On behalf of the entire Allegiant Experts team, we would like to take this opportunity to wish you a very joyous holiday season! Merry Christmas, Happy Hanukkah and Happy Kwanzaa to all! As a reminder, tomorrow will be our last day of operations for the year 2019. We will reopen on January 6th for our first day of work in 2020. So allow us to offer you all a very Happy New Year as well!
There are two individuals who will, in all likelihood, not be celebrating any of the above mentioned occasions. As announced by the Southern District of New York branch of the United States Department of Justice last week, Paul J. Mathieu and Lina Zhitnik are set to face some serious prison time for their roles in a $30 million health care fraud scheme.
Paul J. Mathieu pretended to be a medical clinic owner.
As the DoJ reports, Mathieu was sentenced to 48 months in prison for his role in the scheme which defrauded Medicare and the New York State Medicaid Program. Between 2007 and 2013, he falsely posed as the owner of three medical clinics. In actuality, the clinics were owned a by corrupt businessman, Aleksandr Burman. In addition, Mathieu falsely claimed that he had examined and treated thousands of patients when, in fact, he hadn’t.
The recent sentencing follows Mathieu’s May 2019 conviction. It came after a six-week trial on charges of health care fraud, wire fraud, mail fraud, conspiracy to commit those offenses and conspiracy to make false statements in connection with a federal health care program.
Lina Zhitnik is an occupational therapist.
On December 3rd, she was sentenced to 14 months in prison for her role in the same scheme. Her role involved falsifying medical records in order to claim that she had provided therapy services. Zhitnik pleaded guilty to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud in April 2019. Her guilty plea actually took place during jury selection for her trial.
In addition to Zhitnik’s guilty plea transcript, there was ample evidence presented at trial to convict Mathieu. Burman is currently serving a 10-year prison term for his participation in this scheme. His Brooklyn, New York clinics were used to fraudulently bill Medicare and Medicaid for approximately $30 million for medical services and supplies that were not provided.
There many other fraudulent submissions.
Included were those for medical services that were provided without regard to medical necessity or were otherwise fraudulently billed.
“Under New York State law, professional medical corporations must be owned by a medical professional,” the DoJ report details, “To circumvent this requirement, Burman and Mathieu agreed to have Mathieu pose as the true owner of a succession of three different clinics, which Burman owned and operated for more than five years, from 2007 through 2013.”
During those years, Mathieu signed numerous fraudulent documents that falsely represented to banks as well as Medicare, Medicaid and others that he was the sole owner of several clinics and medical offices. He arrived at the many of the clinics on a weekly basis simply to sign stacks of false and fraudulent medical charts. He also issued referrals for expensive additional testing, occupational therapy and physical therapy, even without seeing any patients at all.
Are you an attorney who is currently trying a health care fraud case?
Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com. Happy Holidays!