Genetic Testing and DME Fraud Crackdown Nets a Dozen South Floridians

Healthcare fraud involving genetic testing and durable medical equipment (DME) have become a focus for federal investigators in recent years and another twelve South Floridians find themselves in the midst of the crackdown.

Earlier this month, Zachary S. Seid, 35, of Boynton Beach and Anthony Cracchiolo, 42 of Parkland were arrested and charged with four counts with conspiracy to commit health care fraud and wire fraud, health care fraud, wire fraud, and receiving kickbacks in violation of the Anti-Kickback Statute.

It is alleged that they paid more than $565,000 in kickbacks to buy fake DME prescriptions, including prescriptions “signed” by doctors who never actually signed or authorized them and didn’t know that their names and identities were being so used. It also is alleged that they received more than $425,000 in kickbacks, reselling some of these prescriptions to DME suppliers, so that those suppliers in turn could fraudulently bill Medicare. Finally, around May and June 2020, the two acquired five of their own fraudulent DME supply companies and used the bogus prescriptions to file more than $11 million in fraudulent Medicare claims, seeking payment to the DME suppliers Seid and Cracchiolo controlled. Those companies are identified as Medical Supplies Corp., Ameri Med Supplies Corp., One Medical Health Supplies Corp., Sun Med Equip Corp., and Sunrise Med Service Group Corp.

Ten Indicted in $67M scheme

In a separate case, ten South Floridians were charged in an indictment that was unsealed late last month in the Southern District of Florida for their alleged roles in a $67 million scheme involving the submission of false claims to Medicare for medically unnecessary genetic tests and DME equipment.

The owners and managers of independent clinical labs and marketing companies were each charged with conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to pay and receive healthcare kickbacks and bribes, paying and receiving kickbacks and bribes, conspiracy to commit money laundering, and money laundering offenses. They are identified as Daniel M. Carver, 35, of Coral Springs; Thomas Dougherty, 39, of Royal Palm Beach; and John Paul Gosney Jr., 39, of Parkland.

Two Hollywood residents, Galina Rozenberg, 39, and Michael Rozenberg, 58, were arrested on Feb. 6 attempting to board a flight to Moscow. They were charged with one count of conspiracy to commit healthcare fraud, healthcare fraud, and conspiracy to commit money laundering. Galina Rozenberg was also charged with additional money laundering offenses.

The other four, Louis Carver, 30, of Delray Beach; Timothy Richardson, 29, of Lantana; Ethan Macier, 22, of Coral Springs; and Jose Goyos, 35, of West Palm Beach were each charged with conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to commit money laundering, and money laundering offenses. Ashley Cigarroa, 29, of North Lauderdale was charged with one count of conspiracy to commit healthcare fraud and committing healthcare fraud.

It’s alleged that between January 2020 and July 2021, those indicted referred Medicare beneficiaries for genetic testing and DME that was not medically necessary. They alleged paid kickbacks and bribes to telemedicine companies in exchange for doctors’ orders and falsified Medicare enrollment forms to hide the real owners and managers of certain labs.

Penalties Can Be Severe

These cases carry heavy penalties and jail time as one South Florida man recently found out. On Feb, 2, Patsy Truglia of Parkland was sentenced to 15 years in federal prison for his role in two consecutive conspiracies to commit healthcare fraud and for making a false statement in a matter involving a healthcare benefit program. He also was ordered to pay $18.3 million to refund those federal healthcare programs as well as an insurance company.

The court also entered a money judgment against Truglia in the amount of $10,117,738 and ordered him to forfeit numerous assets, including $9,308,235.86 seized from various financial accounts, high-end automobiles (Rolls Royce, Lamborghini, and Mercedes), jewelry, and Truglia’s lakefront home, all of which were traceable to the charged criminal conduct. Truglia had pleaded guilty on October 5, 2021.

According to court documents, beginning in January 2018 and continuing into April 2019, Truglia and other conspirators, including co-defendant Ruth Bianca Fernandez (who worked under Truglia’s supervision), generated medically unnecessary physicians’ orders via their telemarketing operation for certain orthotic devices.

He was arrested as part of a nationwide action referred to as “Operation Brace Yourself.” The Operation targeted schemes in which companies were paying illegal bribes to secure signed physicians’ DME brace orders for use as support for fraudulent claims submitted to the federal programs.

The Health Law Offices of Anthony C. Vitale can provide you with compliance oversight services, assuring that your business relationships are compliant with all federal and state fraud, waste and abuse laws. We also represent healthcare professionals in state and federal court who are charged with fraudulent billing, kickbacks, Medicare and Medicaid fraud and false claims, among others. For more information you can contact us at 305-358-4500 or send us an email to info@vitalehealthlaw.com and let’s discuss how we might be able to assist you.

Posted in

The Health Law Offices of Anthony C. Vitale

Categories

Subscribe!