October 20, 09

NEWS / Detroit-Area Physical Therapist Pleads Guilty in Medicare Fraud Scheme

Solomon Nathaniel of Sterling Heights, Mich., pleaded guilty today in U.S. District Court in Detroit to participating in a conspiracy to defraud the Medicare program.

In his guilty plea today, Nathaniel, 51, a licensed physical therapist, admitted that he worked as a contract therapist for Suresh Chand, a co-conspirator who pleaded guilty to similar charges on Sept. 29, 2009. Chand owned and controlled several companies operating in the Detroit area that purported to provide physical and occupational therapy services to Medicare beneficiaries. Nathaniel admitted that he, Chand and others created fictitious therapy files appearing to document physical and occupational therapy services provided to Medicare beneficiaries, when in fact no such services had been provided. According to court documents, the fictitious services reflected in the files were billed to Medicare through sham Medicare providers controlled by Chand and other co-conspirators.

According to plea documents, Chand acknowledged that in order to create the fictitious therapy files, he and his co-conspirators paid cash kickbacks and other inducements to Medicare beneficiaries in exchange for the beneficiaries’ Medicare numbers and signatures on documents falsely indicating that they had received physical or occupational therapy. Nathaniel admitted that he was among the licensed physical or occupational therapists from whom Chand obtained signatures on fictitious "progress notes" and other documents falsely indicating that the therapists had provided services to the Medicare beneficiaries.

Nathaniel admitted that during the course of the scheme , he signed approximately 1,250 fictitious physical therapy files indicating that he had provided physical therapy services to Medicare beneficiaries, when in fact he had not. Nathanial also admitted that between approximately December 2003 and July 2006, he falsified physical therapy files that supported claims to the Medicare program totaling approximately $6,250,000. Medicare actually paid approximately $2,875,000 on those claims. Nathaniel acknowledged that during his participation in the scheme, he was aware that Medicare was being billed for services he falsely represented he had performed.

The case is being prosecuted by Trial Attorneys John K. Neal and Gejaa T. Gobena of the Criminal Division’s Fraud Section and by Special Assistant U.S. Attorney Thomas W. Beimers of the Eastern District of Michigan. The FBI and the HHS Office of Inspector General (HHS-OIG) conducted the investigation.

The case was brought as part of the Medicare Fraud Strike Force, supervised by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and U.S. Attorney Terrence Berg of the Eastern District of Michigan. Since their inception in March 2007, Strike Force operations in four districts have resulted in indictments of 310 individuals who collectively have falsely billed the Medicare program for more than $680 million. In addition, HHS’ Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

http://www.usdoj.gov/opa/pr/2009/October/09-crm-1123.html

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