A federal jury convicted two Florida doctors today for their roles in a scheme to defraud Medicare by submitting over $31 million in claims for expensive durable medical equipment (DME) that Medicare beneficiaries did not need and that were procured through the payment of kickbacks.
According to court documents and evidence presented at trial, Dean Zusmer, 54, of Miami, was a chiropractor who conspired with others to steal millions of dollars from Medicare. Zusmer owned one of four DME companies that collectively billed Medicare over $31 million for medically unnecessary DME, of which over $15 million was paid. Zusmer and his co-conspirators, including Jeremy Waxman, acquired patient referrals and signed doctors’ orders by paying kickbacks to marketers who used overseas call centers to solicit patients and telemedicine companies to procure prescriptions for unnecessary braces for these patients.
Court documents and evidence presented at trial further demonstrated that Lawrence Alexander, M.D., 45, of Miami, was an orthopedic surgeon who owned one of the DME companies with Waxman and concealed both his and Waxman’s roles in the scheme by putting the DME company in the name of one of Alexander’s family members.
Zusmer was convicted of conspiracy to commit health care fraud, health care fraud, conspiracy to pay illegal health care kickbacks, paying illegal health care kickbacks, and false statements relating to health care matters. He is scheduled to be sentenced on April 20 and faces a maximum penalty of 10 years in prison on each of the following counts: conspiracy to commit health care fraud; health care fraud; and paying illegal health care kickbacks. Zusmer faces a maximum penalty of five years in prison for the following counts: conspiracy to pay illegal health care kickbacks and false statements relating to health care matters.
Alexander was convicted of false statements relating to health care matters. He is scheduled to be sentenced on April 20 and faces a maximum penalty of five years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Waxman was previously sentenced to over 15 years in prison for his role in the scheme.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; Assistant Director Luis Quesada of the FBI Criminal Investigative Division; Special Agent in Charge David Walker of the FBI Tampa Field Office; and Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services Office of the Inspector General (HHS-OIG), Miami Regional Office made the announcement.
The FBI and HHS-OIG investigated the case.
Trial Attorneys Catherine Wagner, Patrick Queenan, Meredith Hough, Jamie de Boer, and Keith Clouser of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes.
