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Circle of Fraud

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Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Three years ago, Eric Karlewicz was among two dozen people – including the husband of Drita D’Avanzo, a star of the popular reality TV show “Mob Wives” – accused of participating in a scheme to turn Sour Patch Kids and other popular candy into THC-infused edibles. Enticing little kids into the life of drugs wasn’t the right age bracket for Karlewicz. He targeted the elderly for his next victims, building a circular scheme of kickbacks and bribes with doctors, durable medical equipment businesses, and telemedicine companies that would generate millions in fraudulent Medicare healthcare claims.

In the pure mathematical world, the circle has no beginning or end. In this circular scheme of fraud there is no beginning either. But there is an end, after a loss of $127 million to the U.S. taxpayer unfortunately. Karlewicz and his co-conspirators paid kickbacks and bribes to telemedicine companies. Those companies, in turn, paid off doctors for the signed orders of durable medical equipment (DME) regardless of medical necessity, often without ever speaking to the patient. The DME suppliers then submitted claims to federal health care benefit programs for which they received lucrative reimbursements. The DME suppliers then pays the company with the referrals. Who to go to? Karlewicz.

Karlewicz owned Empire Pain Center Holdings. A company that bought up lists of beneficiaries of Medicare and other health benefit programs with the intent to fraud. Employees at Empire were awarded commissions, bonuses, and other incentives to call Medicare beneficiaries and “press” as many of them as possible to accept the equipment. Karlewicz and his company received more than $63 million from DME suppliers in exchange for the Medicare referrals.

On October 9, 2023, Karlewicz pleaded guilty and is awaiting his sentencing. Hopefully it will be enough for him to not want to do a third scheme.

Shout out to the Health Care Fraud Unit.

Today’s Fraud of The Day is based on article” Chestnut Ridge businessman faces federal prison for $127M healthcare fraud kickback scheme” published by Rockland Westchester Journal News on October 10, 2023
Chestnut Ridge marketing company owner has pleaded guilty to federal charges involving a multi-million dollar healthcare fraud kickback scheme. Eric Karlewicz, aka “Anthony Mazza,” and his conspirators submitted false and fraudulent claims to healthcare benefit programs totaling more than $127 million for durable medical equipment, according to U.S. Attorney Vikas Khanna in a news release.

Khanna said Karlewicz used proceeds from the scheme to purchase luxury vehicles, including a Ferrari, a Lamborghini, a Bentley, and a BMW. Karlewicz pleaded guilty Tuesday before U.S. District Judge Esther Salas in Newark, New Jersey, after waiving prosecution on the indictment.

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