Four New York-based physicians and 16 other individuals have been indicted in connection with a large-scale healthcare fraud scheme that allegedly defrauded New York Medicaid, Medicare and other government-funded programs of $146 million. 14 companies have also been charged.
The defendants allegedly paid patients to take unnecessary tests and undergo unnecessary procedures that were later billed to Medicare and Medicaid. Investigators also found evidence of a money-laundering scheme involving various shell companies. Proceeds from the alleged scheme were also used to purchase luxury items including prime New York real estate and designer purses.
According to acting Brooklyn District Attorney, Eric Gonzalez, “The case presents a cruel theme: The point of the enterprise was to steal money from Medicare and Medicaid by subjecting the most vulnerable people who reside with us in our city to unnecessary tests and imaginary care.”
Prosecutors have identified Kristina Mirbabayeva and her husband Alexander Kopenkin as the ringleaders in the scheme. One of the four doctors indicted, Dr. Robert Vaccarino, is a part-time employee of the NYPD. He has been suspended as a result of the indictment. The other doctors indicted are:
- Dr. Hamid Alam, M.D,
- Dr. Kevin Custis, M.D. (accused of being Mirbabayeva’s business partner),
- and Dr. Jeffrey Chess
The indictment states that Mirbabayeva, her mother Irina Fedorova, her husband, and others conspired with doctors in various local clinics to recruit vulnerable Brooklyn residents at places like soup kitchens.
If the recruits had Medicare/Medicaid cards, they were offered $30-40 and driven to the clinics to undergo covered procedures with the sole purpose of billing government healthcare programs. The equation was rather profitable, as recruited patients were paid a small amount to enable fraudsters to submit hundreds of dollars worth of claims for Medicare and Medicaid reimbursement.
One undercover police officer who was recruited as a patient during the investigation was paid $30 to allow tests to be performed on him. The defendants went on to bill government healthcare programs for 18 different tests on his behalf.
Some of the procedures most commonly performed on the recruited, often indigent, patients were medically unnecessary allergy tests and ultrasounds. Doctors allegedly received financial incentives for signing off on the fraudulent tests.
The evidence introduced by prosecutors included recorded phone calls where Mirbabayeva mentioned being mad at a doctor who had a backlog of thousands of tests to validate.
Mirbabayeva and her husband live in a $3.25 million Brooklyn penthouse which they purchased in cash. When investigators searched the apartment, they found abundant luxury items as well as designer shoeboxes full of cash. The Brooklyn District Attorney held a press conference where designer purses, luxury watches, and boxes full of $100 bills were on display.
During the conference, the acting DA couldn't conceal his contempt for the alleged fraudsters: "This is a black eye to the healthcare profession. These individuals preyed on the vulnerable, and for what, more Chanel bags?"
The 878-count indictment, including enterprise corruption, money laundering, and various instances of fraud, could send some of the defendants to prison for as long as 25 years.