Repeat Offender

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Cropped shot of a handsome mature male doctor using a tablet while standing in the hospital corridor

You have to wonder about people who get caught defrauding a healthcare program – and then do it again. That is the case with an Ohio doctor who is serving a 33-month term in federal prison for his role in defrauding Medicare and Medicaid for more than $1 million.

A podiatrist was caught carrying out a Medicare fraud scheme at his healthcare clinic, Community Foot & Ankle of Mentor, to get money for claims submitted to both programs. The scheme worked – until Medicare and Medicaid officials learned he was the true owner of his practice. (He was not supposed to participate in either program because of a previous criminal conviction.)

Medicare footed the bill for more than $968,000 in services he performed, and Medicare was billed for more than $219,000. All the claims were submitted between 2014 and 2018 and apparently another podiatrist provided the services.

The man from Mentor pleaded guilty to healthcare fraud. In addition to the prison sentence, he was ordered to pay $453,615 in restitution and must forfeit $75,000 in property.

This wasn’t this man’s first rodeo. He was previously convicted in 2013, along with dozens of others, of conspiracy to commit bank fraud. He admitted to acting as a straw buyer for Florida real estate for an Akron man who led a mortgage fraud scheme.

The State Medical Board of Ohio suspended the podiatrist’s medical license in December of 2013, but reinstated it the following March. (That’s just not right.)

Today’s Fraud of the Day comes from the article, “Mentor podiatrist sentenced to prison for health care fraud,” published July 29, 2019 on Cleveland.com.

CLEVELAND, Ohio — A Mentor podiatrist was sentenced Monday to 33 months in federal prison for defrauding Medicare and Medicaid by submitting claims worth more than $1.1 million for treatment he provided, even though he was prohibited from doing so.

Dr. Robert Rosenstein executed a scheme through Community Foot & Ankle of Mentor to get money for claims submitted to both programs, according to charging documents filed in March.

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Larry Benson
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.