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Medical Transportation Provider Pleads Guilty; $13 Million Kickback and Fraud


A Brooklyn, N.Y., resident pleaded guilty for his role as a patient recruiter in a $13 million kickback and health care fraud scheme, the fourth defendant to plead guilty in the scheme based at the Cropsey Medical Care PLLC clinic in Brooklyn. The patient recruiter pleaded guilty before U.S. Magistrate Judge Roanne Mann of the Eastern District of New York to one count of conspiracy to pay and receive illegal health care kickbacks. At sentencing before U.S. District Judge Nina Gershon, scheduled for Dec. 4, 2013, he faces a maximum penalty of five years in prison.

 

Court documents state that the recruiter, working through an ambulette company in Brooklyn, enlisted patients to attend Cropsey Medical. An ambulette is a vehicle that is licensed by New York State’s Medicaid program to transport beneficiaries to and from medical facilities when such transportation is medically necessary. From 2009 to 2012, the patient recruiter paid employees of Cropsey Medical a per beneficiary cash kickback so that Cropsey Medical would accept his beneficiaries as patients and so that his ambulette company could bill Medicaid for the transportation of beneficiaries to and from Cropsey Medical. Once these beneficiaries were transported to Cropsey Medical, they were paid cash kickbacks to induce them to continue to attend the clinic and to receive medically unnecessary physical therapy, diagnostic testing and other services. Such purported medical services were then billed by Cropsey Medical to Medicare and Medicaid.

 

According to court documents, from approximately November 2009 to October 2012, Cropsey Medical submitted more than $13 million in claims to Medicare and Medicaid, seeking reimbursement for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests.

 

The case was investigated by the FBI and HHS-OIG and brought as part of the Medicare Fraud Strike Force.

 

See the DOJ Announcement

 

 

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