Twenty-Two Defendants – Including Eight Doctors – Charged With Enterprise Corruption in Massive $7 Million Medicaid Fraud


FOR IMMEDIATE RELEASE
Tuesday, March 31, 2015

 

Twenty-Two Defendants – Including Eight Doctors – Charged With Enterprise Corruption in Massive $7 Million Medicaid Fraud

Defendants Preyed on Low-Income and Homeless People; Offered Free Sneakers in Exchange For Unnecessary Medical Tests, Treatment

Brooklyn District Attorney Ken Thompson, together with United States Health and Human Services Office of the Inspector General New York region Special Agent in Charge Scott J. Lampert, New York City Human Resources Administration Commissioner Steven Banks and the New York State Acting Medicaid Inspector General Dennis Rosen, today announced that eight doctors are among 22 defendants named in a 199-count indictment that alleges they participated in a massive scheme in which they lured people recruited from low-income neighborhoods, homeless shelters and welfare offices to corrupt medical clinics for unnecessary tests with the promise of free footwear such as sneakers, shoes and boots.

District Attorney Thompson said, “These defendants allegedly exploited the most vulnerable members of our society and raked in millions of dollars by doing so. The many poor people who were allegedly targeted at homeless shelters, welfare offices and soup kitchens and referred to as ‘guinea pigs’ by the defendants were exploited for hours, if not days, just because they needed a pair of shoes. That so many doctors allegedly participated in this elaborate scheme to defraud a health care system designed to help the poor is truly disgraceful.”

Special Agent in Charge Lampert said, “Arresting eight physicians today should be a warning that when you commit health care fraud and compromise patient care, we will arrest you. Justice doesn’t discriminate. HHS OIG commends the Brooklyn District Attorney’s Office for their diligent work in this case. Our offices will continue to work together to combat health care fraud in Kings County.”

Commissioner Banks said, “The alleged conduct here is disgraceful. Clients were misled, the Medicaid system was exploited, and government funding for medical care for clients was diverted. I thank the Kings County District Attorney’s Office, the Office of the Medicaid Inspector General, the Health and Human Services Office of the Inspector General for their excellent work and also the HRA staff who assisted in this successful investigation.”

Acting IG Dennis Rosen said, “Health care fraud compromises the integrity of the Medicaid program as well as the health care delivery system, and it wastes tax payer dollars. Today’s indictment, which is the result of the collaborative efforts of the Brooklyn District Attorney, Health and Human Services, New York City Human Resources Administration and OMIG, sends a clear, unmistakable message that those who commit health care fraud will be identified and held accountable for their actions.”

The District Attorney identified Eric Vainer, 43, of 220 Riverside Boulevard, New York, New York, as the alleged mastermind and leader of the scheme, and his mother, Polina Vainer, 66, of 189 Keating Place, Staten Island, New York, as his second in command. Some of the defendants were arraigned before Brooklyn Supreme Court Justice Danny Chun this morning on an indictment in which they are variously charged with enterprise corruption, first-degree money laundering, first-degree scheme to defraud, first-degree health care fraud, first-degree falsifying business records, first-degree offering a false instrument for filing, fourth-degree grand larceny, fourth-degree attempted grand larceny, fourth-degree conspiracy, social service law, petit larceny and attempted petit larceny. The defendants are being arraigned throughout the day and bail set in varying amounts.

They are ordered to return to court on May 19, 2015. If convicted, they face up to 25 years in prison on the top count. See addendum for identities of other defendants charged in this indictment.

The District Attorney said that the investigation began in July 2012 after a Brooklyn resident reported her concerns to the DA’s Action Center. She said she was approached by recruiters and taken to one of the clinics, where she met with a podiatrist and was given a knee brace and sneakers. When she said she did not need the knee brace, she was told she had to take it to get the sneakers.

The District Attorney said that, according to the indictment, between October 1, 2012 and September 30, 2014, the defendants – including 22 men and women (eight of whom were doctors) and eight companies – engaged in a criminal enterprise by intentionally participating in a pattern of criminal activity through the fraudulent operation of medical clinics and the submission of fraudulent claims to Medicaid, Medicaid-managed health care organizations and Medicare. In addition to doctors, the defendants include nurse practitioners, physician’s assistants, technicians, office staff, recruiters, managers and billers.

