Two Miami-Dade doctors sent to prison after convictions in $31 million Medicare fraud trial [Miami Herald]

A federal judge Thursday sentenced chiropractor Dean Zusmer to eight years in prison and orthopedic surgeon Lawrence Alexander to about three years, the finale to their convictions for participating in a network of medical equipment companies that submitted more than $31 million of false bills to Medicare for unnecessary orthotic braces.

Zusmer, 53, got a harsher sentence from U.S. District Judge K. Michael Moore because a Miami federal jury found him guilty of committing healthcare fraud by filing bogus claims through his own durable medical equipment company. Moore also found that Zusmer lied on the witness stand when he testified at trial and boosted his sentence for obstructing justice.

In addtion, Zusmer was ordered to repay $1.4 million to Medicare that were his profits from the illicit billing scheme.

Alexander, 45, received far less punishment from Moore because the jury only found him guilty of making a false statement about his DME business on a Medicare enrollment application — not of committing actual healthcare fraud. The issue of how much money Alexander might have to repay the taxpayer-funded health insurance program must still be resolved, court records show.

Both doctors, who were detained by the judge immediately after their trial convictions in January, plan to appeal, according to Alexander’s lawyers, Jose Quinon and Frank Quintero, and Zusmer’s attorney, Barry Wax.

Alexander’s lawyers said that while they respect the jury’s verdict, they contend there was “insufficient evidence” to convict their client.

Quintero pointed out that Alexander was convicted of signing a falsified Medicare form for his DME company that dealt with its hours of operation — not claims for orthotic braces. “The false statement [charge] had nothing to do with billing Medicare,” he said, noting that will be a key issue on appeal.

The doctors collaborated with Miami-Dade businessman Jeremy Waxman and other people in a scheme revolving around four durable medical equipment companies in Florida, according to an indictment. Those companies, located in Miami-Dade, Broward and Pinellas counties, were partly owned by Waxman, who pleaded guilty, was sentenced to 15 year and testified against the doctors at trial.

Alexander, a Miami-Dade spinal surgeon, obtained his medical degree from New York University, did post-graduate work at University of North Carolina at Chapel Hill and also served for 10 years in the U.S. Navy Reserves. Alexander had an ownership interest in one of Waxman’s DME companies and made about $250,000 from his investment, according to trial evidence.

Zusmer, who lived in Miami Beach and had a chiropractor practice in Miami Lakes, also shared an interest with Waxman in one of the DME firms. Zusmer made about $1.4 million from his investment, evidence showed.

Justice Department lawyers said the network of DME companies depended on marketing firms that recruited Medicare patients and received kickbacks in an elaborate telemedicine racket. Medicare, the insurance program for senior citizens and indigent, paid out a total of $15 million based on the four companies’ fraudulent claims for orthotic braces, jurors found after a two-week trial.

The DME scheme was reminiscent of Medicare fraud in South Florida in the 1990s before it spread to other areas of medicine, such as physical therapy, diabetic injections and mental health services.

According to trial evidence, Zusmer collaborated with Waxman through their joint ownership and management of Active Assist DME in Pinellas County.

Justice Department lawyers said Zusmer and Waxman obtained patient referrals and doctors’ signed orders by paying kickbacks to marketing firms that used overseas call centers to solicit patients. They also paid kickbacks to telemedicine companies that procured prescriptions from doctors for the unnecessary orthotic braces. The braces were purportedly needed for knee, back, shoulder and wrist injuries, according to federal agents with the FBI and Health and Human Services Office of Inspector General.

Zusmer was convicted of conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to pay illegal healthcare kickbacks, paying illegal healthcare kickbacks, and false statements relating to healthcare matters. But he was also found not guilty of two anti-kickback counts.

One of his defense attorneys, Barry Wax, said the trial pivoted on the testimony of the government’s main witness: Waxman.

“We are extremely surprised and disappointed with the jury’s verdict,” Wax told the Miami Herald Tuesday. “This case had a significant amount of reasonable doubt, primarily based on the testimony of one of the co-defendants, Jeremy Waxman. We expected a much different verdict.”

Trial evidence also showed that Alexander concealed both his and Waxman’s roles in the scheme by putting their DME company in the name of one of Alexander’s family members, Justice Department lawyers said. The company was called Silent Hill Bracing and Orthopedic Supplies, located in Bay Harbor Islands. Court records show that Alexander’s mother appears as the firm’s owner on the 2019 Medicare Application Enrollment form, which is signed by her in 2019.

Alexander, who had his medical practice in Hialeah, was convicted of making a false statement relating to healthcare matters. But he was acquitted of the more serious charge of conspiring to defraud Medicare by paying illegal healthcare kickbacks.

Alexander’s defense attorneys, Jose Quinon and Frank Quintero, questioned the jury’s sole guilty verdict and plan to appeal.

“There was no evidence to convict Dr. Alexander,” Quintero said.

He said Alexander was not involved in running the DME company, Silent Hill; did not fill out the Medicare Enrollment Application and that his mother’s signature was forged on the form, which provides details about the company’s services, including a change in its hours of operation. He added that Waxman managed Silent Hill, not Alexander.

During his testimony at trial, Waxman said that he and his staff filled out the Medicare Enrollment Application for Silent Hill and as a matter of routine would have shown it to Alexander. But he also said he couldn’t remember if he did so in this instance.

Waxman testified that the initial signature on the form belonged to Alexander’s mother. But he further testified that the second signature on the form also belonged to Alexander’s mother, alongside her fingerprints. Then he admitted under oath that the two signatures didn’t match.

Alexander’s defense attorney, Quinon, accused him of “faking signatures” on the form, in an effort to raise doubts that it was his client’s handwriting.

Waxman, who pleaded guilty to healthcare fraud conspiracy and wire fraud, was sentenced before trial to more than 15 years in prison. But he is expected to receive a reduction for his cooperation as a witness against Alexander and Zusmer.

Ronald Davidovic, an owner of a Broward marketing company, also pleaded guilty to healthcare fraud conspiracy. He was sentenced to almost six years.

Umut Vardar, a managing partner of Davidovic’s marketing company, is a resident of Turkey. He is at large, court records show.

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