2012-08-31 / Top Stories

Feds Search Medical Facility

By Nicholas Briano

The clinic where the search warrant was executed last Friday. The clinic where the search warrant was executed last Friday. Federal agents executed a search warrant last Friday at a Far Rockaway medical clinic on suspicions that the office is engaging in a Medicare fraud scheme, federal officials told The Wave this week.

According to Special Agent in Charge Tom O’Donnell, who responded via email to The Wave, the clinic called Community Medical Home, located at 714 Beach 20 Street, is suspected of not rendering claimed services to patients and charging for medically unnecessary services as a means of expanding claims paid through the patient’s Medicare insurance.

O’ Donnell says the area remains a hotbed for Medicare fraud with special attention paid to the practice of Physical Therapy. The investigation, which is ongoing, hasn’t led to any arrests yet and is being conducted by a federal strike force formed as a joint operation between HHS-OIG and the Department of Justice (DOJ) aimed at tackling Medicare fraud. They were the group responsible for the arrests of the operators at Solstice Wellness in Rockaway Park in 2010, another Medicare physical therapy scheme where patients received cash kickbacks for visits. The patients’ Medicare accounts were then billed for services never received or not medically necessary.

This investigation in particular, O’ Donnell says, is suspected to be of the same magnitude but it is unknown yet whether or not the patients were aware of the scheme or received any financial incentive for office visits.

“This investigation is a continuation of a PT/infusion/nerve conduction Medicare fraud scheme that we’ve been following through clinics located in Brooklyn and Queens,” he wrote in an email. “Services are not rendered or aren’t medically necessary. The targets are physicians and the billing company that owns some of the medical clinics where they work. The search warrant was triggered predominantly by data and normal investigative techniques.”

The strike force, he continued, is focused on tackling the physical therapy market as it relates to Medicare and Medicaid fraud.

“Rockaway and Brooklyn as a whole remain a target rich environment with regards to Medicare/Medicaid fraud.”

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