2022-07-22 DOJ SDNY press_release 119 KB 5,548 chars

Man Charged With Multi-Million Dollar Medicare Fraud In Connection With False Claims For Durable Medical Equipment

Caption: United States v. Dme Supply Companies, et al.

summary

Matthew Witkowski, 36, was charged with conspiracy and health care fraud for illegally buying and selling falsified written orders for durable medical equipment using stolen Medicare beneficiary and provider data, resulting in over $10 million in fraudulent claims and $3.5 million in payments to his company, True Prospects Marketing, Inc.

paragraph

Matthew Witkowski, 36, of the Dominican Republic, was arrested for conspiracy to commit health care fraud and health care fraud in connection with a scheme to sell fraudulent written orders for durable medical equipment (DME) such as braces. Between August 2019 and April 2021, Witkowski and a co-conspirator used stolen Medicare beneficiary information and falsified physician signatures through their company, True Prospects Marketing, Inc., to generate over $10 million in fraudulent Medicare claims, receiving more than $3.5 million in payments from DME suppliers. He faces up to five years for conspiracy and up to ten years for health care fraud, totaling a maximum of 15 years in prison if convicted.

narrative

Matthew Witkowski, 36, of the Dominican Republic, was arrested at Fort Lauderdale-Hollywood International Airport upon returning from Santo Domingo for orchestrating a multi-million dollar Medicare fraud scheme involving the illegal purchase and sale of falsified written orders for durable medical equipment (DME). Between August 2019 and April 2021, Witkowski and an unnamed co-conspirator operated through True Prospects Marketing, Inc., acquiring fraudulent DME orders using stolen Medicare beneficiary identities and forged electronic signatures of licensed providers without their knowledge or consent. These falsified orders were sold to DME suppliers in New York City and elsewhere, who then submitted over $10 million in fraudulent claims to Medicare, resulting in over $3.5 million in illicit payments to Witkowski’s company. The scheme violated the federal Anti-Kickback Statute, which prohibits buying or selling referrals for Medicare-covered items. Witkowski was charged with one count of conspiracy to commit health care fraud and one count of health care fraud, each carrying maximum prison sentences of five and ten years respectively. He remains in custody pending a detention hearing scheduled for July 27, 2022, before Magistrate Judge Alicia O. Valle in Fort Lauderdale. The U.S. Attorney’s Office for the Southern District of New York is prosecuting the case, with investigative support from HHS-OIG, emphasizing the government’s commitment to combating Medicare fraud.

Enriched metadata

Scheme: health-care-fraud (100%)
Court: Southern District of New York
Outcome: charged
Victim loss: $10,000,000

Classified health-care-fraud(confidence 100%). No EDGAR filing fingerprint (criminal/DOJ-side scheme). detection rule →

Extracted insights

Dollar amounts 2

$10.00M $10 million $10M–$100M
$3.50M $3.5 million $1M–$10M

Entities 4

person dme supply companies
person fraudulent claims
person matthew witkowski
scheme_term to defraud medicare and to violate the anti-kickback statute

Triples 16

Matthew Witkowski Charged With Multi-Million Dollar Medicare Fraud
Matthew Witkowski Ran A Company Dedicated To Illegally Buying Written Orders For Durable Medical Equipment
Matthew Witkowski Sold Written Orders To Dme Supply Companies
Dme Supply Companies Used Orders To File Fraudulent Medicare Claims
Fraudulent Claims Resulted In Payments Of At Least $10 Million To Witkowski’S Coconspirators
Matthew Witkowski Was Arrested At The Ft. Lauderdale-Hollywood International Airport
Matthew Witkowski Remains In Custody With A Detention Hearing Scheduled For 10:00 A.M. On July 27, 2022
U.S. Attorney Damian Williams Said “Medicare Is A Valuable Taxpayer-Funded Program Designed To Provide Affordable Health Care To Beneficiaries Over 65 Or With Disabilities, Not To Lining The Pockets Of Those Who Would Enrich Themselves Through Fraud.”
Hhs-Oig Special Agent In Charge Scott J. Lampert Said “The Alleged Fraud Scheme That The Defendant Engaged In Was Motivated By Pure Greed.”
Witkowski And An Unnamed Co-Conspirator Engaged In A Scheme To Defraud Medicare And To Violate The Anti-Kickback Statute
Witkowski Illegally Purchased Fraudulent Written Orders For Dme
Witkowski Sold Written Orders To Pharmacies And Dme Suppliers, Including In New York City
Pharmacies And Dme Suppliers Used Written Orders As The Basis For Millions Of Dollars Of Fraudulent Claims To Medicare
Many Of These Fraudulent Written Orders Used Names And Personal Health Information Of Medicare Beneficiaries, Without The Beneficiaries’ Authorization Or Prior Knowledge
Many Of These Fraudulent Written Orders Contained Professional Information Of Doctors And Other Health-Care Providers Enrolled In The Medicare Program
Many Of These Fraudulent Written Orders Contained Purported Electronic Signatures Of These Providers, Which Were Falsified And Created Without The Authorization Or Knowledge Of These Providers

