2019-12-12 DOJ SDNY press_release 121 KB 7,588 chars

Doctor And Occupational Therapist Sentenced To Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid

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

Physician Paul J. Mathieu was sentenced to 48 months in prison and occupational therapist Lina Zhitnik to 14 months for their roles in a $30 million Medicare/Medicaid fraud scheme, in which Mathieu falsely posed as clinic owner, signed thousands of fake medical records, and became New York’s top prescriber of unnecessary adult diapers, while Zhitnik falsified therapy records—even during vacations—resulting in restitution orders and multiple fraud convictions.

paragraph

Physician Paul J. Mathieu was sentenced to 48 months in prison for orchestrating a $30 million Medicare and Medicaid fraud scheme by falsely posing as the owner of three clinics owned by Aleksandr Burman, signing fraudulent medical records for patients he never saw, and writing excessive, unnecessary prescriptions for adult diapers through Burman’s supply company. Occupational therapist Lina Zhitnik, who pled guilty, received a 14-month sentence for falsifying occupational therapy records, including for periods when she was on vacation in New Orleans and Miami or taking flying lessons. Both were convicted on charges including health care fraud, wire fraud, and conspiracy; Zhitnik was ordered to pay $1.37 million in restitution, while Mathieu faced additional forfeiture and restitution obligations as the tenth defendant sentenced in the broader case.

narrative

Between 2007 and 2013, physician Paul J. Mathieu and occupational therapist Lina Zhitnik participated in a $30 million Medicare and Medicaid fraud scheme orchestrated by businessman Aleksandr Burman, who owned six fraudulent clinics in Brooklyn. To circumvent New York’s requirement that medical corporations be owned by licensed professionals, Mathieu falsely posed as the owner of three clinics—The Medical Office of Paul J. Mathieu, P.C., Sunlight Medical, P.C., and Ocean View Medical of Brooklyn, P.C.—while Burman secretly controlled them. Mathieu signed thousands of fraudulent medical records for patients he never treated, even after the clinics ceased operations, and became New York’s top prescriber of adult diapers by writing unnecessary prescriptions for Burman’s supply company, Universal Supply Depot. Zhitnik, employed from mid-2011 to mid-2012, falsified occupational therapy records, backdating them to include services she never provided, even during vacations and personal trips. Mathieu was convicted after a six-week trial on charges including health care fraud, wire fraud, mail fraud, and conspiracy, while Zhitnik pled guilty to similar counts in April 2019. Mathieu received a 48-month prison sentence, and Zhitnik was sentenced to 14 months; both were ordered to pay restitution and forfeiture, with Zhitnik specifically ordered to pay $1.37 million. The case is part of a larger prosecution that has resulted in prison sentences for ten defendants, including Burman, who received a 10-year term, and two other physicians who also posed as clinic owners.

Enriched metadata

Scheme
health-care-fraud (100%)
Court
Southern District of New York
Outcome
convicted
Restitution
$89,682,000,000
Victim loss
$30,000,000
Classified health-care-fraud(confidence 100%). No EDGAR filing fingerprint (criminal/DOJ-side scheme). detection rule →
Parties
aleksandr burmanlina zhitnikpaul mathieu
Keywords
mathieumedicalprisonmedicare medicaidnewclinicsschememedicaremedicaiddefraud medicareburmanfraudzhitnikoccupational therapistmillion scheme

