On May 9, 2019, after a six-week federal jury trial, doctor Paul J. Mathieu and physical therapist Hatem Behiry were each convicted of one count each of conspiracy to commit health care fraud, mail fraud, and wire fraud; and conspiracy to make false statements relating to a health care program; as well as the substantive offenses of health care fraud, mail fraud, and wire fraud. This trial was held in the Southern District of New York.
Between 2007 and 2013, the government alleged that Dr. Mathieu fraudulently posed as the owner of three of six medical clinics in Brooklyn (the “Clinics”), which were all in fact owned by a non-physician and alleged co-conspirator Alexksandr Burman. Mr. Burman has already been sentenced in a related case to 120 months in prison.
The government alleged that from 2009 to 2013, Dr. Mathieu also directly participated in the fraudulent billing practices of the clinics, by visiting several of the clinics on a weekly basis, where he would sign stacks of false and fraudulent medical charts, and issue referrals for expensive additional testing, occupational therapy, and physical therapy, including for physical therapy purportedly provided by Mr. Behiry. It was alleged at trial that during this time period, Dr. Mathieu did not see any patients and simply fabricated medical records falsely stating that he had seen and treated such patients.
During that time period, the government claimed that the Clinics fraudulently billed Medicare and Medicaid approximately $30 million for medical services and supplies that were medically unnecessary and/or not provided.
It was alleged that Mr. Behiry participated in the fraudulent billing practices of the Clinics by pretending to provide physical therapy to many of those same patients, most of whom were receiving cash kickbacks for coming to the Clinics. In fact, the government alleged at trial that Mr. Behiry was engaged in an empty charade designed to create the appearance of physical therapy, while almost no therapy was actually being provided to many patients. Mr. Behiry was also alleged to have prepared and overseen the preparation of a large number of false medical and billing records.
Among other things, Mr. Behiry allegedly completed thousands of fabricated reports, in which patients were described almost identically, and with little or no regard for actual medical conditions or needs. It was also alleged that many of the charts were for patients whom Mr. Behiry and his team had not evaluated or provided therapy to at all.
In addition to his role in the Clinics, it was alleged that Dr. Mathieu also wrote unneeded prescriptions for adult diapers and other incontinence products, which were filled at Universal Supply Depot, a medical supply company also owned by Mr. Burman’s wife, Marina Burman who has already been sentenced to 36 months. The government brought out at trial that Dr. Mathieu throughout this period of the fraud was regularly a top prescriber of adult diapers in the State of New York.
In this case and the related cases, including Dr. Mathieu and PT Behiry a total of 15 people have either plead guilty or been convicted in this and related cases. The other defendants includes two additional physicians (who each got 18 months), occupational therapists, bookkeeper, office managers, and business partners in an ambulette company.