The District Attorney said that, according to the indictment, the Enterprise fraudulently billed for more than $6.9 million over the period covered by the indictment in a scheme in which recruiters for the Enterprise went out to low-income areas and approached people on the street, including outside of homeless shelters and welfare offices, and offered them free sneakers if they could produce a Medicaid card and would agree to have their feet examined at a medical clinic. The recruiters operated throughout the City, including in the Bronx; Richmond Hill and Jamaica, in Queens; a Men’s shelter in Chelsea; and in Brooklyn, in Bushwick, Brownsville and East New York, among other places. If the person agreed, they were immediately taken to one of Vainer’s clinics, which were located in Williamsburg and the Bronx. Once there, a podiatrist performed a cursory, if any, examination. The clinic would then provide the client with footwear and additional medical equipment such as an ankle brace or orthotic insole, for which it could then bill the insurers. It is alleged that these devices were medically unnecessary.

It is further alleged, according to the indictment, that clients were then frequently referred for a battery of other medically unnecessary tests and procedures, including vein tests, pain management evaluations, physical therapy and cardiograms with other members of the criminal enterprise. Eric Vainer allegedly decided what medical tests, procedures and durable medical equipment would be ordered, dispensed and billed, and sometimes, even, how the medical providers would be compensated.

The alleged purpose of the tests was to bill Medicaid, Medicaid managed care organizations and Medicare.  It is alleged that some of the medical providers paid Vainer a kickback and others split with him the money generated from insurance billings. Vainer allegedly ensured that he was properly compensated by tracking the number of patients seen by the different doctors by computer and daily reports from office managers.

As part of the Enterprise, Vainer and his mother owned a durable medical equipment business, T.W. Capital dba West 5th Medical Supply, which worked with the corrupt clinics to carry out the fraud. Polina Vainer also allegedly assisted her son in managing the entire operation, overseeing the billing and payroll departments for several of the clinics and medical professionals.

Furthermore, according to the indictment, among the medical providers that Vainer maintained relationships with were podiatrists, a vascular surgeon, cardiologists, pain management specialists, psychiatrists, and others.

Podiatrists included Benny Ogorek, DPM, at Vainer’s Bronx clinic, Avia Jackson, DPM, and Simeon Isaacs, DPM, at Vainer’s Williamsburg clinics, and Nemaan Ghuman, DPM, at the East Tremont Avenue clinic. The podiatrists allegedly saw patients, fabricated symptoms and created false diagnoses. They then allegedly prescribed unnecessary DME and vein or artery tests. In some cases, the patients were referred for psychiatric care or pain management. These referrals would then generate recurring visits for which they could bill.

It is alleged that the enterprise also used the services of vascular surgeon David Glass, MD, and cardiologist Joseph Grossman, MD, who either billed Medicaid and other insurance carriers for medical services never performed or for reviewing medically unnecessary vein and artery ultrasounds performed by technicians at Vainer’s clinics, or both.

Glass was the owner of The Center for Surgery dba New York Vein Center. Yelena Korsunskaya was his office manager and the alleged liaison between Glass and Vainer. She allegedly tracked the number of vein tests Vainer and other members of the enterprise sent to Glass for review, and the payments Glass sent to Vainer. Although she worked for Glass, her salary was paid by both Glass and Vainer.

Grossman was the owner of Treating Physician Medical Care P.C., and Vainer had access to Treating Physician Medical Care P.C.’s bank account.

It is further alleged that Herbert Meadow, MD, and physician’s assistant Matthew Jordan provided psychiatry services to patients, and charged inflated fees for abbreviated patient visits. They also referred patients to others in the enterprise for costly, frequent and unnecessary tests and procedures. Meadow was the owner of record for Community Medical Disorder P.C., and Vainer opened and was the sole signer of its bank account initially. Meadow is presently the sole signer, and both shared the profits generated by the billings.

Finally, the Enterprise used a network of recruiters to entice individuals covered by Medicaid or other insurers to become “patients” at the corrupt clinics. The recruiters provided patients with transportation to the clinics. Bernard Rorie is alleged to be the Enterprise’s chief recruiter, and he had associates working with him. Vainer paid the recruiters for each patient they brought in.

The case was investigated by Detective Investigator Michael Sidlowski, Supervising Detective Investigator Glenn Kenny and Supervising Detective Investigator Robert Addonizio, under the supervision Deputy Chief Edwin Murphy and the overall supervision of Chief Richard Bellucci, of the District Attorney’s Investigations Bureau.

Senior Financial Investigators Arthur Criscone and Elliot Gallub and Paralegal Charles Machado of the District Attorney’s Office assisted in the investigation.

