6 Physical Therapists Charged In $20M Health Care Fraud, SDNY Says - Insurance News | InsuranceNewsNet

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October 1, 2021 Top Stories
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6 Physical Therapists Charged In $20M Health Care Fraud, SDNY Says

An Ohio man is going to prison for fraud
Jason E. Adkins, 46, solicited victims from all over the country and world, authorities said.
Rivertowns Daily Voice (NY)
Six physical therapists and a pair of acupuncturists in New York are facing charges for their roles in a $20 million health care fraud scheme during the COVID-19 pandemic.

US Attorney for the Southern District of New York Audrey Strauss announced that nine suspects have been indicted for operating an over $20 million health care fraud scheme at fraudulent medical offices in Manhattan, Brooklyn, and Queens.

It is alleged that as part of the fraud scheme, co-conspirators paid a kickback to some patients who were insured by Medicare and other insurance providers to fraudulently bill them for physical therapy and acupuncture services that were unnecessary or never performed.

Those arrested includes:

* Junyi Liu, age 67, of Great Neck;

* Gleen Anciro, age 50, of Floral Park;

* Noemi Algodon, age 49, of Mineola;

* Mohamed Elmandouh, age 48, of Staten Island;

* Gerard Estrella, age 39, of West Hempstead;

* Ramon Garcia III, age 39, of Merrick;

* Henler Dutu Tahıl, age 38, of East Meadow;

* Hongxing Wang, age 61, of Brooklyn;

* Zihao Chen, age 20, of Queens.

Charges filed against the nine are:

* Conspiring to commit health care fraud;

* Conspiring to violate the Anti-Kickback Statute;

* Conspiring to commit money laundering.

Additionally, Liu was charged with wire fraud for "unlawfully enriching herself and a family member through a COVID-19 unemployment benefit scheme."

It is alleged that between 2018 and 2021, Liu, a licensed acupuncturist, fraudulently billed insurance providers, during which she partnered with Anchor, Algodon, Elmandouh, Estrella, Garcia, and Tahil, licensed physical therapists, and Wang, also a licensed acupuncturist.

Strauss said that the collective made false and fraudulent insurance claims, created false medical documents, and paid kickbacks to some patients in the form of cash and expensive wine.

"As alleged, the defendants perpetrated a multimillion-dollar health care fraud scheme in which they billed Medicare and other insurers for physical therapy and acupuncture services that were either not rendered in the manner purported or not rendered at all," Strauss said.

"Large-scale insurance frauds of the type alleged here impose hidden but very real costs on the public as well as insurers."

If convicted, each faces up to 20 years in prison. No return court date has been announced.

"These allegations describe a greed-fueled scheme that undermined our health care system and the people it serves," Scot Lampert, the Special Agent in Charge of the US Department of Health and Human Services Office of Inspector General said in a statement.

"Health care providers participating in the Medicare program are trusted to furnish medically necessary services and to make beneficiaries collaborators in their care, not conspirators in fraud."

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