Kicking Back

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The word ”kickback” has several meanings. The most common social definition involves relaxing with friends or family, such as in, ”Why don’t you come on over and let’s kickback and watch a movie.” Another definition of the word involves unethical behavior, such as when the recipient of a kickback says, ”Thank you,” and the person giving it says, ”Don’t mention it,” inferring that the recipient shouldn’t talk to anyone about the favor. A Department of Justice press release details the story of a Brooklyn Clinic employee who used kickbacks as a way to bilk $77 million from Medicare.

According to the press release, from 2005 to 2010, a 50-year-old man worked in a medical clinic that operated under three different names. The owners, operators and employees paid cash kickbacks to corrupt Medicare beneficiaries in exchange for using their names to bill Medicare for unnecessary or nonexistent services, such as physician office visits, physical therapy and other diagnostic tests.

What is scary is that the clinic worker, who had no medical licenses or certifications, also performed medical tests and procedures on patients even though he was not authorized to do so. Court records state that he even conducted a phony allergy testing fraud that involved giving patients tap water instead of allergy medications. (Talk about sneezy and sleazy.) He also impersonated the clinic’s ”no-show” doctor and co-defendant by signing off on prescriptions and falsely completing medical charts in response to a written audit from Medicare. The fraudster and 12 co-conspirators used the ”no-show” doctor’s Medicare billing number to submit claims worth more than $20 million.

So, how did they get caught? The Medicare Fraud Strike Force, whose focus is to fight Medicare fraud, was able to place a hidden recording device in a room at the clinic. Audio and video recordings captured the co-conspirators paying out approximately $500,000 in cash kickbacks over a period of six weeks. According to the press release, the ”kickback room” was marked ”PRIVATE” and featured a Soviet-era poster of a woman with her finger to her lips and the words ”Don’t Gossip” in Russian. (A picture is worth a thousand words if you don’t speak Russian.)

The fraudster is headed to prison for eight years and the other 12 have also been convicted in this case.

In the clinic worker’s effort to earn extra income so he could relax and enjoy life, he neglected to think about what would happen if he was caught and prosecuted for his actions. Needless to say, there won’t be much relaxing going on in jail.

Source: Today’s ”Fraud of the Day” is based on a Department of Justice press release titled ”Brooklyn Clinic Employee Sentenced to Eight Years in Prison in Connection with $77 Million Medicare Fraud Scheme” on July 30, 2013.

Yuri Khandrius, 50, of Brooklyn, N.Y., 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.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.