Dec. 18: Week That Was in Healthcare Fraud and Malpractice
By - Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General (OIG). The crimes reported below result in multiple millions of dollars in healthcare fraud and the possibility of extensive prison time.
Sentencing begins in last March’s $50M Medicare fraud scheme
One of the year’s biggest Medicare fraud cases and federal investigations may finally be soon put to rest.
Two doctors and a registered nurse were sentenced to jail this week for participation in a $50 million healthcare fraud scheme based in the New Orleans area.
Last March, over a dozen individuals were indicted. Paige Okpalobi, 58, the owner and operator of the New Orleans-based medical clinic Medical Specialists of New Orleans and her accountant, Christopher White, 48, pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of conspiracy to falsify records.
Between 2007 and 2014, Okpalobi submitted almost $50 million in claims to Medicare for home health services that were performed but deemed medically unnecessary. Other services were simply not delivered.
This week, sentencing is set to begin for 4 defendants: Dr. Barbara Smith, of Metairie, Louisiana, Dr. Roy Berkowitz of Slidell, Louisiana, Beverly Breaux, a registered nurse of New Orleans, and Joe Ann Murthil of New Orleans, according to a NOLA.com report.
Smith, Berkowitz, and Breaux were sentenced to 80 months, 64 months, and 50 months in prison, respectively. They were ordered to pay over $9.4 million, over $4.9 million, and over $2 million in restitution, respectively.
According to the indictment, 88 percent of over 9,000 Medicare claims that Memorial Home Health submitted from 2007 to 2014 were fraudulent. Services rendered were both medically unnecessary and not provided.
Three additional companies – Interlink Health Care Services, Lakeland Health Care Services and Lexmark Health Care – reportedly filed Medicare claims for fraudulently obtained medical equipment.
Okpalobi, White, and 5 other individuals still await sentencing, according to Justice Department spokesman Peter Carr.
NY physician’s assistant sentenced in oxycodone conspiracy
Leonard Marchetta, a physician’s assistant in Staten Island, was sentenced this week to 11 years in prison for conspiring to distribute large amounts of oxycodone from his medical clinic.
“Leonard Marchetta was responsible for the illegal distribution of more than 125,000 medically unnecessary oxycodone pills. With his criminal distribution of highly addictive and dangerous drugs, Marchetta helped fuel the prescription pill epidemic plaguing our community,” stated Preet Bharara, Manhattan United States Attorney.
For nearly three years, Marchetta prescribed oxycodone for individuals claiming to be “patients” who did not medically require it, according to Indictment allegations and sentencing statements.
Marchetta reportedly charged a general fee of $250 in cash for “doctor visits” that tended to last no longer than 1 or 2 minutes, did not involve any kind of physical exam, and resulted in the distribution of 150 30-milligram tablets.
He supposedly received a separate fee of around $500 in cash for each medically unnecessary prescription administered. Other "patients" were merely fictitious, reports the Department of Justice.
