California doc gets jail time for ultrasound Medicare fraud

By Kate Madden Yee, AuntMinnie.com staff writer

July 1, 2008 -- A California physician was sentenced to 30 months in prison for billing Medicare for ultrasound and other exams that weren't needed or weren't performed, according to the U.S. Department of Justice (DOJ).

General practitioner Dr. Armond Tollette of Culver City, CA, received the sentence on June 26 after pleading guilty last year to conspiring to commit healthcare fraud. The DOJ had accused Tollette and four other individuals with charging Medicare for tests that were based on falsified physician orders that claimed the exams were medically necessary.

According to the DOJ, the five individuals established the Milpitas Medical Clinic in Milpitas, CA, to scam Medicare for ultrasound tests:

  • For patients whom neither Tollette nor any other physician ever examined
  • That were not legitimately ordered by Tollette or any other physician
  • That were not medically necessary
  • That were not performed by a certified technologist
  • That were not performed at all

Medicare patients were recruited to the clinic with the promise of free transportation, food, and medical care. Clinic workers copied the patients' Medicare cards, and other workers posed as physicians and nurses and performed bogus examinations.

Tollette and his co-conspirators submitted $1.1 million in fake claims to Medicare and received more than $909,000 in illegitimate reimbursements, according to the DOJ. The Federal Bureau of Investigation (FBI) and the Department of Health and Human Services (HHS) pursued the investigation for two years.

In addition to the jail time, U.S. District Court Judge Jeremy Fogel sentenced Tollette to three years of supervised release. In October, Fogel sentenced the other co-conspirators in the case: Leonid Dzhuga of Reseda, CA, received two years in prison; Alexander Dzhuga of Encino, CA, got 21 months; and their co-defendant Vladimir Semenov of Sherman Oaks, CA, received 18 months. Natalia Stadnik, also of Reseda, was given 200 hours of community service, plus three years of probation including six months of house arrest with electronic monitoring.

All five defendants also were ordered to repay the more than $909,000 they received from Medicare.

The case is the latest in what appears to be a trend toward increased government scrutiny of Medicare fraud, both within medical imaging and in other medical specialties and services. In April, the DOJ reached a $7 million settlement with a Florida radiologist to resolve allegations of healthcare fraud; in the last month, the DOJ has caught more healthcare providers in the act of fraud:

  • On June 27, the DOJ sentenced the owners of four Miami-based healthcare corporations for their roles in schemes to defraud the Medicare program of more than $14 million for unnecessary medicine, durable medical equipment, and home healthcare services.
  • On June 11, three Miami-area brothers who allegedly financed 11 corrupt HIV infusion clinics and a physician's assistant who worked at those clinics were charged with conspiring to submit approximately $110 million in false and fraudulent claims to the Medicare program.
  • On June 6, the FBI and Internal Revenue Service Criminal Investigation arrested the operator of Wescove Home Health Services of Covina, CA, on healthcare fraud and money laundering charges stemming from participation in a scheme that defrauded Medicare of more than $12 million.

"Medicare benefits are paid for by the public and are meant for examinations and tests that are actually performed and medically necessary," the DOJ said in a statement. "The theft of those benefits by those individuals involved in operating the Milpitas Medical Clinic amounts to theft from the American taxpayer and from the Medicare beneficiaries who truly need medical treatment."

By Kate Madden Yee
AuntMinnie.com staff writer
July 1, 2008

Florida fraud case: A harbinger of increased federal scrutiny? April 30, 2008

Radiologist pays $7 million to settle federal fraud claims, April 14, 2008

U.S. DOJ joins 'kickback' case against Ohio heart centers, April 2, 2008

Whistleblower accuses radiologist of referral, lease kickbacks, July 19, 2005

Copyright © 2008 AuntMinnie.com

 

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