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.
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.
