A federal jury today convicted two Florida doctors of their involvement in a scheme to defraud Medicare by submitting more than $31 million in claims for expensive durable medical equipment (DME) that Medicare beneficiaries did not need and that were obtained by paying of bribes.
According to court documents and evidence presented at trial, Dean Zusmer, 54, of Miami, was a chiropractor who conspired with others to steal millions of dollars from Medicare. Zusmer owned one of four DME companies that collectively billed Medicare for more than $31 million for medically unnecessary DME, of which more than $15 million was paid. Zusmer and his co-conspirators, including Jeremy Waxman, obtained patient referrals and signed medical orders by paying kickbacks to marketers who used overseas call centers to solicit patients and telemedicine companies to obtain prescriptions for unnecessary braces for them. patients.
Court documents and evidence presented at trial further showed that Lawrence Alexander, MD, 45, of Miami, was an orthopedic surgeon who owned one of Waxman’s DME companies and concealed his and Waxman’s involvement in the scheme. by placing the DME company in the name of one of Alexander’s family members.
Zusmer was convicted of conspiracy to commit health care fraud, health care fraud, conspiracy to pay illegal health care bribes, payment of illegal health care bribes, and false statements related to health care matters. His sentencing is scheduled for April 20 and he faces a maximum sentence of 10 years in prison for each of the following charges: conspiracy to commit health care fraud; health care fraud; and paying illegal bribes in health care. Zusmer faces a maximum sentence of five years in prison for the following charges: conspiracy to pay illegal health care kickbacks and false statements related to health care matters.
Alexander was convicted of false statements related to health care matters. His sentencing is scheduled for April 20 and he faces a maximum sentence of five years in prison. A federal district court judge will determine any sentence after considering the US Sentencing Guidelines and other legal factors.
Waxman was previously sentenced to more than 15 years in prison for his role in the scheme.
Assistant Attorney General Kenneth A. Polite, Jr. of the Department of Justice’s Criminal Division; Deputy Director Luis Quesada of the FBI Criminal Investigation Division; Special Agent in Charge Robert M. DeWitt of the FBI Miami Field Office; and Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services, Office of Inspector General (HHS-OIG), Miami Regional Office made the announcement.
The FBI and HHS-OIG investigated the case.
Trial attorneys Catherine Wagner, Patrick Queenan, Meredith Hough, Jamie de Boer and Keith Clouser of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, made up of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who, together, have billed the Medicare program more than $19 billion. In addition, the Centers for Medicare & Medicaid Services, in conjunction with the Department of Health and Human Services’ Office of Inspector General, is taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
