The Department of Justice announced Thursday that federal prosecutors have convicted six individuals on healthcare fraud charges in trials concluded over the past three weeks, with total fraudulent billing topping $1.1 billion. The cases were tried in Fort Lauderdale, Fla., Los Angeles, Detroit, New York City and Nashville.
“The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people,” a department press release said. The National Fraud Enforcement Division was created on April 7, and President Donald Trump designated Vice President JD Vance as the nation’s fraud czar on April 3.
The largest case involves Brett Blackman, 42, of Johnson County, Kan., founder and CEO of HealthSplash, which owned the online platform DMERx. According to the department, Blackman connected Medicare beneficiaries to companies that prescribed orthopedic braces to patients who had never been physically examined. The scheme generated more than $1 billion in false billings, of which Medicare paid more than $450 million. Blackman was convicted of healthcare fraud conspiracy, kickback conspiracy and conspiracy to defraud the United States. His co-defendant, Gary Cox, was convicted in an earlier trial and sentenced to 15 years in prison.
Dr. Violetta Mailya, 45, of Glendale, Calif., collected more than $24 million from Medicare for Botox injections for migraines that she never delivered, the department said. About $19 million of that amount was billed while her clinic was closed. Some claims were backdated to before patients had contacted her. Mailya was convicted of nine counts of wire fraud and three counts of obstruction of a criminal investigation of a healthcare offense.
Ruby Scott, a licensed nurse and owner of Delta Home Health Care in Michigan, was convicted for operating a $1.6 million kickback scheme. According to the Justice Department, she billed Medicare for services that patients were never evaluated for. Scott was convicted of five counts of healthcare fraud, conspiracy, and four counts of paying illegal kickbacks.
Tony Brown-Arkah owned American Medical Centers, a Brooklyn substance abuse clinic. The department said his clinic prescribed Suboxone, and if patients did not want the drug, staff directed them to a van that would buy it from them. Prescriptions were signed by a nurse practitioner who lived in Florida and never saw or spoke with patients. Brown-Arkah billed Medicare and Medicaid for office visits where he, a non-clinician, was the only person who met with the patient, and for services that were never provided. Total fraud losses exceeded $52 million across both programs. Brown-Arkah was convicted of conspiracy to commit healthcare fraud, 12 counts of healthcare fraud, conspiracy to illegally distribute narcotics, three counts of illegal distribution of narcotics, conspiracy to pay and receive kickbacks and to defraud the United States, and two counts of receipt of kickbacks.
Olga Popovych managed a group of Brooklyn physical therapy clinics that gave cash payments to patient transport drivers for Medicare beneficiaries, according to the department. She was convicted of conspiracy to commit healthcare fraud, conspiracy to make false statements, four counts of healthcare fraud, and three counts of making false statements relating to healthcare matters. She billed more than $8 million to Medicare.
Heather Marks was a nurse practitioner who prescribed controlled substances to patients seeking pain treatment at Lifeforce Pain and Wellness in Carthage, Tenn. The department said Marks and others overprescribed highly addictive opioids, including oxycodone and oxymorphone, to Lifeforce patients. Marks prescribed nearly a million opioid pills to almost 1,000 patients. She was convicted of conspiracy to illegally distribute controlled substances and eight counts of illegally distributing controlled substances.