Tuesday, December 2, 2014

78 Year Old Physician Assistant Sentenced to Three Years In Prison For Medicare Fraud - Older Physicians and PAs Are Often Solicited by Suspect Health Care Businesses That Engage in Billing Fraud and Abuse

A 78 year old Los Angeles physician’s assistant was sentenced on November 24, 2018 to three years in federal prison for defrauding Medicare by signing fraudulent prescriptions and other medical documents for durable medical equipment (DME) while working at two separate medical clinics in the Los Angeles area. This was after a guilty plea and not a trial.

Erasmus Kotey, 78, of Montebello, was sentenced by United States District Judge Margaret M. Morrow. In addition to the 36-month prison term, Judge Morrow ordered Kotey to pay approximately $3.5 million in restitution to the Medicare program. Kotey pleaded guilty in March to one count of health care fraud and one count of conspiracy to commit health care fraud in two separate cases. In a plea agreement filed earlier this year in United States District Court, Kotey admitted that he engaged in a scheme to commit health care fraud while working as a physician’s assistant at a clinic  located at 866 North Vermont Avenue in Los Angeles. (A co-conspirator in this scheme was Susanna Artsruni, a North Hollywood woman who owned a medical supply company and admitted that she got unnecessary prescriptions from physician assistants at three clinics was sentenced to over 6 years in prison for causing Medicare to pay $9.6 million for the $25 million in fraudulent claims submitted.) 

In addition to his role in the scheme at the clinic on North Vermont, Kotey admitted that he engaged in a conspiracy to commit health care fraud through his work as a physician’s assistant at another clinic at 943 South Atlantic Boulevard in Monterey Park.

At both clinics, Kotey admitted that he signed prescriptions and other medical documents for medically unnecessary power wheelchairs and other DME. Using these fraudulent prescriptions, DME supply companies submitted fraudulent claims to Medicare.
Kotey also admitted that he ordered medically unnecessary diagnostic testing at the North Vermont clinic. In the two cases combined, the government alleged that Kotey’s fraudulent prescriptions resulted in approximately $7 million in false and fraudulent claims to Medicare. Medicare paid approximately $3.5 million on those claims.

Attorney Commentary: Esasmus Kotey is 78 years old and our office often sees physicians and physician assistants who are older get caught up in Medicare or other fraud cases. There are a couple of reasons for this. One is that often the older physicians or providers are vulnerable in that they are having financial problems and are looking for a position and the only places that will hire senior citizens are health care businesses that are engaged in suspect activities or want to be able to take advantage of an older person's trusting nature. Sometimes these physicians retired and due to the economy or bad business investments need to work. 

In the past. these physicians were viewed as "victims" by the government but now they are being prosecuted alongside the individuals who created and profited from the fraud scheme. The older physicians and providers usually do not make much money from these schemes. If you or someone you know is an older provider be sure to perform due diligence on any clinic or health care business before working there especially when there is billing to government or insurance programs. 

Posted by Tracy Green, Esq. 


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