Extracted insights

Dollar amounts 4
  • $30.00M $30 Million $10M–$100M
  • $30.00M $30 million $10M–$100M
  • $1.37M $1,369,554 $1M–$10M
  • $90K $89,682 $10K–$100K
Entities 3
  • person aleksandr burman
  • person lina zhitnik
  • person paul mathieu
Triples 17
  • Doctor And Occupational Therapist Sentenced To Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid
  • Paul Mathieu Was Sentenced To 48 Months In Prison
  • Paul Mathieu Participated In A $30 Million Scheme To Defraud Medicare And The New York State Medicaid Program
  • Paul Mathieu Falsely Posed As The Owner Of Three Medical Clinics
  • Paul Mathieu Falsely Claimed That He Had Examined And Treated Thousands Of Patients Whom He Had Not In Fact Seen
  • Lina Zhitnik Was Sentenced To 14 Months In Prison
  • Lina Zhitnik Played A Role In The Same Scheme
  • Lina Zhitnik Falsified Medical Records In Order To Claim That She Had Provided Therapy Services That She Had Not In Fact Provided
  • Paul Mathieu Was Convicted 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
  • Lina Zhitnik Pled Guilty To Health Care Fraud And Conspiracy To Commit Health Care Fraud, Mail Fraud And Wire Fraud
  • U.S. Attorney Geoffrey S. Berman Sentenced Corrupt Doctors And Therapists Who Defraud Medicare And Medicaid
  • Aleksandr Burman Owned And Operated Six Medical Clinics In Brooklyn
  • Aleksandr Burman 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
  • Burman And Paul Mathieu Agreed To Have Paul Mathieu Pose As The True Owner Of A Succession Of Three Different Clinics
  • Paul Mathieu Signed A Variety Of Fraudulent Documents That Falsely Represented To Banks, Medicare, Medicaid, And Others That Paul Mathieu Was The Sole Owner Of The Medical Office Of Paul J. Mathieu, P.C.; Sunlight Medical, P.C.; And Ocean View Medical Of Brooklyn, P.C.
  • Aleksandr Burman Hired Two Other Doctors Ewald J. Antoine And Mustak Y. Vaid To Pose Fraudulently As The Owners Of Three Additional, Related Clinics
  • Paul Mathieu Came Weekly To Several Of The Clinics Where He Signed Stacks Of False And Fraudulent Medical Chart
View original DOJ press releasejustice.gov
Extracted body text (7,588c)
Press Release Doctor And Occupational Therapist Sentenced To Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid Thursday, December 12, 2019 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 Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced that physician PAUL J. MATHIEU was sentenced yesterday evening by U.S. District Judge Lorna G. Schofield to 48 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program. Between 2007 and 2013, MATHIEU falsely posed as the owner of three medical clinics, which were actually owned a by corrupt businessman, and falsely claimed that he had examined and treated thousands of patients whom he had not in fact seen. In addition, occupational therapist LINA ZHITNIK was sentenced by Judge Schofield on December 3, 2019, to 14 months in prison for her role in the same scheme, which included falsifying medical records in order to claim that she had provided therapy services that she had not in fact provided. MATHIEU was 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. ZHITNIK pled guilty to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud in April 2019, during jury selection for trial. U.S. Attorney Geoffrey S. Berman said: “Corrupt doctors and therapists 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 doctors and other fraudsters. Paul Mathieu’s sentence sends a clear message that those who cheat Medicare and Medicaid will be held accountable.” According to the evidence presented at trial and other public documents, including Zhitnik’s guilty plea transcript: 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. Under New York State law, professional medical corporations must be owned by a medical professional. To circumvent this requirement, Burman and MATHIEU agreed to have MATHIEU pose as the true owner of a succession of three different clinics, which Burman owned and operated for more than five years, from 2007 through 2013. Throughout those years, MATHIEU signed a variety of fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that MATHIEU was the sole owner of The Medical Office of Paul J. Mathieu, P.C.; Sunlight Medical, P.C.; and Ocean View Medical of Brooklyn, P.C. Burman also hired two other doctors, Ewald J. Antoine and Mustak Y. Vaid, to pose fraudulently as the owners of three additional, related clinics. MATHIEU also came weekly to several of the clinics, where he signed stacks of false and fraudulent medical charts, and issued referrals for expensive additional testing, occupational therapy, and physical therapy. For the last 3½ years of the scheme, MATHIEU saw no patients at all, simply falsifying enormous stacks of phony medical records falsely stating that he had seen and treated such patients. In addition to his role in the clinics, MATHIEU also wrote unneeded prescriptions for adult diapers and other incontinence products, which prescriptions were filled at Universal Supply Depot, a medical supply company also owned by Aleksandr Burman. MATHIEU was so prolific in this regard that, throughout the period of the fraud, he was the No. 1 top prescriber of adult diapers in the State of New York. The only year MATHIEU ranked second, he ranked behind another member of the same criminal scheme. MATHIEU continued to write such prescriptions, even after the medical clinics closed after Medicare stopped paying any of the clinics’ claims. ZHITNIK participated in the scheme for more than a year, from mid-2011 through mid-2012. ZHITNIK was paid to come to one of the clinics for a portion of each day. While there, ZHITNIK signed large numbers of medical records to be used in fraudulent billing, falsely claiming to have provided occupational therapy services that she did not in fact provide. Indeed, ZHITNIK signed such fraudulent paperwork, backdated, even for weeks when she was on family vacations in New Orleans and Miami, as well as when she was on shorter trips or out of town taking private flying lessons. MATHIEU is the tenth defendant, and the third physician, who has been sentenced in this case and a related case. 