Two Doctors In Florida Sentenced In Eight Figure Medicare Fraud Case
On April 12th, 2024, Bloomberg Law News two doctors in Florida were sentenced to prison as part of an approximately $31 million dollar Medicare fraud case. Dean Zusmer and Lawrence Alexander have been sentenced to serve approximately eight years and thirty-three months in prison respectively for their role in the massive fraud scheme. Below, our Orlando white collar criminal defense attorney discusses the allegations, the charges, and the sentences.
The Scheme: Medicare Knowingly Billed for Medically Unnecessary Procedures
Dean Zusmer and Lawrence Alexander were allegedly involved in a $31 million Medicare fraud scheme in Florida. Prosecutors argued that their operation was centered around submitting false claims to Medicare for costly durable medical equipment (DME). Broadly explained, DME refers to medical devices that are intended for repeated use—often in a patient’s home—to aid in the treatment or management of a medical condition or injury. However, the DME in this case was deemed not medically necessary and was procured through illegal kickbacks. Prosecutors contend that Dr. Zusmer, a chiropractor, managed a DME company that fraudulently billed Medicare over $31 million. Dr. Alexander, an orthopedic surgeon, was also implicated in the fraud.
Understanding the Criminal Charges in the Medicare Fraud Scheme
The doctors in this case faced several different criminal charges related to the Medicare fraud allegations. Here is an overview of charges that were filed:
- Conspiracy to Commit Healthcare Fraud: The charge of conspiracy to commit healthcare fraud involves an agreement between two or more persons to defraud a healthcare benefit program, such as Medicare. It does require the fraud itself to actually be perpetrated.
- Healthcare Fraud: Healthcare fraud entails knowingly and willfully executing a scheme to defraud any healthcare benefit program or to obtain, by means of false or fraudulent pretenses, representations, or promises. Medicare fraud is a federal crime. Not only can it lead to felony criminal charges, a doctor accused of fraud against Medicare or Medicaid could be permanently barred from participating in federal health programs.
- Illegal Health Care Kickbacks: The Anti-Kickback Statute aims to prevent medical providers from making medical decisions based on personal gain rather than patient interests. A doctor could face federal charges for a scheme involving illegal kickback.
Florida Doctors Sentenced to Prison Time
A criminal sentence has been handed down against both doctors. Dr. Dean Zusmer will serve eight years and one month in federal prison. Dr. Lawrence Alexander will serve two years and nine months in federal prison. Both men have also been ordered to pay significant financial restitution.
Set Up a Confidential Consultation With Our Orlando Defense Lawyer for Doctors Today
At The Baez Law Firm, our Orlando white collar criminal defense attorney has the skills and experience to represent doctors and other medical professionals. If you have any questions about Medicare fraud allegations, we are here to help. Contact us today for your strictly confidential initial consultation. We defend Medicare fraud allegations in Orlando, Orange County, and across Florida.
Source:
news.bloomberglaw.com/white-collar-and-criminal-law/florida-doctors-sentenced-in-31-million-medicare-fraud-scheme
