Hospice Owner Sentenced to More Than 14 Years in Prison in Multi-Million-Dollar Health Care Fraud Scheme
|U.S. Attorney’s Office May 27, 2014|
PHILADELPHIA—Matthew Kolodesh, a/k/a “Matvei Kolodech,” 52, of Churchville, Pennsylvania, was sentenced Friday to 176 months in prison and ordered to pay $16.2 million in restitution to Medicare and $16.2 million in a forfeiture money judgment for orchestrating a scheme to defraud Medicare through his home hospice business, among other crimes, announced United States Attorney Zane David Memeger.
In October 2013, following a four-week jury trial, a federal jury found Kolodesh guilty of conspiracy to commit health care fraud, 21 counts of health care fraud, 11 counts of money laundering, and two counts of mail fraud. From 2003 to 2008, Kolodesh’s business, Home Care Hospice Inc. (HCH), located on Grant Avenue in NE Philadelphia, submitted false claims to Medicare totaling approximately $16.2 million for patients that were not eligible for hospice services and for patients that never received the level of hospice services billed by HCH. Ineligible patients were patients who were not terminally ill and patients who were on service for more than six months.
The scheme was successful because nurses and other staff participated in a massive fraud that involved altering patient records to make patients appear eligible for hospice services, when in reality they were not. HCH even tricked Medicare auditors. At the direction of Kolodesh and co-owner and co-conspirator Alex Pugman, who was the director of HCH, HCH nurses and supervisory staff routinely “fixed” patient files and re-wrote nursing documentation to make patients appear sicker “on paper” by showing decline in medical condition through false entries for infections, fever, and weight loss, among other things. Old records were destroyed. The staff was also paid to falsely document 24 hour periods of high cost, intensive hospice care than was actually provided to the patient.
In order to buildup patient enrollment, Kolodesh and Pugman also paid health care professionals, including doctors, for referring patients to HCH, even when those patients were not eligible or appropriate for hospice services. In an effort to mask the kickback scheme, HCH fraudulently represented that some of those health care professionals were paid for services as medical directors, advisers, or hospice physicians.
“This massive fraud on a critical federal program costs taxpayers dearly,” said United States Attorney Zane David Memeger. “Today’s sentence makes clear that the justice system will punish severely those criminals who engage in this type of fraud and abuse. We will continue to work diligently with our federal partners to bring to justice those who defraud the government and deprive federal programs of valuable tax dollars.”
“Medicare is a crucial component of our nation’s healthcare system,” said FBI Special Agent in Charge Edward J. Hanko. “This sentence sends a clear message to anyone looking to game that system and steal taxpayers’ money: we will catch you, and we will put you away.”
“Kolodesh’s 14-year prison sentence is a clear message to those stealing from Medicare,” said Nick DiGiulio, Special Agent in Charge for the Inspector General’s Office of the U.S. Department of Health and Human Services in Philadelphia. “We will keep working with our partners to protect our health care system from fraud, waste, and abuse and to send thieves to prison.”
Kolodesh siphoned $7.77 million dollars from HCH’s bank account for his own personal enrichment. His spouse was set up as a sham CEO of the company and received millions of dollars in salary draws and bonuses. Kolodesh also used funds for extensive renovations to his mansion, travel expenses for his family and friends, college tuition for his son, and a luxury automobile. He siphoned substantial sums of cash from the HCH operating account through cash kickback arrangements with various HCH vendors using a system of phony and inflated invoicing and through a charitable donation scam arranged with a local synagogue in which he was a member.
The mail fraud convictions stemmed from another scam orchestrated by Kolodesh which involved the Philadelphia Development Corporation (PIDC). In 2005, Kolodesh and Pugman applied for a low-interest loan worth $2.5 million with PIDC, a program designed to stimulate business investment and create jobs in the city of Philadelphia. The loan money was to be used to acquire and renovate a property for the business and to create 50 bona fide jobs in Philadelphia at 2801 Grant Avenue, the site of HCH. However, between August 2005 and July 2009, the job quota was not being met. To prevent default on the loan, Kolodesh set up a sham office at the Grant Avenue location purportedly for Community Home Health (CHH), his Bucks County health care business. Kolodesh falsely identified 73 CHH employees as working at that office location on Grant Avenue who, in fact, did not work there.
The case was investigated by the Federal Bureau of Investigation and the Department of Health and Human Services, Office of Inspector General. It was prosecuted by Assistant United States Attorney Suzanne B. Ercole and Trial Attorney Margaret Vierbuchen of the Organized Crime and Gang Section in the Justice Department’s Criminal Division.