Articles Posted in Therapy Fraud

Justice.jpgMIAMI, FLORIDA (JULY 27, 2011) – A Miami-based patient recruiter, Vicente Guerra-Nistal, has pled guilty to one count of conspiracy to commit health care fraud before U.S. District Court Judge Joan A. Lenard.

Guerra was part of a 20-member team that scammed Medicare out of more than $25 million. The company for which Guerra worked, ABC Home Health, provided home health services and physical therapy, but the company billed for medically unnecessary services or for services that were never provided. Two physicians, Jose Nunez, M.D. and Francisco Gonzalez, M.D. were also charged in the original February 2011 indictment for prescribing the services.

For his part in the scheme, Guerra recruited participation of Medicare beneficiaries by paying kickbacks and bribes for use of Medicare billing information. As a result of Guerra’s actions, Medicare was billed $194,000. Guerra said he knew that the patients didn’t qualify for the services and that patient records had been altered in order to appear as though they did qualify.

Photobucket WHITTIER, CALIFORNIA – Clinical psychologist and co-founder of World Legion of Power bodybuilding organization Arnold P. Nerenberg, 69, was charged with seven counts of mail fraud in connection with workers’ compensation claims made to the U.S. Postal Service. Also charged with two counts of mail fraud and two counts of making false statements to obtain workers’ compensation were two co-conspirators and ex-postal workers Lois L. Washington, 47, from Inglewood and Cetric T. Fletcher, 51, from Long Beach.

Allegations contained in the indictment include that from June 2000 to April 2008, reimbursement for medical expenses arising from undiagnosed psychological conditions were claimed using fraudulent paperwork. The doctor also billed for treatment sessions performed while he was out of the country. An undercover Homeland Security Investigator posed as a patient and Nerenberg’s paperwork secured disability pay from the U.S. Department of Labor for the patient’s fear of dogs.

In total, Nerenberg billed the Postal Service for approximately $1 million in medical fees and received almost $500,000, as court documents state. Fletcher allegedly received over $200,000 and Washington allegedly received $145,000.

Photobucket BROOKLYN, NEW YORK – A New York therapist pled guilty to five counts of Medicare fraud for submitting false claims for physical therapy services that were either unnecessary or never performed. The Justice Department indicted Aleksandr Kharkover on charges with billing Medicare for $11.9 million in services from January 2005 to July 2010; received $7.3 million in Medicare reimbursements.

The Wall Street Journal played a part in the investigation stemming from a December 2010 profile it ran on Kharkover after mining the Medicare claims database. The Journal suspected financial abuse after discovery that Kharkover billed far more than the norm. Another allegation states that he billed for services performed during the time period in which he was actually away on vacation. Click here to read the December 2010 WSJ article.

According to Mr. Kharkover’s lawyer, there was no plea deal; his client simply “pled guilty to all charges listed in the indictment,” according to the Journal.