Medicare Billed for Phony Surgeries in New York Health Care Fraud Scheme

Whistleblowers play a vital role in putting an end to Medicare fraud schemes like the one in New York for which a Brooklyn board-certified colorectal surgeon was recently sentenced to prison. Medicare fraud costs everyone money. Taxpayers foot the bill for the Medicare programs that are cheated in health care fraud scams.

Patients Complain When Colorectal Surgeon Bills Medicare for Surgeries Never Performed

Dr. Boris Sachakov, 43, owned and operated a medical clinic called Colon and Rectal Care of New York P.C. Between January 2008 and January 2010, Sachakov defrauded Medicare as well as private insurers by billing for medical procedures — including surgeries — that the doctor simply had not performed. The fraud was uncovered when Dr. Sachakov’s patients began to complain to their private insurance companies that they had never received the surgeries the doctor claimed to have done.

At trial, medical records from Sachakov’s office were introduced. The records, which included letters to patients’ referring doctors, did not support Sachakov’s billings to Medicare or the private insurance companies. When two private insurers confronted Sachakov, the doctor mailed letters to his patients asking them to lie for him about the phony surgeries. In total, Sachakov was responsible for submitting over $22.6 million in fraudulent claims to Medicare and private insurers. The doctor collected over $9 million on those phony claims, the Department of Justice reports.

A jury found Sachakov guilty in June 2012 on five counts of health care false statements and one count of health care fraud. U.S. District Judge Jack Weinstein sentenced Sachakov in December to a prison term and three years of supervised release. Sachakov was also ordered to pay forfeiture of $1,103,069 and to make restitution of $1,103,069 to Medicare and the private insurers.

Whistleblowers Help Fight Medicare Fraud

Patients reported the health care fraud scheme at Colon and Rectal Care of New York P.C. But Medicare fraud is often uncovered when an insider comes forward as a whistleblower to bring a False Claims Act lawsuit. The qui tam provisions of the federal False Claims Act allow individuals to file suit on the government’s behalf and to receive part of any amount received in settlement or in a jury award.

Understanding your legal rights under the False Claims Act is crucial. Waters & Kraus’ qui tam attorneys can help. Send us an email or call our whistleblower lawyers at 800.226.9880 to learn more about our law firm and how we can assist.

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