2020-10-06 DOJ SDNY press_release 120 KB 6,612 chars

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

Caption: United States v. Aleksandr Burman, et al.

summary

Physical therapist Hatem Behiry was sentenced to 24 months in prison for orchestrating a $30 million Medicare/Medicaid fraud scheme by billing for non-existent physical therapy services, falsifying medical records, and receiving over $800,000 in illicit transfers, resulting in $5.76 million in restitution and forfeiture.

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Hatem Behiry, a physical therapist, was convicted alongside physician Paul J. Mathieu after a six-week trial for participating in a $30 million Medicare and Medicaid fraud scheme operating through six Brooklyn clinics from 2007 to 2012. He falsely billed for physical therapy services he never provided, signing fraudulent records while patients received no legitimate care—often just waiting in rooms—and oversaw other therapists who did the same, leading to over $5.7 million in fraudulent payments under his name. Behiry was sentenced to 24 months in prison, three years of supervised release, $5,757,661 in restitution, and forfeiture of $808,975, becoming the eleventh defendant sentenced in the case.

narrative

Physical therapist Hatem Behiry was sentenced to 24 months in prison for his central role in a $30 million Medicare and Medicaid fraud scheme that operated through six Brooklyn clinics between 2007 and 2012. He routinely signed fraudulent medical records claiming he provided physical therapy services, despite providing little to no actual care—patients often merely sat in waiting rooms watching TV or used unsupervised exercise equipment. Behiry also oversaw a group of other physical therapists who similarly billed for non-existent services, and he received over $800,000 in illicit transfers from the clinics to his personal company. Alongside physician Paul J. Mathieu, Behiry was convicted after a six-week trial on charges including health care fraud, wire fraud, mail fraud, and conspiracy. Medicare and Medicaid paid more than $5.7 million for services billed under Behiry’s name, and he was ordered to pay $5,757,661 in restitution and forfeit $808,975. He was the eleventh defendant sentenced in the case, which also included clinic owner Aleksandr Burman (10 years), three other convicted physicians, and multiple clinic staff who fabricated patient visits and medical documentation to enrich themselves.

Enriched metadata

Scheme: health-care-fraud (100%)
Court: Southern District of New York
Outcome: convicted · 2019-12-11
Restitution: $808,975,000
Victim loss: $30,000,000

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

Extracted insights

Dollar amounts 6

$30.00M $30 Million $10M–$100M
$30.00M $30 million $10M–$100M
$5.76M $5,757,661 $1M–$10M
$5.00M $5 million $1M–$10M
$800K $800,000 $100K–$1M
$809 $808.975 <$10K

Entities 9

person aleksandr burman
person ewald j. antone
person fraudulent documents
person hatem behiry
scheme_term health care fraud, wire fraud, mail fraud, and conspiracy
person medical records
person mustak y. vaid
person paul j. mathieu
person physical therapy services

Triples 23

Hatem Behiry sentenced to 24 months in prison
Hatem Behiry participated in $30 million scheme to defraud Medicare and Medicaid
Hatem Behiry falsely pretended to provide physical therapy services
Hatem Behiry falsified medical records
Hatem Behiry convicted of health care fraud, wire fraud, mail fraud, and conspiracy
Paul J. Mathieu convicted of health care fraud, wire fraud, mail fraud, and conspiracy
Aleksandr Burman owned and operated six medical clinics in Brooklyn
Aleksandr Burman serving 10-year prison term
Aleksandr Burman fraudulently billed Medicare and Medicaid approximately $30 million
Paul J. Mathieu falsely posed as owners of the clinics
Mustak Y. Vaid falsely posed as owners of the clinics
Ewald J. Antone falsely posed as owners of the clinics
Paul J. Mathieu signed fraudulent documents
Mustak Y. Vaid signed fraudulent documents
Ewald J. Antone signed fraudulent documents
Paul J. Mathieu signed false and fraudulent medical charts and billing documents
Mustak Y. Vaid signed false and fraudulent medical charts and billing documents
Ewald J. Antone signed false and fraudulent medical charts and billing documents
Paul J. Mathieu issued referrals for unnecessary testing, occupational therapy, and physical therapy
Mustak Y. Vaid issued referrals for unnecessary testing, occupational therapy, and physical therapy
Ewald J. Antone issued referrals for unnecessary testing, occupational therapy, and physical therapy
Hatem Behiry signed medical records for fraudulent billing
Hatem Behiry falsely claimed to have provided physical therapy services

View original DOJ press releasejustice.gov

Extracted body text (6,612c)