View original DOJ press releasejustice.gov

Extracted body text (5,548c)

Press Release Man Charged With Multi-Million Dollar Medicare Fraud In Connection With False Claims For Durable Medical Equipment Friday, July 22, 2022 Share FacebookLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. XLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. LinkedInLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. Email For Immediate Release U.S. Attorney's Office, Southern District of New York Damian Williams, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) New York Regional Office announced today the arrest of MATTHEW WITKOWSKI on charges of conspiracy and health care fraud. As alleged in a Complaint unsealed today in federal court, and at a presentment held this morning before U.S. Magistrate Judge Jared M. Strauss of the United States District Court for the Southern District of Florida, WITKOWSKI, ran a company dedicated to illegally buying written orders for durable medical equipment (“DME”) such as leg, arm, and back braces, and then selling those written orders to DME supply companies, which in turn used those orders to file fraudulent Medicare claims. These fraudulent claims are estimated to have resulted in payments to WITKOWSKI’s coconspirators of at least $10 million. WITKOWSKI was arrested yesterday evening at the Ft. Lauderdale-Hollywood International Airport, after he flew in from Santo Domingo, Dominican Republic. Witkowski remains in custody, with a detention hearing scheduled for 10:00 a.m. on July 27, 2022, before the Magistrate Judge is Alicia O. Valle in Fort Lauderdale. U.S. Attorney Damian Williams said: “Medicare is a valuable taxpayer-funded program designed to provide affordable health care to beneficiaries over 65 or with disabilities, not to lining the pockets of those who would enrich themselves through fraud. Here, the defendant is charged with illegally selling written orders for medical equipment used to bilk Medicare out of millions of dollars.” HHS-OIG Special Agent in Charge Scott J. Lampert said: “The alleged fraud scheme that the defendant engaged in was motivated by pure greed. HHS-OIG and our law enforcement partners will continue to aggressively pursue all those who seek to unlawfully enrich themselves by victimizing participants of the Medicare program.” As alleged in the Complaint and at the detention hearing held this morning:[1] From at least August 2019 through at least April 2021, WITKOWSKI and an unnamed co-conspirator (“CC-1”) engaged in a scheme to defraud Medicare and to violate the Anti-Kickback Statute, which prohibits the buying and selling of written orders for goods and services paid for by Medicare, including DME. WITKOWSKI illegally purchased fraudulent written orders for DME, and then sold those written orders to pharmacies and DME suppliers, including in New York City. Those pharmacies and DME suppliers then used those written orders as the basis for millions of dollars of fraudulent claims to Medicare. Many of these fraudulent written orders used names and personal health information of Medicare beneficiaries, without the beneficiaries’ authorization or prior knowledge. Many of these written orders also contained professional information of doctors and other health-care providers enrolled in the Medicare program, as well as the purported electronic signatures of these providers, which were falsified and created without the authorization or knowledge of these providers. During the course of the scheme, WITKOWSKI and CC-1 took in more than $3.5 million from DME suppliers, who made these payments to True Prospects Marketing, Inc., a company controlled by Witkowski and CC-1. The Government estimates that the orders for DME illegally sold by True Prospects were used to bill Medicare for more than $10 million. * * * WITKOWSKI, 36, of the Dominican Republic, is charged with one count of conspiracy to commit health care fraud and to violate the Anti-Kickback Statute, which carries a maximum prison sentence of five years; and one count of health care fraud, which carries a maximum prison sentence of 10 years. The maximum potential penalties are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant will be determined by the judge. Mr. Williams praised the investigative work of HHS-OIG. This case is being handled by the Office’s Complex Frauds and Cybercrime Unit. Assistant United States Attorney David Raymond Lewis is in charge of the prosecution. The allegations contained in the Complaint are merely accusations, and the defendants are presumed innocent unless and until proven guilty. [1] As the introductory phrase signifies, the entirety of the text of the Complaint and the description of the Complaint set forth below constitute only allegations, and every fact described should be treated as an allegation. Contact Nicholas Biase (212) 637-2600 Updated July 22, 2022 Topic Financial Fraud Component USAO - New York, Southern Press Release Number: 22-236

OCR text (5,548c · plain-text · 99% conf)