Five defendants, including two medical doctors, charged as part of Northeast Regional Health Care Fraud Takedown
Alleged health care schemes in the Eastern District of New York exceeded $17 million in fraudulently billed claims
BROOKLYN, NY - Four individuals, including two doctors, a pharmacist who had previously lost his license and been excluded from participating in the Medicaid and Medicare programs and a pharmacy owner have been charged for their participation in schemes in which the Medicare and Medicaid programs were fraudulently billed more than $17 million. A fifth individual, a registered nurse, pleaded guilty to possession of fentanyl that he stole from his employer, a hospital on Long Island. The charges filed in federal court in Brooklyn and Central Islip are part of a coordinated health care fraud enforcement action across seven federal districts in the northeast United States, led by the Medicare Fraud Strike Force, that resulted in criminal charges against 48 defendants for their alleged participation in health care fraud schemes involving more than $800 million in false and fraudulent claims.
The charges were announced by Richard P. Donoghue, United States Attorney for the Eastern District of New York; Brian A. Benczkowski, Assistant Attorney General of the Justice Department’s Criminal Division; William F. Sweeney, Jr., Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office; Ray Donovan, Special Agent in Charge, Drug Enforcement Administration, New York Division; and Scott J. Lampert, Special Agent-in-Charge, U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, New York Regional Office.
“As alleged, defendants charged in the Eastern District of New York used fraud and deceit to steal Medicaid and Medicare funds meant to protect our elderly and most vulnerable residents,” said United States Attorney Donoghue. “As this initiative demonstrates, we will continue to bring to justice those that defraud our nation’s health care programs.”
“Physicians and other medical professionals who fraudulently bill our federal health care programs are stealing from taxpayers and robbing vulnerable patients of necessary medical care. The medical professionals and others engaging in criminal behavior by peddling opioids for profit continue to fuel our nation’s drug crisis,” said Assistant Attorney General Benczkowski. “The Department of Justice will continue to use every tool at our disposal, including data analytics and traditional law enforcement techniques, to investigate, prosecute, and punish this reprehensible behavior and protect federal programs from abuse.”
“As alleged today, the defendants took advantage of programs established for the benefit of those less fortunate, allowing themselves to profit by defrauding the government of public money. May today’s charges remind those who tear holes in the government safety net that they will face the error of their ways,” said FBI Assistant Director-in-Charge Sweeney.
“There is no difference between the diversion of prescription medication to street drug trafficking,” said DEA Special Agent in Charge Donovan. “Allegedly, Kevin McMahon abused his position as a registered nurse diverting fentanyl for his personal use. The DEA and our law enforcement partners’ goal is to keep our citizens safe by guarding against health care fraud and the illegal diversion of prescription medication.”
“Healthcare fraud is not a victimless crime—with unscrupulous providers preying on Medicare beneficiaries and taxpayers alike. Especially insidious is the fraud committed by healthcare professionals who are trusted to provide needed, quality services to patients,” said HHS-OIG Special Agent-in-Charge Lampert. “With our law enforcement partners, our agency will continue to thoroughly investigate medical providers and others involved in healthcare fraud.”
The schemes charged in the Eastern District of New York, detailed in two indictments, one complaint and one criminal information, are as follows:
United States v. Anna Steiner: The superseding indictment charges Anna Steiner, a licensed anesthesiologist, was charged for her role in an alleged $17.4 million health care fraud scheme related to the payment of kickbacks in return for prescribing and ordering durable medical equipment, prescription drugs and diagnostic tests that were neither medically necessary nor resulted from an examination by or consultation with a physician. Steiner was charged with conspiracy to commit health care fraud and health care fraud in a superseding indictment filed on September 19, 2019. The case is being prosecuted by Department of Justice Trial Attorney Andrew Estes of the Criminal Division’s Fraud Section.
United States v. Denny Martin: Denny Martin, a licensed neurologist who was the sole owner of AM PM Medical P.C., was charged with health care fraud for his role in a scheme to falsely bill Medicare for treatments that were never performed. Between 2015 and 2019, AM PM Medical P.C. submitted more than 3,000 in fraudulent claims for home health and podiatry visits to the Medicare program. Martin was arrested this morning and arraigned before United States Magistrate Judge Robert M. Levy at the federal courthouse in Brooklyn. The case is being prosecuted by Assistant United States Attorney William P. Campos of the U.S. Attorney’s Office for the Eastern District of New York.
United States v. Andrew Barrett and Phyllis Pincus: Andrew Barrett, a pharmacist who had been previously convicted of healthcare fraud in 2016 and excluded from the Medicare and Medicaid programs, and Phyllis Pincus, the sole proprietor of two New York-based pharmacies, were indicted on September 24, 2019 for health care fraud, false claims and conspiracy to defraud the United States by submitting fraudulent claims to Medicare and Medicaid for medications that were not actually dispensed to patients. The case is being prosecuted by Assistant United States Attorney William P. Campos of the U.S. Attorney’s Office for the Eastern District of New York.
United States v. Kevin McMahon: Kevin McMahon, a registered nurse, was charged with possession of fentanyl, a Schedule II controlled substance. The charge stem from McMahon’s theft of a synthetic opioid fentanyl while employed at Nassau University Medical Center. McMahon was arraigned and pleaded guilty to a criminal information at the federal courthouse in Central Islip on September 25, 2019. The case is being prosecuted by Assistant United States Attorney Erin E. Argo of the U.S. Attorney’s Office for the Eastern District of New York.
The Eastern District of New York’s Healthcare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Eastern District of New York and the Criminal Division’s Fraud Section, was created in 2009 and since its inception has charged well over 100 defendants, many of which were medical professionals.
The charges are allegations, and the defendants are presumed innocent unless and until proven guilty.