As readers of the Allegiant Experts Blog are well aware, health care fraud comes in many different forms and is committed by many different types of people. As of late, we’ve noticed what seems to be a growing number of health care fraud cases committed by large groups. In most cases, the crimes require teamwork. This is also what makes the act of committing health care fraud so heinous.
Obviously, fraudulently bilking insurance companies for money is a premeditated offense. And when individuals group together in order to conduct their fraudulent actions, it takes detailed planning. As Peter Belfiore reports on LIHerald.com this week, Dr. Abraham Demoz was one of a dozen people who took part in a conspiracy to defraud Medicare and Medicaid for no less than $163 million.
The indictment was handed down as part of a nationwide health care fraud takedown.
The Oceanside, New York physician and his 11 co-conspirators were all indicted on June 28 for their roles in a major health care fraud scheme. Demoz is alleged to have been part of a scheme that lasted between 2009 and 2016, netting his group north of $116 million between all of the billings sent the way of the two insurance programs.
According to prosecutors, the 58 year-old Demoz and his team of fraudsters allegedly paid illegal kickbacks for the referral of patients to their clinics. “The patients then purportedly subjected themselves physical and occupational therapy as well as other procedures in return for the payments, and the medical professionals benefited from the Medicaid and Medicare reimbursements as a result,” explains Belfiore.
Demoz and his fellow defendants are faced with a number of charges.
They include conspiracy to commit health care fraud, conspiracy to commit money laundering, conspiracy to pay health care kickbacks, conspiracy to defraud the United States by obstructing the lawful functions of the IRS and subscribing to a false and fraudulent tax return
United States Attorney Richard Donoghue didn’t mince words when speaking about the indictment. “As alleged, the defendants charged throughout the Eastern District of New York as a part of the nationwide health care takedown abused their positions to enrich themselves, while bilking Medicare and Medicaid,” he is quoted as saying, “They did so without regard to the elderly and vulnerable citizens whose health depends upon these essential programs.”
FBI Assistant Director-in-Charge William Sweeney also weighed in on the allegations. “Turning a blind eye to the needs of Medicare and Medicaid recipients, these medical officials set their sights on personal gain,” he added, “Our doctors and healthcare professionals are entrusted to serve those in need, but these individuals used their occupations as leverage to fulfill their fraudulent scheme. By allegedly billing Medicare and Medicaid more than $163 million, the defendants selfishly diverted funds allocated to our most vulnerable citizens.”
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