Health care fraud by physical therapists and acupuncturists

On Behalf of | Oct 28, 2021 | Health Care Fraud

The U.S. Attorney’s Office for the Southern District of New York has announced that two acupuncturists, six physical therapists and a cashier have been charged with conspiring to violate the Anti-Kickback Statute, commit health care fraud and engage in money laundering. The six men and three women were taken into custody by federal agents in New York City and on Long Island on Sept. 28. They all face decades in federal prison if they are convicted.

Kickbacks and fraud

According to federal prosecutors, the acupuncturists and physical therapists offered their patients kickbacks in the form of cash and bottles of expensive wine to encourage them to agree to unnecessary treatment. They allegedly then billed Medicare and insurance companies for treatment that was not needed and sometimes not provided at all. Prosecutors claim that kickbacks were also paid to health insurance company employees. The cashier has been charged because he allegedly delivered kickbacks to patients and arranged for them to sign falsified health insurance documents. The fraud scheme is said to have bilked insurers out of more than $20 million between 2018 and 2021.

Federal and state agencies

The healthcare fraud scheme was investigated by federal agents from the Internal Revenue Service and the Department of Health and Human Services Office of the Inspector General and state investigators from the New York Attorney General Office’s Medicare Fraud Control Unit. U.S. attorneys from the Southern District’s Complex Fraud and Cybercrime Unit have been assigned to the case.

Co-conspirators

Cases like this one that involve several alleged co-conspirators are often settled quickly when one of the suspects agrees to plead guilty and provide evidence against the others in return for lenient treatment. The remaining suspects then agree to plea deals of their own after determining that their chances of prevailing in court are extremely slim. The plea offers made by U.S. attorneys tend to become less generous as their positions grow stronger, so individuals taken into custody during large operations should act sooner rather than later if they wish to negotiate an agreement.