Defendants Billed Medicare Over $1 Million For Tests Based On Falsified Physician’s Orders
SAN JOSE – LAWFUEL – US Legal Newswire – United States Attorney Scott N. Schools announced that four defendants were sentenced by United States District Court Judge Jeremy Fogel for perpetrating a scheme that defrauded Medicare of over $1 million for tests that were based on falsified physician orders that claimed the tests were performed because they were medically necessary.
Alexander Dzhuga of Encino, California, Leonid Dzhuga of Reseda, California, Vladimir Semenov of Sherman Oaks, California, and Natalia Stadnik of Reseda, California, had previously pleaded guilty on January 10, 2007 to 38 counts of health care fraud and aiding and abetting in violation of Title 18, United States Code, Sections 1347 and 2 .
Alexander Dzhuga, the owner of Direct Vision, AD, Inc., was sentenced to 21 months in prison. Leonid Dzhuga, the owner of National Diagnostic, Inc., was sentenced to 24 months in prison. Vladimir Semenov, the owner of Pulse Diagnostic Services, Inc., was sentenced to 18 months in prison. Natalia Stadnik, the owner of Prolink Diagnostic, Inc., was sentenced to six months of home confinement, 200 hours of community service and three years of probation. All four defendants were additionally order to pay restitution to Medicare amounting to $909,000.
U.S. Attorney Scott N. Schools stated, “Medicare benefits are paid for by the public and are meant for examinations and tests that are actually performed and are medically necessary. The theft of those benefits by these individuals involved in operating the Milpitas Medical Clinic, amounts to theft from the American taxpayer and from the Medicare beneficiaries who truly need medical treatment.”
Alexander Dzhuga, Leonid Dzhuga, Vladimir Semenov and Natalia Stadnik all previously admitted at their guilty pleas that they participated in the scheme to defraud Medicare by knowingly submitting claims to Medicare, while knowing that the tests they billed for were not medically necessary, not legitimately ordered by, nor supervised by any physician, were not performed by a certified technician or not performed at all. The four owners of the ultrasound companies further admitted that they knew Medicare patients had been recruited to the Milpitas Medical Clinic by promising them free transportation, food, and medical care, along with free “milk” or Ensure, and Chinese ointment or oil. Upon arrival at the clinic, workers at the clinic copied the beneficiaries’ Medicare cards. Other workers held themselves out as physicians and nurses and conducted a cursory examination of the beneficiaries. The four owners of the ultrasound companies, also admitted that as part of the scheme to defraud Medicare, they and their employees performed ultrasound tests on the beneficiaries on the premises of MMC without first obtaining a legitimate physician’s order based on medical necessity. In reality, neither Tollette nor any other physician actually examined the beneficiaries, the ultrasound test which were supposed performed on the Medicare patients and ordered after they had already been performed or were not medically necessary.
Richard C. Cheng is the Assistant U.S. Attorney who prosecuted the case with the assistance of paralegal Lauri Gomez. The prosecution is the result of a two-year investigation by the Federal Bureau of Investigation and the Department of Health and Human Services.