Doctor from Queens sentenced in Medicare fraud scheme

Medical professionals are always under the microscope. In some cases, law enforcement agencies implement periodic investigations of medical specialists in order to uncover illegal activity, including fraud.

For example, a physician from Queens was recently sentenced to a year behind bars for his function in an insurance fraud scheme. The professional was accused of billing Medicare over $15 million for illegal actions, including lesion removal and physical therapy services that were not essential and never actually provided.

The defendant was sentenced in the Eastern District of New York. In addition to prison time, the man is ordered to a few years of supervised release and must pay over $2 million in restitution.

The defendant pleaded guilty to "conspiracy to commit health care fraud." Court records explain that the doctor worked with others to perpetuate a scheme wherein the defendant and other participants provided varied services - massages, facials, meals and social events - to beneficiaries of Medicare at URI Medical Service, P.C., and Sarang Medical, P.C. The plan was to encourage the beneficiaries to bill Medicare for treatment that was not medically needed and never actually performed. URI and Sarang purportedly provided lesion removals and physical therapy in Queens. In sum, the defendant and relative participants submitted around $15.1 million in false claims.

In this particular matter, the charges evolved out of an investigation by the FBI and the U.S. Department of Health and Human Services Office of Inspector General.

Medicare fraud in New York

In New York, the Zone Program Integrity Contractor and federal government will stop at nothing to investigate Medicare and Medicaid fraud and related unlawful activity, including the following:

  • Billing for unperformed services
  • False claims
  • Self-referrals and kickbacks
  • Overbilling
  • Providing services not actually required

If your professional license is on the line, it may help to retain legal assistance. During an investigation, a legal professional can facilitate the conversation with the applicable division of law enforcement. Opening lines of communication, an attorney can help decipher concerning issues within the investigation. Moreover, a lawyer can retrieve records and other relevant materials that may have been taken within the course of the investigation. This is important, as a business needs to proceed even when an investigation is pending.

Ultimately, an experienced lawyer can help resolve any issues with the investigative agency before things become too complicated. Too uncover more about your matter, contact a local attorney.