Four individuals, including two doctors, a pharmacist who had previously lost his license and been excluded from participating in the Medicaid and Medicare programs and a pharmacy owner have been charged for their participation in schemes in which the Medicare and Medicaid programs were fraudulently billed more than $17 million. A fifth individual, a registered nurse, pleaded guilty to possession of fentanyl that he stole from his employer, a hospital on Long Island. The charges filed in federal court in Brooklyn and Central Islip are part of a coordinated health care fraud enforcement action across seven federal districts in the northeast United States, led by the Medicare Fraud Strike Force, that resulted in criminal charges against 48 defendants for their alleged participation in health care fraud schemes involving more than $800 million in false and fraudulent claims.
The charges were announced by Richard P. Donoghue, United States Attorney for the Eastern District of New York; Brian A. Benczkowski, Assistant Attorney General of the Justice Department’s Criminal Division; William F. Sweeney, Jr., Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI); Ray Donovan, Special Agent-in-Charge, Drug Enforcement Administration, New York Division (DEA); and Scott J. Lampert, Special Agent-in-Charge, U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations, New York Regional Office (HHS-OIG).
“As alleged, defendants charged in the Eastern District of New York used fraud and deceit to steal Medicaid and Medicare funds meant to protect our elderly and most vulnerable residents,” stated United States Attorney Donoghue. “As this initiative demonstrates, we will continue to bring to justice those that defraud our nation’s health care programs.”
“Physicians and other medical professionals who fraudulently bill our federal health care programs are stealing from taxpayers and robbing vulnerable patients of necessary medical care. The medical professionals and others engaging in criminal behavior by peddling opioids for profit continue to fuel our nation’s drug crisis,” stated Assistant Attorney General Benczkowski. “The Department of Justice will continue to use every tool at our disposal, including data analytics and traditional law enforcement techniques, to investigate, prosecute, and punish this reprehensible behavior and protect federal programs from abuse.”
“As alleged today, the defendants took advantage of programs established for the benefit of those less fortunate, allowing themselves to profit by defrauding the government of public money. May today’s charges remind those who tear holes in the government safety net that they will face the error of their ways,” stated FBI Assistant Director-in-Charge Sweeney.
“There is no difference between the diversion of prescription medication to street drug trafficking,” stated DEA Special Agent-in-Charge Donovan. “Allegedly, Kevin McMahon abused his position as a registered nurse diverting fentanyl for his personal use. The DEA and our law enforcement partners’ goal is to keep our citizens safe by guarding against health care fraud and the illegal diversion of prescription medication.”
“Healthcare fraud is not a victimless crime—with unscrupulous providers preying on Medicare beneficiaries and taxpayers alike. Especially insidious is the fraud committed by healthcare professionals who are trusted to provide needed, quality services to patients,” stated HHS-OIG Special Agent-in-Charge Lampert. “With our law enforcement partners, our agency will continue to thoroughly investigate medical providers and others involved in healthcare fraud.”
The schemes charged in the Eastern District of New York, detailed in two indictments, one complaint and one criminal information, are as follows:
United States v. Anna Steiner: The superseding indictment charges Anna Steiner, a licensed anesthesiologist, was charged for her role in an alleged $17.4 million health care fraud scheme related to the payment of kickbacks in return for prescribing and ordering durable medical equipment, prescription drugs and diagnostic tests that were neither medically necessary nor resulted from an examination by or consultation with a physician. Steiner was charged with conspiracy to commit health care fraud and health care fraud in a superseding indictment filed on September 19, 2019. The case is being prosecuted by Department of Justice Trial Attorney Andrew Estes of the Criminal Division’s Fraud Section.
United States v. Denny Martin: Denny Martin, a licensed neurologist who was the sole owner of AM PM Medical P.C., was charged with health care fraud for his role in a scheme to falsely bill Medicare for treatments that were never performed. Between 2015 and 2019, AM PM Medical P.C. submitted more than 3,000 in fraudulent claims for home health and podiatry visits to the Medicare program. Martin was arrested this morning and arraigned before United States Magistrate Judge Robert M. Levy at the federal courthouse in Brooklyn. The case is being prosecuted by Assistant United States Attorney William P. Campos of the U.S. Attorney’s Office for the Eastern District of New York.
United States v. Andrew Barrett and Phyllis Pincus: Andrew Barrett, a pharmacist who had been previously convicted of healthcare fraud in 2016 and excluded from the Medicare and Medicaid programs, and Phyllis Pincus, the sole proprietor of two New York-based pharmacies, were indicted on September 24, 2019 for health care fraud, false claims and conspiracy to defraud the United States by submitting fraudulent claims to Medicare and Medicaid for medications that were not actually dispensed to patients. The case is being prosecuted by Assistant United States Attorney William P. Campos of the U.S. Attorney’s Office for the Eastern District of New York.
