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Thursday, 1 August 2013

Brooklyn Clinic Employee Sentenced to Eight Years in Prison in Connection with $77 Million Medicare Fraud Scheme

Posted on 08:42 by Unknown

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FBI New York Field Office Press Release:

Brooklyn Clinic Employee Sentenced to Eight Years in Prison in Connection with $77 Million Medicare Fraud Scheme

U.S. Department of Justice July 30, 2013
  • Office of Public Affairs (202) 514-2007/TDD (202)514-1888
BROOKLYN, NY—Yuri Khandrius, 50, of Brooklyn, New York, was sentenced today to eight years in prison for his role in a $77 million Medicare fraud scheme.
In addition to the prison term, U.S. District Judge Nina Gershon of the Eastern District of New York sentenced Khandrius to three years of supervised release with a concurrent exclusion from Medicare, Medicaid, and all federal and state health programs and an exclusion from any employment that involves handling of any federal or state funds; ordered him to forfeit $446,655; and ordered him to pay restitution in the amount of $10 million.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Loretta E. Lynch of the Eastern District of New York; Assistant Director in Charge George Venizelos of the FBI’s New York Field Office; and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services’s Office of Inspector General (HHS-OIG) made the announcement.
Khandrius pleaded guilty on December 3, 2012, to one count of conspiracy to commit health care fraud, one count of health care fraud, and one count of conspiracy to pay kickbacks.
Including Khandrius, 13 individuals have been convicted in this case.
According to court documents, from 2005 to 2010, Khandrius was an employee of a clinic in Brooklyn that operated under three corporate names: Bay Medical Care PC, SVS Wellcare Medical PLLC, and SZS Medical Care PLLC. According to court documents, the owners, operators, and employees of the Bay Medical clinic paid cash kickbacks to Medicare beneficiaries and used the beneficiaries’ names to bill Medicare for more than $77 million in services that were medically unnecessary or never provided. The defendants billed Medicare for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy, and diagnostic tests.
According to trial testimony, Khandrius, who holds no medical licenses or certifications, impersonated his co-defendant Dr. Gustave Drivas at the clinic. Drivas was the Bay Medical clinic’s “no-show” doctor. Khandrius admitted at his change of plea hearing that he signed prescriptions and medical charts in Drivas’s name and performed medical tests and procedures on patients although he was not licensed to do so. Drivas was convicted by a federal jury on April 8, 2013, of health care fraud conspiracy and health care fraud.
Khandrius’s impersonation of Drivas assisted the conspirators in disguising the use of Drivas’s Medicare billing number to bill more than $20 million in claims for services that were not rendered or medically unnecessary. According to trial testimony, Khandrius also directed a phony allergy testing fraud at the Bay Medical clinic that involved giving patients bottles of tap water instead of allergy medications; wrote prescriptions for co-workers and at least one minor child using Drivas’s prescription pad; and, in response to a written audit from Medicare, falsely filled out medical charts in an attempt to back up the billing and deceive Medicare.
The government’s investigation included the use of a court-ordered audio/video recording device hidden in a room at the clinic where the conspirators paid cash kickbacks to corrupt Medicare beneficiaries. The conspirators were recorded paying approximately $500,000 in cash kickbacks during a period of approximately six weeks from April to June 2010. This room was marked “PRIVATE” and featured a Soviet-era poster of a woman with a finger to her lips and the words “Don’t Gossip” in Russian. The purpose of the kickbacks was to induce the beneficiaries to receive unnecessary medical services or to stay silent when services not provided to the patients were billed to Medicare.
The case was investigated by the FBI and HHS and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. This case is being prosecuted by Trial Attorney Sarah M. Hall of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Shannon Jones of the Eastern District of New York.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
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