In key enforcement actions from last week, a married couple who together owned several diagnostic testing facilities will see time behind bars for their participation in an $18 million healthcare fraud scheme. The two were each sentenced on Dec. 1 to three years in prison, the U.S. Department of Justice (DOJ) said in a statement.
According to the DOJ, the pair—Tea Kaganovich, 50, and Ramazi Mitaishvili, 62—paid more than $18 million in kickbacks in exchange for beneficiary referrals to their Brooklyn-based testing facilities for “diagnostic testing and other purported medical services.”
In addition, in order to disguise the kickbacks as “legitimate business expenses” in tax form submissions to the Internal Revenue Service, Kaganovich and Mitaishvili “under-reported business income and claimed deductions to which they were not entitled,” the DOJ states.1
Other Key Healthcare-Related Actions from Last Week
Nov. 29: The owners and operators of Senior Community Care LLC a/k/a Momentum Med Services, LLC were charged for participating in a complex $2.9 million Medicare fraud scheme involving the marketing of genetic tests via their company. In addition to the conspiracy charges, the two also face 22 counts of wire fraud. Timothy A. Chin, 64, and Lauren M. Sword, 36, allegedly paid or were themselves paid kickbacks and bribes in exchange for Medicare beneficiaries’ information and cheek swabs as well as for referrals of those beneficiaries for genetic testing, regardless of medical necessity. Those referrals caused two labs to bill $2,927,706 to Medicare, of which Medicare paid $861,399.2
Nov. 29: An Illinois OB-GYN pled guilty to misdemeanor vendor fraud for billing her state’s Medicaid program “$58,747.57 for ultrasounds and other medical procedures” she never actually provided, according to the Illinois Attorney General’s Office. As a result, Dr. Monique Brotman, 52, was sentenced to five days of community service, must pay full restitution up front, and faces an exclusion from Medicare and Medicaid programs for at least five years.3