United States v. Kevin McMahon: Kevin McMahon, a registered nurse, was charged with possession of fentanyl, a Schedule II controlled substance. The charge stem from McMahon’s theft of a synthetic opioid fentanyl while employed at Nassau University Medical Center. McMahon was arraigned and pleaded guilty to a criminal information at the federal courthouse in Central Islip on September 25, 2019. The case is being prosecuted by Assistant United States Attorney Erin E. Argo of the U.S. Attorney’s Office for the Eastern District of New York.
The Eastern District of New York’s Healthcare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Eastern District of New York and the Criminal Division’s Fraud Section, was created in 2009 and since its inception has charged well over 100 defendants, many of which were medical professionals.
The charges are allegations, and the defendants are presumed innocent unless and until proven guilty.
The Defendants:
DR. ANNA STEINER
Age: 63
Valatie, New York
E.D.N.Y. Docket No. 19-CR-295 (ILG)
DR. DENNY MARTIN
Age: 46
New York, New York
E.D.N.Y. Docket No. 19-MJ-847
ANDREW BARRETT
Age: 60
New City, New YorkE.D.N.Y. Docket No. 19-CR-436 (RJD)
PHYLLIS PINCUS
Age: 58
New City, New York
E.D.N.Y. Docket No. 19-CR-0436 (RJD)
KEVIN McMAHON
Age: 31
Seaford, New York
E.D.N.Y. Docket No. 19-CR-422 (ARL)
Earlier today, in federal court in Brooklyn, Anna Steiner, an anesthesiologist, was arraigned on an indictment charging her with conspiracy to commit health care fraud for her alleged role in a telemedicine scheme to submit fraudulent claims to Medicare, Medicare Part D plans and private insurance plans. Steiner was previously arrested on a complaint in April 2019, and was arraigned this morning before United States District Judge I. Leo Glasser.
Richard P. Donoghue, United States Attorney for the Eastern District of New York, Brian A. Benczkowski, Assistant Attorney General of the Justice Department’s Criminal Division, William F. Sweeney, Jr., Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI), and Scott J. Lampert, Special Agent-in-Charge, U.S. Department of Health and Human Services Office of Inspector General, Office of Investigations (HHS OIG), announced the indictment.
“As alleged, Steiner claimed to provide telemedicine services to patients, but in reality, her telecare was a fiction and the claims submitted to Medicare unnecessary and fraudulent,” said United States Attorney Donoghue. “This Office and our law enforcement partners will continue vigorously investigating and prosecuting health care professionals who seek personal enrichment by stealing from a taxpayer-funded program.”
“Fraud against both public and private health care plans is not a victimless crime—the cost of doing business is ultimately transferred to members and taxpayers alike,” said FBI Assistant Director-in-Charge Sweeney. “More importantly, prescribing medication and medical equipment to patients for the sole purpose of turning a profit is not only unethical, it’s dangerous business. Today’s indictment is a victory for the FBI and our partners, the public at large, and those in the medical community who operate within the confines of the law.”
“When physicians boost their profits by billing federal healthcare programs for medically unnecessary services, the Office of Inspector General, along with our law enforcement partners, will thoroughly investigate such deceptive schemes,” said HHS-OIG Special Agent-in-Charge Lampert.
As alleged in the indictment, telemedicine is a service connecting medical providers with individuals who receive healthcare benefits through real-time, interactive audio and video telecommunications. Beginning in approximately January 2015, Steiner and other medical providers purported to practice telemedicine pursuant to agreements with an entity identified in the indictment as “Company-1” and others, in exchange for kickbacks paid for each purported telemedicine encounter with a beneficiary. In fact, Steiner and other medical providers signed numerous prescriptions and order forms for durable medical equipment (DME) and drugs for beneficiaries, when the DME and drugs were not medically necessary and not the result of an actual doctor-patient relationship or examination. Suppliers of DME and pharmacies then submitted to Medicare more than $7 million in claims, on behalf of more than 3,000 beneficiaries, including residents of the Eastern District of New York. Medicare paid more than $3 million on these claims.
The charge in the indictment is an allegation, and the defendant is presumed innocent unless and until proven guilty.
The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision by the U.S. Attorney’s Office for the Eastern District of New York and the Criminal Division’s Fraud Section. Trial Attorney Andrew Estes of the Fraud Section is in charge of the prosecution.
