One of the largest busts concerning Medicaid fraud occurred in Brooklyn, where twenty people, four of whom are doctors, were arrested. Fourteen companies were also included on the indictment. All are accused of engaging in a massive scheme to defraud Medicare, Medicaid and other healthcare organizations out of over $146 million. The Brooklyn District Attorneys allege that this is the biggest healthcare case in the office’s entire history.
The Brooklyn DA’s office allege that the defendants created a scheme where recruiters offered cash to low-income or homeless people to undergo medically unnecessary tests at six Brooklyn-based medical clinics. Some of these tests included ultrasounds and allergy tests. The medical staff then billed publicly funded health care programs for the costs of those tests, pushing the money through various shell companies based in foreign countries, including China, Taiwan, Lithuania and Turkey. The money eventually reached the defendants, which they allegedly used to buy designer clothes, and expensive real estate, including a $3.25 million apartment in downtown Brooklyn, paid for in cash by alleged ringleader, Brooklyn-ite Kristina Mirbabayeva, age 35.
Among the areas targeted were a soup kitchen and a job center. The individuals were paid on a cash basis – usually around $30 or $40, to sit for unnecessary medical tests. Like most healthcare fraud crimes, the investigation started based on a referral. The investigation was wide-reaching: undercover detectives were employed, who intercepted communications between parties, and conducted surveillance. One undercover officer was actually recruited and he received $30 to undergo tests. He reported that he was in the office for about an hour without ever seeing a doctor. Records showed that the office billed for 18 separate tests for the visit, which should have taken over 12 hours. Investigators also relied on the social media accounts of suspects. Ms. Mirbabyeva had closets full of designer handbags and shoes, and showed off her latest purchases online. Law enforcement recovered $700,000.00 in cash alone when they executed a search warrant, according to the District Attorney’s office. A New York Police Department (NYPD) surgeon, Dr. Robert Vaccarino, has also been implicated. An NYPD surgeon is awarded this honorary title based on their field of specialty. These doctors have passed an extensive review process, and are the first-choice in caring for injured police and their immediate families.
On top of the charges typically associated with health care and insurance fraud, the DA’s office has also filed charges for enterprise corruption, grand larceny, and money laundering. The indictment includes 878 counts spanning a period of three years. The individuals charged in this case face up to 25 years in prison if they are convicted.
The indictment comes nearly 6 months after Attorney General Jeff Sessions announced his plan to target healthcare fraud, particularly on the opioid treatment programs exploiting insurers and public health systems. The Justice Department has invested time, money and expertise in cracking down on the fraudulent claim. The district attorney leading the case asserts that the list of defendants will grow in this case as they continue to investigate and interview persons of interest.