Undercover Surveillance

67327994 - doctor writing a perscription on his desk

When you think of surveillance, a non-descript white van or black sedan with tinted windows parked by the curb might come to mind. While a story reported in the Brooklyn Daily Eagle doesn’t exactly give details on how the surveillance was conducted, however, it was certainly useful in providing convincing evidence that a licensed psychiatrist was not providing constant care to his Medicare patients as claimed.

The story states that over a seven-year period, the Department of Veterans Affairs (VA)-employed psychiatrist submitted claims to Medicare stating that he made home medical visits seven days a week, 365-days a year. That didn’t include the time that he put in at the VA. (Now that’s what I call a very hard working doctor.)

Evidently, the claims made by the 55-year-old man piqued the interest of the Department of Health and Human Services, so they set up surveillance outside of his apartment. According to the article, the doctor did not leave his home once he arrived home from his eight-hour a day job at the VA. This fact negates the claim that he supposedly saw an average of 14.66 patients per day, after he got home from work. Assuming he spent at least 30 minutes with each patient, that means he would have worked a 15-hour day. (Talk about burnout.) The surveillance also provided proof that the doctor was out of town during the time he claimed to provide house calls to his patients.

The man was sentenced to 18 months in prison for his fraudulent activities. He will also serve three years of supervised release and pay $1.2 million in restitution to Medicare. (That seems a bit lenient for someone who received more than $2.8 million from the false claims.)

This fraudster blatantly took advantage of his veteran patients, who were entitled to the hard-earned benefits because of their military service. Instead of providing legitimate mental health care, he selfishly pocketed money he did not deserve. In the process, he robbed beneficiaries of treatment they deserved. Perhaps while serving out his prison sentence, the doctor will get what he deserves – some intense counseling to rehabilitate his corrupt and selfish tendencies.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Brooklyn Doctor Sentenced to 18 Years for Medicare Fraud,” written by Charisma L. Miller, Esq., and published by the Brooklyn Daily Eagle on March 26, 2014.

Brooklyn Federal Judge I. Leo Glasser has sentenced Dr. Mikhail L. Presman, a licensed psychiatrist employed by the Department of Veterans Affairs (VA), to 18 months’ imprisonment for Medicare fraud charges.

Presman, 55, had been charged with submitting false Medicare claims and unjustly receiving more than $2.8 million in Medicare payments. It was alleged that ”between 2006 and 2012, Presman submitted claims for home medical visits for substantially every day of the year – seven days a week, 365 days a year,” for patients he supposedly assisted while off duty.

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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.