Federal prosecutors crackdown on Medicare fraud schemes.
A federal jury convicted Dallas area owners of Metro DME Supply LLC (Metro) and Ortho Pain Solutions LLC (Ortho Pain), Leah Hagen, 49, and Michael Hagen, 54, of Arlington, of Medicare fraud including one count of conspiracy to defraud the United States and to pay and receive health care kickbacks and one count of conspiracy to commit money laundering.
The Department of Justice contends, “The defendants paid a fixed rate per DME item in exchange for prescriptions and paperwork completed by telemedicine doctors that were used to submit false claims to Medicare.” Furthermore, “The defendants paid illegal bribes and kickbacks and wired money to their co-conspirator’s call center in the Philippines that provided signed doctor’s orders for orthotic braces.”
Multiple emails exchanged between the Hagens were presented at trial and showed a per-product pricing structure for orthotic braces. The co-conspirators, in total, billed Medicare Parts B and C approximately $59 million and were paid approximately $27 million. They wired the millions they received to their personal bank accounts.
According to the DOJ, “Evidence also showed defendants offered fixed-rate payment for each durable medical equipment item in exchange for prescriptions and documents completed by telemedicine doctors, which were used to fraudulently bill Medicare. The defendants offered unlawful kickbacks and bribes and wired funds to their co-conspirator’s call center in the Philippines in exchange for signed physician orders for orthotic braces.”
When the Hagens are sentenced, they will each face a maximum sentence of 25 years in prison.
Akop Atoyan, 48, of Glendale, California, also pleaded guilty this past week to one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive health care kickbacks, according to Acting U.S. Attorney Phillip A. Talbert. Atoyan and his wife, Liana Karapetyan, owned home health care and hospice facilities in the Sacramento area, including ANG Health Care Inc., Excel Home Healthcare Inc., and Excel Hospice Inc.
Atoyan and Karapetyan paid and kickbacks to others for beneficiary referrals, including “employees of health care facilities, as well as employees’ spouses,” according to federal prosecutors. “The kickback recipients included John Eby, a registered nurse who worked for a hospital in Sacramento; Anita Vijay, the director of social services at a skilled nursing and assisted living facility in Sacramento; Jai Vijay, Anita Vijay’s husband; and Mariela Panganiban, the director of social services at a skilled nursing facility in Roseville,” federal court records showed.
Atoyan, Karapetyan, and others they solicited to help in their scheme, caused the facilities they owned to submit more than 8,000 claims to Medicare for costs related to home health care and hospice, and Medicare paid the agencies approximately $31 million. As part of his guilty plea, Atoyan agreed to pay $2,525,363 in restitution to the U.S. Department of Health and Human Services and to hand over the same amount to the U.S.