The manager of a Philadelphia-based ambulance company was sentenced to five years in prison last month for bilking Medicare of millions by transporting dialysis patients who didn’t need the ambulance service to clinics.
Mikhail Vasserman, 51, of Philadelphia, pleaded guilty last October to conspiracy to commit health care fraud, false statements relating to health care matters, and paying kickbacks to patients, a total of 14 counts. Vasserman, who was the manager for Penn Choice’s Huntingdon Valley base, was indicted with the company’s owner Anna Mudrova, and operators Yury Gerasyuk, Irina Vasserman, Aleksandr Vasserman, Khusen Akhmedov, and Valeriy Davydchik, all of whom have pleaded guilty.
The scheme involved more than $3.6 million in fraudulent claims submitted to Medicare. The defendants recruited patients who were able to walk and could travel safely by means other than ambulance and who therefore were not eligible for ambulance transportation under Medicare requirements. The defendants, and others acting on their behalf, falsified reports to make it appear that the patients needed to be transported by ambulance. The defendants themselves, or through others, paid illegal kickbacks to the patients as part of the scheme.
In September 2009, Penn Choice became a Medicare-approved provider for basic life support ambulance transport, according to background information provided in the sentencing memorandum. Penn Choice actively recruited ambulatory dialysis patients who required regular transport to and from dialysis three times per week. Medicare paid approximately $400, plus a mileage allowance, for each round trip ambulance transport. As a result, each dialysis patient covered by Medicare could generate approximately $1,200 per week in revenues for Penn Choice.
According to background information provided in the sentencing memorandum, Penn Choice started in Camp Hill, Pa., and then expanded the fraud scheme to the Philadelphia area. In 2010, Anna Mudrova recruited Vasserman to open a Penn Choice base in Huntingdon Valley. According to prosecutors, Vasserman “bought” patients for Penn Choice from Brotherly Love, an ambulance company that was being investigated for Medicare fraud. Vasserman delivered about $2,000 per patient to Brotherly Love’s operatives in exchange for transport schedules and Medicare billing information for those patients who had agreed, for a fee, to ride with Penn Choice.
Prosecutors said the fraud at Penn Choice was widespread and blatant. For example, Penn Choice regularly transported one beneficiary who rode in the front passenger seat of the ambulance and smoked cigarettes during his trip. Penn Choice billed Medicare more than $100,000 for ambulance transport for this patient. To conceal the true condition of the patients being transported, Vasserman and his co-conspirators falsified documents, and directed others to falsify documents, to reflect that patients were bed-confined and required continuous medical monitoring and care during transport, when in fact patients.
Penn Choice operated as many as five ambulances that repeatedly failed to pass inspections by the Pennsylvania Department of Health for, among other reasons, failing to have appropriate medical supplies and equipment on board.
In addition to the prison term, U.S. District Court Judge Juan R. Sánchez ordered three years of supervised release, restitution in the amount of $1,703,450.74, joint and several with the co-defendants, a special assessment of $1,400 and forfeiture of any assets traceable to the offense.
In prior proceedings, defendant Khusen Akhmedov, an EMT, was sentenced to 27 months in prison; ambulance drivers, Valeriy Davydchik and Yury Gerasyuk, were each sentenced to 24 months in prison; and the corporation was ordered to pay restitution and to cease all operations. The three remaining defendants are awaiting sentencing.?
In addition to restitution to Medicare of $1,548,583.93, the Court ordered restitution of $154,866.81 payable to Highmark Blue Cross, which provides supplemental insurance to Medicare beneficiaries.