June 26: 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. The crimes reported below result in multiple millions of dollars in healthcare fraud and the possibility of extensive prison time.
$2.5M Medicare fraud scheme in Orlando
Husband and wife Juan Carlos Delgado and Nereyda Infante pleaded guilty this week to conspiracy to commit healthcare fraud. The couple owned and operated several healthcare clinics across Orlando, Florida under various branching offs of the name “Prestige Medical.” Medicare was fraudulently billed by Prestige to the tune of $2.5 million for services that were never administered.
Both Delgado and Infante confirmed they had billed Medicare $1.2 million for the costly anticancer chemotherapeutic medication pentostatin although such was never actually administered.
NY Doctor creates false records after Medicare audit
Melvin Cwibeker, a doctor of chiropractic medicine based in Nassau County, NY, has pled guilty to both healthcare fraud and obstruction of a federal audit this week. Cwibeker, owner of Mel Cwibeker DC, will pay both a restitution and a $500,000 forfeiture. He additionally faces a maximum of 15 years in prison. He will be sentenced at the beginning of November.
Between 2006 and 2012, Cwibeker and co-conspirators fraudulently billed Medicare in excess of $7 million for allegedly providing treatments for residents of assisted living facilities. Three chiropractors employed by Cwibeker who have pled guilty to healthcare fraud charges were specifically trained not to provide Medicare required patient care. Pretend patient records were created and sent to Medicare.
“Dr. Cwibeker violated his oath and the law by hiring individuals to create fictitious patient records which were submitted to Medicare to obstruct its audit of his chiropractic billings,” states Acting Attorney for the Eastern District of New York, Kelly T. Currie. “Health care providers who falsely bill for care are on notice that they will face serious consequences,” Currie adds.
According to Federal Bureau of Investigation (FBI) Assistant Director-in-Charge Diego Rodriguez stated, “Financial crimes, like the ones allegedly committed by Dr. Cwibeker when he fictitiously billed Medicare for treatments not provided, may appear victimless. However, these crimes impact society, through rising costs and diminishing services provided. By allegedly profiting over $4.3 million through illegitimate claims, Dr. Cwibeker put greed above his license and patient care.”
“Dr. Cwibeker engaged in a greed-fueled fraud scheme that undermined our health care system and the vulnerable individuals it serves,” maintains Scott Lampert, Health of Human Services, Office of Inspector General (HHS-OIG) Special Agent-in-Charge, “HHS-OIG, together with our law enforcement partners, will continue to vigorously pursue those who steal from government health programs for personal gain.”