Description: The fiscal year of the data file obtained from the AOUSC
Format: YYYY
Description: The code of the federal judicial circuit where the case was located
Format: A2
Description: The code of the federal judicial district where the case was located
Format: A2
Description: The code of the district office where the case was located
Format: A2
Description: Docket number assigned by the district to the case
Format: A7
Description: A unique number assigned to each defendant in a case which cannot be modified by the court
Format: A3
Description: A unique number assigned to each defendant in a case which can be modified by the court
Format: A3
Description: A sequential number indicating whether a case is an original proceeding or a reopen
Format: N5
Description: Case type associated with the current defendant record
Format: A2
Description: Case type associated with a magistrate case if the current case was merged from a magistrate case
Format: A2
Description: A concatenation of district, office, docket number, case type, defendant number, and reopen sequence number
Format: A18
Description: A concatenation of district, office, docket number, case type, and reopen sequence number
Format: A15
Description: The docket number originally given to a case assigned to a magistrate judge and subsequently merged into a criminal case
Format: A7
Description: A unique number assigned to each defendant in a magistrate case
Format: A3
Description: The status of the defendant as assigned by the AOUSC
Format: A2
Description: A code indicating the fugitive status of a defendant
Format: A1
Description: The date upon which a defendant became a fugitive
Format: YYYYMMDD
Description: The date upon which a fugitive defendant was taken into custody
Format: YYYYMMDD
Description: The date when a case was first docketed in the district court
Format: YYYYMMDD
Description: The date upon which proceedings in a case commenced on charges pending in the district court where the defendant appeared, or the date of the defendant’s felony-waiver of indictment
Format: YYYYMMDD
Description: A code used to identify the nature of the proceeding
Format: N2
Description: The date when a defendant first appeared before a judicial officer in the district court where a charge was pending
Format: YYYYMMDD
Description: A code indicating the event by which a defendant appeared before a judicial officer in the district court where a charge was pending
Format: A2
Description: A code indicating the type of legal counsel assigned to a defendant
Format: N2
Description: The title and section of the U.S. Code applicable to the offense committed which carried the highest severity
Format: A20
Description: A code indicating the level of offense associated with FTITLE1
Format: N2
Description: The four digit AO offense code associated with FTITLE1
Format: A4
Description: The four digit D2 offense code associated with FTITLE1
Format: A4
Description: A code indicating the severity associated with FTITLE1
Format: A3
Description: The title and section of the U.S. Code applicable to the offense committed which carried the second highest severity
Format: A20
Description: A code indicating the level of offense associated with FTITLE2
Format: N2
Description: The four digit AO offense code associated with FTITLE2
Format: A4
Description: The four digit D2 offense code associated with FTITLE2
Format: A4
Description: A code indicating the severity associated with FTITLE2
Format: A3
Description: The title and section of the U.S. Code applicable to the offense committed which carried the third highest severity
Format: A20
Description: A code indicating the level of offense associated with FTITLE3
Format: N2
Description: The four digit AO offense code associated with FTITLE3
Format: A4
Description: The four digit D2 offense code associated with FTITLE3
Format: A4
Description: A code indicating the severity associated with FTITLE3
Format: A3
Description: The FIPS code used to indicate the county or parish where an offense was committed
Format: A5
Description: The date of the last action taken on the record
Format: YYYYMMDD
Description: The date upon which judicial proceedings before the court concluded
Format: YYYYMMDD
Description: The date upon which the final sentence is recorded on the docket
Format: YYYYMMDD
Description: The date upon which the case was closed
Format: YYYYMMDD
Description: The total fine imposed at sentencing for all offenses of which the defendant was convicted and a fine was imposed
Format: N8
Description: A count of defendants filed including inter-district transfers
Format: N1
Description: A count of defendants filed excluding inter-district transfers
Format: N1
Description: A count of original proceedings commenced
Format: N1
Description: A count of defendants filed whose proceedings commenced by reopen, remand, appeal, or retrial
Format: N1
Description: A count of defendants terminated including interdistrict transfers
Format: N1
Description: A count of defendants terminated excluding interdistrict transfers
Format: N1
Description: A count of original proceedings terminated
Format: N1
Description: A count of defendants terminated whose proceedings commenced by reopen, remand, appeal, or retrial
Format: N1
Description: A count of defendants pending as of the last day of the period including long term fugitives
Format: N1
Description: A count of defendants pending as of the last day of the period excluding long term fugitives
Format: N1
Description: The source from which the data were loaded into the AOUSC’s NewSTATS database
Format: A10
Description: A sequential number indicating the iteration of the defendant record
Format: N2
Description: The date the record was loaded into the AOUSC’s NewSTATS database
Format: YYYYMMDD
Description: Statistical year ID label on data file obtained from the AOUSC which represents termination year
