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March 6, 2015

New York Doctor Pleads Guilty in $14.2 Million Medicare Fraud Scheme

A New York doctor pleaded guilty today for his involvement in a scheme to fraudulently bill Medicare for $14.2 million in claims for medically unnecessary treatments.

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 Diego G. Rodriguez of the FBI’s New York Field Office and Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) New York Field Office made the announcement.

Roman Johnson, 40, formerly of Buffalo, New York, pleaded guilty before U.S. Magistrate Judge Marilyn D. Go in the Eastern District of New York to one count of conspiracy to commit health care fraud. Sentencing will be scheduled at a later date. As part of the plea, Johnson agreed to pay $5,386,363 in restitution to the Medicare program, which represents the total amount of money Medicare paid as the result of the fraudulent claims.

In connection with his guilty plea, Johnson admitted that he and other medical providers at the clinic submitted approximately $14.2 million in false and fraudulent claims to Medicare for medically unnecessary vitamin infusions, physical therapy, and occupational therapy that did not qualify for reimbursement by Medicare.

The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case was prosecuted by Trial Attorney Bryan D. Fields of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Erin E. Argo 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 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion. In addition, HHS’ Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: www.stopmedicarefraud.gov.

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