April 27, 10

NEWS / Detroit-Area Doctor Sentenced to 72 Months in Prison for Medicare Fraud Scheme

Patient Recruiter Sentenced to 40 Months in Prison

Dr. Toe Myint was sentenced today in Detroit to 72 months in prison for participating in a conspiracy to defraud the Medicare program, announced the Departments of Justice and Health and Human Services (HHS). A patient recruiter was also sentenced today in Detroit to 40 months in prison for his role in the conspiracy.

U.S. District Court Chief Judge Gerald E. Rosen ordered Myint, of Bloomfield Hills, Mich., to pay more than $3.1 million in restitution, jointly with co-defendants, and to serve two years of supervised release following his prison term. Chief Judge Rosen also ordered Terrence Hicks, a Jackson, Mich., resident and patient recruiter, to pay more than $4.9 million in restitution, jointly with co-defendants, and to serve three years of supervised release following his prison term.

Myint, 56, was convicted by a Detroit jury on Jan. 22, 2010, of one count of conspiracy to commit health care fraud, following a week-long trial. In the last three months, three Michigan-area doctors have been convicted at trial of separate health care fraud offenses as part of the Medicare Fraud Strike Force operations in Detroit. Hicks, 43, pleaded guilty to one count of conspiracy to commit health care fraud on Dec. 18, 2009.

Between approximately October 2006 and March 2007, Myint, Hicks and their co-conspirators caused more than $4.2 million in false and fraudulent claims to be submitted to the Medicare program for services supposedly provided by Myint at Sacred Hope Center Inc., a purported infusion clinic. Medicare actually paid more than $3.1 million of those claims. Hicks also worked at a second, related infusion clinic, called Xpress Center, Inc., which billed an additional $2.3 million in false and fraudulent claims to Medicare.

Evidence presented during Myint’s trial established that beginning in approximately October 2006 and continuing until March 2007, Myint routinely prescribed medications for patients at Sacred Hope that they did not need, and that in many cases, were never provided to the patients at all. In fact, the clinic existed for the purpose of causing fictitious claims for injection and infusion therapy services to be billed to Medicare. Myint was the only doctor who worked at Sacred Hope, and the owners of the clinic asked him to prescribe particular drugs to patients because they believed that Medicare would reimburse the medications at a high rate. Evidence at trial showed that Myint agreed to prescribe the medications even though he knew the patients did not need them.

According to court documents and evidence presented at trial, Medicare beneficiaries were not referred to Sacred Hope or Xpress Center by their primary care physicians, or for any other legitimate medical purpose, but were recruited by Hicks to come to the clinics in exchange for the payment of cash kickbacks. Hicks recruited the beneficiaries in downtown Detroit and drove them to the suburbs of Southfield and Livonia, Mich., where the clinics were located. Trial evidence showed that in exchange for the cash kickbacks Hicks paid them, the Medicare beneficiaries visited the clinics and signed documents indicating that they had received the services billed to Medicare.

To date, eleven defendants have pleaded guilty or have been convicted at trial for their roles in the two fraudulent clinics. Daisy Martinez, an owner of Sacred Hope and Xpress Center, was sentenced in March 2010 to 96 months in prison.

Today’s sentencings were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

These cases were prosecuted by Assistant Chief John Neal and Trial Attorney Benjamin D. Singer of the Criminal Division’s Fraud Section. The FBI and HHS Office of Inspector General (HHS-OIG) conducted the investigation. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since the inception of Medicare Fraud Strike Force operations in March 2007, Strike Force operations in seven districts have obtained indictments of more than 560 individuals who collectively have falsely billed the Medicare program for approximately $1.2 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

http://www.justice.gov/opa/pr/2010/April/10-crm-485.html

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