For their individual roles in a plan to cheat Medicare by filing over $31 million in claims for pricey durable medical equipment (DME) that Medicare patients did not want or need and that was obtained through the payment of bribes, two Florida doctors received prison sentences.
Miami resident Dean Zusmer was given an eight-year prison term and ordered to pay $1,404,200.97 in restitution. Dr. Lawrence Alexander, a Miami resident, received a prison term of two years and nine months. A later hearing will decide on restitution.
Zusmer, a chiropractor, allegedly plotted with others to steal millions of dollars from Medicare, according to court filings. One of the four DME businesses owned by Zusmer billed Medicare more than $31 million for medically unnecessary DME, of which more than $15 million was reimbursed.
The tweet below confirms the news:
MEDICARE FRAUD: Two Miami healthcare providers were sentenced Thursday for their roles in a $31 million Medicare fraud scheme, prosecutors say. https://t.co/ddGX2eUlwv
— WPLG Local 10 News (@WPLGLocal10) April 20, 2023
By paying bribes to marketers who utilized international call centers to attract patients and telemedicine businesses to obtain prescriptions for superfluous braces for these patients, Zusmer and his accomplices—among them, Jeremy Waxman—acquired patient referrals and had doctors sign orders.
Alexander, an orthopedic surgeon who co-owned a DME business with Waxman, disguised his and Waxman’s involvement in the plan by renaming the DME business under the name of a member of Alexander’s family.
After a trial, Zusmer was found guilty in January 2023 of several charges of health care fraud as well as making a false statement on medical issues. Alexander was also found guilty of the same charge. For his involvement in the conspiracy, Waxman had previously received a prison term of more than 15 years.
The announcement was made by the Criminal Division of the Justice Department’s Assistant Attorney General Kenneth A. Polite, Jr., the Criminal Investigative Division of the FBI Assistant Director Luis Quesada, and the Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Deputy Inspector General for Investigations Christian J. Schrank.
The situation was looked into by the FBI and HHS-OIG.
The case was prosecuted by trial attorneys Keith Clouser, Meredith Hough, Jamie de Boer, Patrick Queenan, and Catherine Wagner of the Criminal Division’s Fraud Section.
The Criminal Division’s fight against healthcare fraud is coordinated by the Fraud Section through the Health Care Fraud Strike Force Program. This operation, which consists of 15 strike groups working in 25 federal districts since March 2007, has filed charges against more than 5,000 defendants, who have together billed public health insurance programs and commercial insurers for more than $24 billion.
Additionally, the Centers for Medicare & Medicaid Services are taking action to hold providers accountable for their involvement in healthcare fraud schemes in collaboration with the Office of the Inspector General for the Department of Health and Human Services.
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