A medical clinic owner has been sentenced to seven years in prison over a $55 million fraud scheme that involved submitting false claims for Medicare to the U.S. government.
According to a report from Law360 emphasizes that the owner, Valentina Kovalienko, had two medical clinics based out of Brooklyn, N.Y. Kovalienko owned Prime Care on the Bay LLC and Bensonhurst Mega Medical Care PC.
The court issued the sentence after Kovalienko pled guilty to participating in the $55 million health care fraud scheme of submitting false claims for Medicare and a money laundering conspiracy, Law360 says. Kovalienko plead guilty in October 2015 to one count of conspiracy to commit health care fraud and a second count for conspiracy to commit money laundering.
U.S. District Judge Roslynn R. Mauskopf presided over the case.
Kovalienko is also being required to pay $29 million in restitution and to forfeit the same amount for submitting false claims to the U.S. government and for bribing patients to enter the clinic and receive services from unlicensed medical professionals.
According to Law360, the U.S. acting Attorney said in a statement that “the defendant made stealing from Medicare and Medicaid her full -time business by agreeing with others to pay cash kickbacks to patients, submit fraudulent claims to Medicare and Medicaid, and write checks to sham companies to disburse the proceeds of the illegal scheme.”
“This office and our law enforcement partners are committed to protecting precious taxpayer dollars from unscrupulous providers seeking to defraud federal health care programs,” the U.S. attorney said.
The Department of Justice alleged that between February 2008 and February 2011, Kovalienko and other co-conspirators paid patients to undergo medically unnecessary therapy and diagnostic tests, and to show up for office visits that were not performed by licensed medical professionals.
Kovalienko and her co-conspirators would then bill Medicare and Medicaid for these medically unnecessary services.
She was also accused of paying physical therapists and occupational therapists to falsify patient charts and billing records. Medicare funds were then funneled through her clinics’ own bank accounts, from which Kovalienko and her co-conspirators could access the funds by cashing checks.
Kovalienko would allegedly write checks to fake third-party vendors who purported to provide consulting, advertising, and computer services for her medical clinics. They would continue to cash the checks they received and would continue to pay their patients kickbacks for their fake services.
According to Law360, twenty other individuals have pleaded guilty to the false claims for Medicare scheme.
The health and Human Services Office of Inspector General Special Agent-in-Charge said that this scheme was motivated by greed. “This sentencing should serve as a warning to any health care provider that dares to put personal profit ahead of proper patient care.”
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