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OIG Enforcement Actions on Therapy Practices

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  • 6 Physical Therapists And 2 Acupuncturists Charged In Over $20 Million Health Care Fraud Scheme

    28 Sep 2021 10:48 AM | Zachary Edgar (Administrator)

    Audrey Strauss, the United States Attorney for the Southern District of New York, and Scott Lampert, Special Agent in Charge of the New York Office of the U.S. Department of Health and Human Services, Office of Inspector General (“HHS-OIG”), announced the unsealing today of an indictment charging acupuncturists JUNYI LIU, a/k/a “Jenny,” and HONGXING WANG, as well as physical therapists GLEEN ANCIRO, NOEMI ALGODON, MOHAMED ELMANDOUH, GERARD ESTRELLA, RAMON GARCIA III, and HENLER DATU TAHIL, and cashier ZIHAO CHEN with operating an over $20 million health care fraud scheme at fraudulent medical offices in Manhattan, Brooklyn, and Queens.

    Read more on www.justice.gov


  • IvyRehab Physical Therapy Agreed to Pay $155,000 for Allegedly Violating the Civil Monetary Penalties Law by Paying Remuneration in the Form of Waived Copayments and Submitting Claims for Services by Unlicensed Individuals

    8 Sep 2021 10:49 AM | Zachary Edgar (Administrator)

    After it self-disclosed conduct to OIG, IvyRehab Physical Therapy, PLLC (IvyRehab), New York, agreed to pay 155,833.50 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that IvyRehab paid improper remuneration to beneficiaries in the form of waived copayments for services. OIG also alleged that IvyRehab billed for codes 97110, 97112, and 97530 when these services were provided by unlicensed physical therapy aides.


  • Contract Rehabilitation Therapy Providers Agree to Pay $8.4 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Therapy Services

    2 Jul 2021 10:50 AM | Zachary Edgar (Administrator)

    Select Medical Corporation and Encore GC Acquisition LLC have agreed to pay $8.4 million to resolve allegations that Select Medical Rehabilitation Services Inc. (SMRS) violated the False Claims Act by knowingly causing 12 skilled nursing facilities (SNFs) in New York and New Jersey to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary or skilled.

    Read more on www.justice.gov


  • Pediatric Services of America Agreed to Pay $274,000 for Allegedly Violating the Civil Monetary Penalties Law by Employing an Excluded Individual and Submitting Claims for Services Provided by an Individual Without a Valid Provider Agreement

    10 Mar 2021 10:52 AM | Zachary Edgar (Administrator)

    After it disclosed conduct to OIG pursuant to its CIA, Pediatric Services of America, Inc. (PSA), entered into a $274,752.87 settlement agreement with OIG. OIG alleged that PSA submitted false claims to a Pennsylvania state Medicaid waiver program for support services provided by an excluded individual and to the Colorado state Medicaid program for services provided by an occupational therapist who did not have a valid Medicaid provider agreement.


  • Barry McLeod-Hughes Agreed to Be Excluded for 7 Years for Submitting False Claims for Physical Therapy Services

    4 Dec 2020 11:02 AM | Zachary Edgar (Administrator)

    On December 4, 2020, in connection with the resolution of his False Claims Act liability, Barry McLeod-Hughes (McLeod-Hughes), Byron, Georgia, agreed to be excluded under 42 U.S.C. 1320a-7(b)(7) for 7 years. The investigation revealed and OIG alleged that McLeod-Hughes and his practice, McLeod-Hughes and Associates Physical Therapy and Rehabilitation Clinic, d/b/a McLeod-Hughes and Associates Inc., submitted claims to Medicare and TRICARE for physical therapy services purportedly provided by McLeod-Hughes to Medicare and TRICARE beneficiaries when, in fact, athletic trainers and other unlicensed or uncredentialed individuals actually furnished the physical therapy services. Senior Counsel Matthew Westbrook represented OIG.


  • Physical Therapist Sentenced To 2 Years In Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid

    6 Oct 2020 11:02 AM | Zachary Edgar (Administrator)

    Audrey Strauss, the Acting United States Attorney for the Southern District of New York, announced that physical therapist HATEM BEHIRY was sentenced today by U.S. District Judge Lorna G. Schofield to 24 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program ("Medicaid").


  • Attorney General James Secures $4 Million from Companies Involved in Alleged Fraudulent Physical Therapy Scheme

    2 Oct 2020 11:04 AM | Zachary Edgar (Administrator)

    NEW YORK - New York Attorney General Letitia James today announced her office has secured $4 million from several physical therapy offices operated throughout New York City by Alex and Diana Klurfeld, and their companies Williamsburg Physical Therapy, P.C. and Euro Physical Therapy, P.C. (Williamsburg PT). Today's agreement resolves allegations that the couple and their companies falsely billed Medicaid and other federal health care programs for physical therapy services, as well as for having had non-licensed individuals provide physical therapy services.

    Read more on ag.ny.gov



  • Two Doctors, Two Licensed Physical Therapists, a Pharmacist, and Four Pharmacy Owners and Operators Among Those Charged in Brooklyn as Part of National Health Care Fraud Takedown

    30 Sep 2020 11:05 AM | Zachary Edgar (Administrator)

    Fifteen individuals, including two doctors, two licensed physical therapists, a licensed clinical social worker, a pharmacist and four pharmacy owners and operators, have been charged for their participation in schemes that fraudulently billed the Medicare and Medicaid programs for more than $15 million. The charges filed in federal court in Brooklyn, New York are part of a nationwide health care fraud takedown led by the Medicare Fraud Strike Force, which resulted in criminal charges against more than 300 individuals for their alleged participation in health care fraud schemes involving approximately $6 billion in fraudulent claims.


  • Doctor And Occupational Therapist Sentenced To Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid

    12 Dec 2019 11:06 AM | Zachary Edgar (Administrator)

    Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced that physician PAUL J. MATHIEU was sentenced yesterday evening by U.S. District Judge Lorna G. Schofield to 48 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program. Between 2007 and 2013, MATHIEU falsely posed as the owner of three medical clinics, which were actually owned a by corrupt businessman, and falsely claimed that he had examined and treated thousands of patients whom he had not in fact seen. In addition, occupational therapist LINA ZHITNIK was sentenced by Judge Schofield on December 3, 2019, to 14 months in prison for her role in the same scheme, which included falsifying medical records in order to claim that she had provided therapy services that she had not in fact provided. MATHIEU was convicted in May 2019, following a six-week trial, on charges of health care fraud, wire fraud, mail fraud, conspiracy to commit those offenses, and conspiracy to make false statements in connection with a federal health care program. ZHITNIK pled guilty to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud in April 2019, during jury selection for trial.


  • The Rehabilitation Hospital of the Pacific Hilo Clinic Agreed to Pay $231,000 for Allegedly Violating the Civil Monetary Penalties Law by Providing Remuneration to a Physician in the Form of Free Services and Supplies

    22 Nov 2019 11:11 AM | Zachary Edgar (Administrator)

    After it self-disclosed conduct to OIG, The Rehabilitation Hospital of the Pacific Hilo Clinic (Rehab-Hilo), Hawaii, agreed to pay $231,510.58 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks. OIG alleged that Rehab-Hilo paid remuneration to a physician in the form of hand therapy services and splinting supplies provided by a certified hand therapist employed by Rehab-Hilo.


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