June 8, 12

NEWS / Co-Owner of Detroit-Area Therapy Company Sentenced to 30 Months for Medicare Fraud Scheme

WASHINGTON – The co-owner of a Detroit-area physical and occupational therapy company was sentenced today to 30 months in prison for his leading role in a more than $1.9 million Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Victor Jayasundera, 59, was sentenced by U.S. District Judge Avern Cohn in the Eastern District of Michigan. In addition to his prison term, Jayasundera was sentenced to three years of supervised release and was ordered to pay $855,484 in restitution, joint and several with his co-defendants.

Jayasundera pleaded guilty on Jan. 18, 2012, to the charges against him in a superseding indictment: one count of conspiracy to commit health care fraud and six counts of health care fraud. According to the superseding indictment, Jayausundera co-owned a company known as Jos Campau Physical Therapy with co-defendant Fatima Hassan. Jos Campau Physical Therapy did not have a Medicare provider number and was not entitled to bill Medicare for therapy services.

According to the superseding indictment and evidence presented at the trial of a co-defendant, Jos Campau paid kickbacks to recruiters who obtained Medicare beneficiary information and signatures needed to create fictitious physical and occupational therapy files. The Medicare beneficiaries pre-signed forms and visit sheets that were later falsified to indicate that they received therapy services that were never provided.

Jayasundera, a physical therapist, falsified patient evaluation forms and fictitious patient notes for physical therapy services that were never rendered. Jayasundera and his co-owner also hired and paid an occupational therapist and an uncertified occupational therapy assistant to falsify medical files. The occupational therapist created patient evaluation forms for beneficiaries whom she had never met, seen or evaluated. The uncertified therapy assistant fabricated and signed patient notes for occupational therapy visits. The uncertified therapy assistant did not provide the services reflected in the fictitious patient notes.

Jayasundera and his co-owner sold the fictitious physical and occupational therapy files to multiple fraudulent therapy companies that had obtained Medicare provider numbers. Those companies billed the fictitious files created by Jos Campau Physical Therapy to Medicare and paid kickbacks to Jos Campau Physical Therapy based on these billings. Jayasundera and his co-owner split the profits from the sale of the falsified files.

Between approximately June 2005 and May 2007, the false files created and sold by Jos Campau Physical Therapy resulted in the submission of approximately $1.9 million in fraudulent claims to the Medicare program for physical and occupational therapy services that were never rendered.

Jayasundera’s co-owner, Fatima Hassan, pleaded guilty on Aug. 25, 2011, for her role in the scheme, and on May 17, 2012, was sentenced to 48 months in prison. Carol Gant, the occupational therapist, and Vanessa Dowell, the uncertified occupational therapy assistant, also pleaded guilty in 2011. Tariq Mahmud, the owner of a Medicare provider company that bought and billed Jos Campau Physical Therapy’s fake files, was convicted at trial on Feb. 2, 2012, for his role in the scheme and is scheduled to be sentenced on July 19, 2012.

Today’s sentence was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

This case was prosecuted by Trial Attorney Catherine K. Dick and Assistant Chief Benjamin D. Singer of the Criminal Division’s Fraud Section. It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,330 individuals who collectively have falsely billed the Medicare program for more than $4 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

http://www.justice.gov/opa/pr/2012/June/12-crm-726.html