Description: The fiscal year of the data file obtained from the AOUSC
Format: YYYY
Description: The code of the federal judicial circuit where the case was located
Format: A2
Description: The code of the federal judicial district where the case was located
Format: A2
Description: The code of the district office where the case was located
Format: A2
Description: Docket number assigned by the district to the case
Format: A7
Description: A unique number assigned to each defendant in a case which cannot be modified by the court
Format: A3
Description: A unique number assigned to each defendant in a case which can be modified by the court
Format: A3
Description: A sequential number indicating whether a case is an original proceeding or a reopen
Format: N5
Description: Case type associated with the current defendant record
Format: A2
Description: Case type associated with a magistrate case if the current case was merged from a magistrate case
Format: A2
Description: A concatenation of district, office, docket number, case type, defendant number, and reopen sequence number
Format: A18
Description: A concatenation of district, office, docket number, case type, and reopen sequence number
Format: A15
Description: The docket number originally given to a case assigned to a magistrate judge and subsequently merged into a criminal case
Format: A7
Description: A unique number assigned to each defendant in a magistrate case
Format: A3
Description: The status of the defendant as assigned by the AOUSC
Format: A2
Description: A code indicating the fugitive status of a defendant
Format: A1
Description: The date upon which a defendant became a fugitive
Format: YYYYMMDD
Description: The date upon which a fugitive defendant was taken into custody
Format: YYYYMMDD
Description: The date when a case was first docketed in the district court
Format: YYYYMMDD
Description: The date upon which proceedings in a case commenced on charges pending in the district court where the defendant appeared, or the date of the defendant’s felony-waiver of indictment
Format: YYYYMMDD
Description: A code used to identify the nature of the proceeding
Format: N2
Description: The date when a defendant first appeared before a judicial officer in the district court where a charge was pending
Format: YYYYMMDD
Description: A code indicating the event by which a defendant appeared before a judicial officer in the district court where a charge was pending
Format: A2
Description: A code indicating the type of legal counsel assigned to a defendant
Format: N2
Description: The title and section of the U.S. Code applicable to the offense committed which carried the highest severity
Format: A20
Description: A code indicating the level of offense associated with FTITLE1
Format: N2
Description: The four digit AO offense code associated with FTITLE1
Format: A4
Description: The four digit D2 offense code associated with FTITLE1
Format: A4
Description: A code indicating the severity associated with FTITLE1
Format: A3
Description: The title and section of the U.S. Code applicable to the offense committed which carried the second highest severity
Format: A20
Description: A code indicating the level of offense associated with FTITLE2
Format: N2
Description: The four digit AO offense code associated with FTITLE2
Format: A4
Description: The four digit D2 offense code associated with FTITLE2
Format: A4
Description: A code indicating the severity associated with FTITLE2
Format: A3
Description: The title and section of the U.S. Code applicable to the offense committed which carried the third highest severity
Format: A20
Description: A code indicating the level of offense associated with FTITLE3
Format: N2
Description: The four digit AO offense code associated with FTITLE3
Format: A4
Description: The four digit D2 offense code associated with FTITLE3
Format: A4
Description: A code indicating the severity associated with FTITLE3
Format: A3
Description: The FIPS code used to indicate the county or parish where an offense was committed
Format: A5
Description: The date of the last action taken on the record
Format: YYYYMMDD
Description: The date upon which judicial proceedings before the court concluded
Format: YYYYMMDD
Description: The date upon which the final sentence is recorded on the docket
Format: YYYYMMDD
Description: The date upon which the case was closed
Format: YYYYMMDD
Description: The total fine imposed at sentencing for all offenses of which the defendant was convicted and a fine was imposed
Format: N8
Description: A count of defendants filed including inter-district transfers
Format: N1
Description: A count of defendants filed excluding inter-district transfers
Format: N1
Description: A count of original proceedings commenced
Format: N1
Description: A count of defendants filed whose proceedings commenced by reopen, remand, appeal, or retrial
Format: N1
Description: A count of defendants terminated including interdistrict transfers
Format: N1
Description: A count of defendants terminated excluding interdistrict transfers
Format: N1
Description: A count of original proceedings terminated
Format: N1
Description: A count of defendants terminated whose proceedings commenced by reopen, remand, appeal, or retrial
Format: N1
Description: A count of defendants pending as of the last day of the period including long term fugitives
Format: N1
Description: A count of defendants pending as of the last day of the period excluding long term fugitives
Format: N1
Description: The source from which the data were loaded into the AOUSC’s NewSTATS database
Format: A10
Description: A sequential number indicating the iteration of the defendant record
Format: N2
Description: The date the record was loaded into the AOUSC’s NewSTATS database
Format: YYYYMMDD
Description: Statistical year ID label on data file obtained from the AOUSC which represents termination year