Press Release Physical Therapist Sentenced To 2 Years In Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid Tuesday, October 6, 2020 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 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”). Between 2007 and late 2012, on a regular basis, BEHIRY falsely pretended to provide physical therapy services to patients, and falsified medical records in a fraudulent scheme to bill Medicare and Medicaid for non-existent services. BEHIRY and a co-defendant physician, Paul J. Mathieu, were 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. Acting U.S. Attorney Audrey Strauss said: “At a time when our medical system may be more important than ever, today’s sentence sends an unambiguous message that those who cheat Medicare and Medicaid will be held accountable. Corrupt health care professionals who defraud Medicare and Medicaid betray their medical training, their professions, their patients, and the taxpayers. These taxpayer-funded programs are designed to provide essential medical services to the elderly and the needy, not to enrich corrupt therapists and other fraudsters.” According to the evidence presented at trial and other public documents: Between 2007 and 2013, Aleksandr Burman – who is currently serving a 10-year prison term for his participation in this scheme – owned and operated six medical clinics in Brooklyn (the “Clinics”) that fraudulently billed Medicare and Medicaid approximately $30 million for medical services and supplies that were not provided, were provided without regard to medical necessity, or were otherwise fraudulently billed. As part of this scheme, three medical doctors – Mathieu, Mustak Y. Vaid, and Ewald J. Antone, all of whom have been convicted and sentenced in this case – falsely posed as the owners of the Clinics. The doctors did so by, among other things, signing various fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that they were the owners of the clinics. Mathieu, Vaid, and Antoine also came weekly to the clinics, where they signed stacks of false and fraudulent medical charts and billing documents for patients that they had not seen, and issued referrals for unnecessary testing, occupational therapy, and physical therapy. BEHIRY participated in the scheme almost from its inception, in 2007, until late 2012. BEHIRY regularly signed medical records to be used in fraudulent billing, in which he falsely claimed to have provided physical therapy services that he did not in fact provide. Generally, BEHIRY provided no physical therapy services at all to patients, engaging instead in brief pro forma conversations with the patients, and then completing paperwork that was used to bill Medicare and Medicaid for roughly an hour of physical therapy services. Typically, patients were told that they had to remain in the clinic for nearly an hour – which they often did by simply watching television in a waiting room for much of that time, and sometimes receiving massages or making unsupervised use of exercise machines (activities that are not billable to Medicare or Medicaid as physical therapy). In addition, BEHIRY oversaw a group of other physical therapists, whom he arranged to bring to the Clinics to bill fraudulently for physical therapy services that were not in fact provided. All told, Medicare and Medicaid paid more than $5 million for purported physical therapy services billed under BEHIRY’s name. As part of the scheme, more than $800,000 was transferred from the Clinics to BEHIRY’s own company. BEHIRY is the eleventh defendant to be sentenced in this and Burman’s related case. Mathieu, who was convicted at trial with BEHIRY, was sentenced on December 11, 2019, to four years in prison. The other defendants, each of whom pled guilty, include: Aleksandr Burman, who was sentenced in a related case on May 8, 2017, to 10 years in prison; Marina Burman, the former wife of Aleksandr Burman and the owner of a related medical supply company, sentenced on May 17, 2018, to three years in prison; Mustak Y. Vaid, a physician sentenced on August 1, 2018, to 18 months in prison; Ewald J. Antoine, a physician sentenced on August 21, 2018, to a year and a day in prison; Asher Oleg Kataev, a Burman business partner, sentenced on May 31, 2018, to three years in prison; Alla Tsirlin, a Clinic office manager, sentenced on June 5, 2018, to a year and a day in prison; and Edward Miselevich and Ivan Voychak, Burman partners who jointly ran a related ambulette company, sentenced on June 12 and July 19, 2018, to three years in prison each. * * * In addition to the prison term, BEHIRY, 52, of Brooklyn, New York, was sentenced to three years of supervised release. Judge Schofield also ordered BEHIRY to pay restitution of $5,757,661 and forfeiture of $808.975. Ms. Strauss praised the outstanding investigative work of the Federal Bureau of Investigation, the Office of the Inspector General of the U.S. Department of Health and Human Services, and the New York State Office of the Medicaid Inspector General (“OMIG”). The prosecution of this case is being handled by the Office’s Complex Frauds and Cybercrime Unit. Assistant U.S. Attorneys David Raymond Lewis, Stephen J. Ritchin, and Timothy V. Capozzi are in charge of the prosecution. Contact James Margolin, Nicholas Biase (212) 637-2600 Updated October 6, 2020 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 20-227

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