March 5, 2014 — Fraudulent Medicaid scams fuel the increasing costs of health care and imperil our country’s health care system. When health care providers run afoul of the federal False Claims Act by making false Medicaid claims, insider employees are often the first to know. The qui tam provisions in the False Claims Act allow tipsters to file a lawsuit for the government and receive a significant share of the government’s recovery as a reward for doing the right thing.
Patient Recruiter Paid Kickbacks to Medicaid Patients at Brooklyn Clinic that Billed the Government for Unnecessary Health Care Services
A New York man has pleaded guilty to charges involving false claims to Medicaid for ambulette services and false claims to Medicare and Medicaid for other purported health care treatment. Pavel Zborovskiy pleaded guilty to receiving illegal kickbacks related to a health care fraud operation that billed the government $13 million in phony charges.
Zborovskiy ran an ambulette service, transporting New York Medicaid patients to and from health care providers when transportation was medically required. Between 2010 and 2012, Zborovskiy recruited the Medicaid beneficiaries he transported to agree to be seen for treatment at Cropsey Medical Care PLLC, a Brooklyn clinic. Zborovskiy would bill New York’s Medicaid program for the transportation services.
When the Medicaid beneficiaries were delivered to Cropsey Medical, they were paid kickbacks to take part in the scam. At Cropsey Medical, the beneficiaries were given tests, therapy and other services that were not medically required. Cropsey Medical then billed Medicare and Medicaid for the unnecessary services.
The U.S. Department of Justice maintains that between November 2009 and October 2012, Cropsey Medical filed over $13 million in false claims to Medicaid and Medicare.
Health Care Insiders Collaborate to End False Claims Act Violations
Health care workers frequently root out health care fraud long before federal investigators learn about it. Yet tipsters may be unsure about how to file a whistleblower claim. Waters & Kraus can help. Contact us by email or call our experienced whistleblower lawyers at 855.784.0268 to learn more about collaborating to fight health care fraud.