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December 1, 2014

Doctor Pleads Guilty in Connection with $13 Million Health Care Fraud Scheme

WASHINGTON—A doctor at a Brooklyn, New York, health care clinic pleaded guilty today in the Eastern District of New York to conspiring to defraud the United States in connection with his role in a $13 million health care fraud scheme. Dr. Okon Umana, 67, of Connecticut, is the last of nine defendants charged to plead guilty in connection with the scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Loretta E. Lynch of the Eastern District of New York, Assistant Director in Charge George Venizelos of the FBI’s New York Field Office and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) New York Office made the announcement.

According to court documents, from 2009 to 2012, Umana was the medical director of Cropsey Medical Care PLLC in Brooklyn. Patients at Cropsey Medical received medically unnecessary physical therapy, diagnostic testing and other services, which were provided by a physician assistant who was acting without supervision. Such purported medical services were then fraudulently billed by Cropsey Medical to Medicare and Medicaid under Dr. Umana’s provider number. From approximately November 2009 to October 2012, Cropsey Medical submitted more than $13 million in claims to Medicare and Medicaid, seeking reimbursement for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests that were not medically necessary and often did not even occur.

Umana pleaded guilty before U.S. District Judge John Gleeson of the Eastern District of New York. Sentencing is scheduled for April 15, 2015.

The case was investigated by the FBI and HHS-OIG, brought as part of the Medicare Fraud Strike Force, and supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case is being prosecuted by Trial Attorney Sarah M. Hall of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Shannon Jones of the Eastern District of New York.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

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