Thorny Problem

34631372 - closeup of a medicare enrollment form with money

Thorns are unpleasant. When one encounters a thorn, it tends to leave them wounded and often bleeding. Fraudsters are a lot like thorns. They are prickly, unpleasant and the primary reason why the Medicare program hemorrhaged an estimated $60 billion in 2017. (According to this chart, that’s more than the annual budget for some of the government’s most important programs.) Read on to learn more about a medical assistant from Brooklyn who is part of the thorny problem of Medicare fraud in the Eastern District of New York.

The medical assistant at the center of today’s fraud article actually collected a salary of $270,064 while working at two medical clinic locations in Brooklyn, overseeing unneeded treatments for patients. (It’s important to know that he worked as an unlicensed physical and occupational therapist.) Although unlicensed, it’s ironic that he supervised and worked with licensed therapists to fake documentation and file claims to public health programs.

The medical assistant wasn’t the only one in on the scam. Other co-conspirators paid patients to visit the clinics. One of the co-conspirators happened to be the medical assistant’s wife, who raked in an annual salary of $265,286 from the scam. (That’s an incredible salary for a medical biller.)

The 49-year-old medical assistant was found guilty of Medicare fraud for his role in the $17 million government healthcare scam that was carried out through two medical clinics in southern Brooklyn. The judge found this fraudster’s crimes egregious and ordered him to serve three years in prison. (I think the judge’s exact words were, “These unlicensed therapists had no business putting their hand on these patients.” Enough said.)

The medical assistant’s 49-year-old wife and a co-conspirator, who paid patients to come to the clinics, both pleaded guilty for their roles in the $55 million healthcare fraud scheme. (Apparently 15 individuals have been found guilty for submitting a collective $55 million in false claims to Medicare and Medicaid over three years.) Since today’s fraudster was indicted in 2015, there have been additional incidences involving other Brooklyn workers participating in other healthcare scam rings. (It sounds like an epidemic of epic proportions.) Congratulations goes to the Medicare Strike Force for pruning back these pesky, fraudulent thorns.

Today’s “Fraud of the Day” is based on an article entitled, Medical assistant gets 3 years for role in $17M southern Brooklyn Medicare fraud,” published by Brooklyn Daily Eagle on March 8, 2018.

A Brooklyn federal judge called health care schemes a “thorny problem” in the Eastern District of New York before sentencing a medical assistant to three years in prison for his role in a $17 million Medicaid and Medicare scam in southern Brooklyn.

Yuriy Omelchenko previously pleaded guilty to working at as an unlicensed physical and occupational therapist, supervising aides as they gave unnecessary “treatments,” to patients at two Brooklyn clinics for Medicaid kickbacks

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.