and mentally ill patients available to get unnecessary respiratory therapy treatments. Why? Because such behavior, no matter how egregious, resulted in $12 million in Medicare monies. Eighteen defendants, half of them medical doctors, were indicted by a Santa Ana federal grand jury for doing exactly that. Six of the doctors and three marketers are also charged with money laundering. The defendants are Dr. Paul Arnold Lessler (Corona Del Mar), Dr. Alexander Zinovy Rivkin (Los Angeles), Dr. Gershon Walter Hepner (Los Angeles), Dr. Xinming Fu (Irvine), Dr. Ramin Sarshad (Los Angeles), Dr. Aginah M. DeBerry (Colorado Springs), Dr. Michael Wayne Chapman (Cypress), Dr. Truc Huy Dao (Rowland Heights.):
According to a Federal Bureau of Investigation Press Release: “The indictments allege that the scheme targeted elderly, infirm and mentally ill residents of board-and-care facilities throughout Southern California. The doctors paid kickbacks to gain access to residents of board-and-care facilities. The doctors would order respiratory treatment for the residents regardless of whether the residents had respiratory conditions. Respiratory therapists were paid to go out to the board-and-care facilities to perform daily or almost-daily respiratory treatments on the residents. The therapists were ordered to entice the residents to undergo the treatments with gifts, such as sodas, candy and donuts. These respiratory treatments would take place without any doctor present, although Medicare requires that a doctor be present because of the potential danger of a reaction to the treatment. Further, the respiratory treatments were falsely billed as being performed at the doctors’ offices or in a mobile medical van because Medicare prohibited the treatments being performed at board-and-care facilities.”
An indictment is simply al allegation that a defendant has committed a crime (to which s/he is presumed innocent until and unless proven guilty in court), but if any of these defendants are proven guilty of the accusations against them, they face a statutory maximum sentence of 10 years in federal prison for each health care fraud count, 20 years in federal prison for each money laundering count, and five years in prison for each conspiracy count. That’s a whole lot of time behind bars.
The Federal Bureau of Investigation, the United States Postal Inspection Service and IRS-Criminal Investigation Division participated in this investigation.
© Copyright 2007 The John Cooke Fraud Report