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. One additional defendant awaits sentencing, physical therapist Hatem Behiry, who was convicted at trial with MATHIEU. In addition to the prison term, MATHIEU, 54, of Morristown, New Jersey, was sentenced to three years of supervised release. Judge Schofield also ordered MATHIEU to pay restitution and forfeiture. ZHITNIK, 52, of Brooklyn, New York, was also sentenced to three years of supervised release, ordered to pay restitution of $1,369,554, and to forfeit $89,682. Mr. Berman 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 Jim Margolin, Nicholas Biase (212) 637-2600 Updated December 12, 2019 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 19-424
OCR text (7,588c · plain-text · 99% conf)
Press Release Doctor And Occupational Therapist Sentenced To Prison For Participating In $30 Million Scheme To Defraud Medicare And Medicaid Thursday, December 12, 2019 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 Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced that physician PAUL J. MATHIEU was sentenced yesterday evening by U.S. District Judge Lorna G. Schofield to 48 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program. Between 2007 and 2013, MATHIEU falsely posed as the owner of three medical clinics, which were actually owned a by corrupt businessman, and falsely claimed that he had examined and treated thousands of patients whom he had not in fact seen. In addition, occupational therapist LINA ZHITNIK was sentenced by Judge Schofield on December 3, 2019, to 14 months in prison for her role in the same scheme, which included falsifying medical records in order to claim that she had provided therapy services that she had not in fact provided. MATHIEU was 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. ZHITNIK pled guilty to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud in April 2019, during jury selection for trial. U.S. Attorney Geoffrey S. Berman said: “Corrupt doctors and therapists 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 doctors and other fraudsters. Paul Mathieu’s sentence sends a clear message that those who cheat Medicare and Medicaid will be held accountable.” According to the evidence presented at trial and other public documents, including Zhitnik’s guilty plea transcript: 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. Under New York State law, professional medical corporations must be owned by a medical professional. To circumvent this requirement, Burman and MATHIEU agreed to have MATHIEU pose as the true owner of a succession of three different clinics, which Burman owned and operated for more than five years, from 2007 through 2013. Throughout those years, MATHIEU signed a variety of fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that MATHIEU was the sole owner of The Medical Office of Paul J. Mathieu, P.C.; Sunlight Medical, P.C.; and Ocean View Medical of Brooklyn, P.C. Burman also hired two other doctors, Ewald J. Antoine and Mustak Y. Vaid, to pose fraudulently as the owners of three additional, related clinics. MATHIEU also came weekly to several of the clinics, where he signed stacks of false and fraudulent medical charts, and issued referrals for expensive additional testing, occupational therapy, and physical therapy. For the last 3½ years of the scheme, MATHIEU saw no patients at all, simply falsifying enormous stacks of phony medical records falsely stating that he had seen and treated such patients. In addition to his role in the clinics, MATHIEU also wrote unneeded prescriptions for adult diapers and other incontinence products, which prescriptions were filled at Universal Supply Depot, a medical supply company also owned by Aleksandr Burman. MATHIEU was so prolific in this regard that, throughout the period of the fraud, he was the No. 1 top prescriber of adult diapers in the State of New York. The only year MATHIEU ranked second, he ranked behind another member of the same criminal scheme. MATHIEU continued to write such prescriptions, even after the medical clinics closed after Medicare stopped paying any of the clinics’ claims. ZHITNIK participated in the scheme for more than a year, from mid-2011 through mid-2012. ZHITNIK was paid to come to one of the clinics for a portion of each day. While there, ZHITNIK signed large numbers of medical records to be used in fraudulent billing, falsely claiming to have provided occupational therapy services that she did not in fact provide. Indeed, ZHITNIK signed such fraudulent paperwork, backdated, even for weeks when she was on family vacations in New Orleans and Miami, as well as when she was on shorter trips or out of town taking private flying lessons. MATHIEU is the tenth defendant, and the third physician, who has been sentenced in this case and a related case. 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. One additional defendant awaits sentencing, physical therapist Hatem Behiry, who was convicted at trial with MATHIEU. In addition to the prison term, MATHIEU, 54, of Morristown, New Jersey, was sentenced to three years of supervised release. Judge Schofield also ordered MATHIEU to pay restitution and forfeiture. ZHITNIK, 52, of Brooklyn, New York, was also sentenced to three years of supervised release, ordered to pay restitution of $1,369,554, and to forfeit $89,682. Mr. Berman 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 Jim Margolin, Nicholas Biase (212) 637-2600 Updated December 12, 2019 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 19-424