Health care fraud is apparently a big business. The problem with it, of course, is that it is illegal, not to mention immoral. So why are so many medical professionals engaged in acts of fraud throughout this country? Yes, as mentioned, it’s quite the money maker. A lot of people have made off with millions in stolen insurance money. However, as the old saying goes, crime doesn’t pay.
Criminal acts will catch up with their perpetrators at some point.
44 year-old, Aleksandr Pikus of Brooklyn, New York just found this out. Last week, the United States Department of Justice reported that the medical clinic manager was found guilty for his role in a nearly $100 million health care kickback and money laundering scheme. After a two-week trial, Pikus was convicted for several charges.
He was found guilty of one count of conspiracy to commit money laundering, two counts of money laundering, one count of conspiracy to receive and pay health care kickbacks and one count of conspiracy to defraud the United States by obstructing the IRS. The DoJ report adds that Pikus will be sentenced on April 8, 2020.
Pikus operated medical clinics in both Brooklyn and Queens.
Evidence presented during the trial showed that, through the clinics, he and a number of co-conspirators submitted approximately $96 million in medical claims, over the course of almost a decade. The clinics employed several medical professionals including physicians, physical therapists and occupational therapists. Each of them was enrolled in the Medicare and Medicaid programs.
“In return for illegal kickbacks, Pikus and his co-conspirators referred beneficiaries to these health care providers, who submitted claims to the Medicare and Medicaid programs,” the DoJ report informs, “Pikus then laundered a substantial portion of those proceeds through companies he and his co-conspirators controlled, including by cashing checks at several New York City check-cashing businesses; he and his co-conspirators then failed to report that cash income to the IRS.”
The report goes on to reveal that Pikus used his cash to enrich himself and others.
He also paid kickbacks to patient recruiters. Among his recruiters were ambulette drivers, who, in turn, paid beneficiaries to receive treatment at the medical clinics Pikus operated. Evidence at the trial also showed that the defendant used shell companies and fake invoices to conceal his illegal activities.
More than 25 people have pleaded guilty to or have been convicted of participating in the scheme. They include doctors, physical and occupational therapists, ambulette drivers and the owners of several of the sham shell companies used to launder the stolen money.
Said Special Agent in Charge Scott J. Lampert for the Office of Inspector General of the U.S. Department of Health and Human Services (HHS-OIG): “Mr. Pikus brazenly participated in a greed-fueled scheme that stole millions from Medicare and Medicaid. Along with our law enforcement partners, HHS-OIG will continue to protect the public and the taxpayer funded health care programs that serve those who need them.”
Are you an attorney who is currently trying a health care fraud case?
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