In connection with today’s charges, the United States Attorney’s Office for the Eastern District of New York obtained warrants to seize 13 bank accounts into which payments from the defrauded federally funded programs could be traced.

The District Attorney thanked our partners in the investigation, including United States Health and Human Services Office of the Inspector General, New York City’s Human Resources Administration’s Office of Medicaid Provider Fraud and Abuse Investigation, New York State Office of the Medicaid Inspector General, New York State Department of Health, and the United States Attorney’s Office for the Eastern District of New York.

The case is being prosecuted by Assistant District Attorney Debra Jaroslawicz, Assistant District Attorney Joel Greenwald and Deputy Chief Dana Roth, of the District Attorney’s Frauds Bureau, under the supervision of Assistant District Attorney Felice Sontupe, Chief, and the overall supervision of Executive Assistant District Attorney William E. Schaeffer, Chief of the District Attorney’s Investigations Division. 

An indictment is an accusatory instrument and not proof of a defendant’s guilt.

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DEFENDANT ADDENDUM: 

  1. Eric Vanier, 43, of 220 Riverside Boulevard, New York, New York.
  2. Polina Vainer, 66, of 189 Keating Place, Staten Island, New York.
  3. Igor Marmulevskiy, 30, of 88 East End Avenue, New York, New York.
  4. Melissa Gonzalez, 31, of 210 Roebling Street, Williamsburg, Brooklyn.
  5. Shawn Mayo, 38, of 192 Sand Street, Vinegar Hill, Brooklyn.
  6. Kirill Shakhov, 26, of 1522 West Fourth Street, Bensonhurst, Brooklyn.
  7. Marina Vargas, 49, of 3620 Coney Island Avenue, Brighton Beach, Brooklyn.
  12. Dr. David Glass, MD (vascular medicine) 65, of 333 Rector Place, New York, New York.
  13. Yelena Korsunskaya, 60, of 7902 19th Avenue, Bensonhurst, Brooklyn.
  14. Dr. Benny Ogorek, DPM (podiatrist), 64, of 67-15 102nd Street, Forest Hills, Queens.
  15. Dr. Avia Jackson, DPM (podiatrist) 43, of 146-18 Liberty Avenue, Jamaica, New York.
  16. Isaacs, DPM (podiatrist) 63, of 141-19 71st Road, Flushing, Queens.
  17. Dr. Neeman Ghuman, DPM (podiatrist) 40, of 78 70th Street, Bay Ridge, Brooklyn.
  18. Dr. Herbert Meadow, MD (psychiatrist) 79, of 1025 5th Avenue, New York, New York.
  19. Matthew Jordan, 33, of 365 Oscawana Lake Road, Putnam Valley, New York.
  20. Dr. Joseph Grossman, MD (cardiologist) 82, 6 Elizabeth Court, Briarcliff Manor, New York.
  21. Bernard Rorie, 59, of 211 Malcolm X Boulevard, Brooklyn, New York.
  22. Assist Medical Supplies, Corp.
  23. T.W. Capital Corp. dba West 5th Medical Supply
  24. Ned Mgmt. Corp.
  25. NYC Podiatry P.C.
  26. Community Medical Disorder P.C.
  27. Hylan Boulevard Physical Medicine And Rehabilitation, PLLC.
  28. Treating Physician Medical Care P.C.
  29. The Center for Surgery dba New York Vein Center, LLC.

 

MEDICAL CLINICS OWNED BY OR AFFILIATED WITH ERIC VANIER:

  1. 721 Flushing Avenue, Williamsburg, Brooklyn.
  2. 741 Flushing Avenue, Williamsburg, Brooklyn.
  3. 953 Southern Boulevard, Bronx, New York.
  4. 1396 Myrtle Avenue, Bushwick, Brooklyn.
  5. 471 East Tremont Avenue, Bronx, New York.

 

OTHER ENTITIES OWNED BY OR AFFILIATED WITH ERIC OR POLINA VANIER: 

  1. Assist Medical Supplies, Corp., a durable medical equipment company that billed for medically unnecessary DME, located at 67 35th Street, Sunset Park, Brooklyn. Eric Vanier served as its Chief Executive Officer.
  2. Ned Mgmt Corp., of which Eric Vanier was the owner and President (same location as above), and was allegedly used by Vanier to operate the Enterprise and to launder funds.
  3. T.W. Capital Corp., dba, West 5th Medical Supply, owned Polina Vanier. Durable Medical Equipment company that billed for medically unnecessary DME.