Area Chiropractor Pleads Guilty to Health Care Fraud in Scheme Involving Billings to D.C. Medicaid Program
WASHINGTON—Lewis J. Levine, 57, a chiropractor who practiced in Southeast Washington, pled guilty today to a federal charge of health care fraud for his role in a scheme involving fraudulent claims to the District of Columbia Medicaid program.
The guilty plea was announced by U.S. Attorney Ronald C. Machen Jr.; Andrew G. McCabe, Assistant Director in Charge of the FBI’s Washington Field Office, and Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), for the region that includes Washington, D.C.
Levine, of Laurel, Md., pled guilty in the U.S. District Court for the District of Columbia. The Honorable Colleen Kollar-Kotelly scheduled a status hearing for Jan. 8, 2015. The charge carries a statutory maximum of 10 years in prison and financial penalties. Under federal sentencing guidelines, the parties have agreed that Levine faces a likely range of 10 to 16 months in prison and a fine of $3,000 to $30,000. He also has agreed to pay $50,260 in restitution to the D.C. Medicaid program and an identical amount in a forfeiture money judgment.
The plea agreement calls for Levine to cooperate in a continuing investigation involving fraud, kickbacks, and false billings in the field of home care services for D.C. Medicaid patients.
The fraud involved D.C. Medicaid payments for home care services to be performed by personal care aides, working for home care agencies. The aides assist Medicaid beneficiaries in performing activities of daily living, such as getting in and out of bed, bathing, dressing, keeping track of medication, and so forth. In order to be covered for such benefits, the beneficiaries must get prescriptions from physicians or advanced practice registered nurses. D.C. Medicaid only reimburses for care services if a physician determines after a physical examination that the beneficiary has functional limitations impairing activities of daily living. The prescriptions, also known as “intakes,” propose the frequency and duration of the services to be provided. The prescriptions are translated later into plans of care, also to be signed by the physician.
In the District of Columbia, a typical prescription, or “intake,” calls for eight hours of personal care services per day for five days per week, or eight hours per day for seven days per week. Over the six-month time span authorized by such a prescription, D.C. Medicaid could pay between $16,952 and $23,732 for personal care services provided to one beneficiary.
According to a statement of offense, signed by the government as well as the defendant, Levine is licensed as a chiropractor in the District of Columbia, not as a physician. He worked at the Anacostia Neck & Back Pain Center in Southeast Washington. He was not authorized to prescribe personal care services, and he was not enrolled as a provider in D.C. Medicaid.
“This chiropractor fueled health care fraud in the District of Columbia by signing hundreds of fake prescriptions used to bilk Medicaid in exchange for cash payments,” said U.S. Attorney Machen. “Levine even signed off as the ‘ordering physician’ on prescriptions for patients that he never even met. His guilty plea is another step forward in our efforts to address the epidemic levels of fraud in D.C.’s home health care industry. We will continue to battle this fraud that diverts precious taxpayer dollars, drives up the cost of health care, and jeopardizes the strength of a program that serves the most vulnerable members of our society.”
“Mr. Levine took advantage of D.C.’s Medicaid program by taking money from home health care agencies in exchange for illegally writing prescriptions for patients he never saw or services he was not qualified to provide, ” said Assistant Director in Charge McCabe. “The FBI, with our partners at HHS-OIG, will continue to investigate this criminal activity which impacts our health care system and our public safety, and makes it more difficult for those who truly deserve to receive proper health care services.”
“Being a health care provider in the Medicaid program is a privilege, not a right. When Lewis Levine sold prescriptions for personal care services that he was not even authorized to prescribe, just to enrich himself, he violated the basic trust that taxpayers extend to health care professionals,” said Special Agent in Charge DiGiulio. “Our agents will continue to work with the Department of Justice to root out all forms of waste, fraud and abuse in our federal health care programs.”
According to the statement of offense, Levine and others carried out their scheme to defraud the D.C. Medicaid program from approximately November 2012 through February 2014. Personal care aides, working for at least eight home care agencies, brought numerous beneficiaries to Levine, and he wrote prescriptions and plans of care, listing himself as the “ordering physician,” after brief examinations; sometimes, however, he never even met the beneficiary.
Levine initially was paid $75 for each D.C. Medicaid beneficiary brought to his office by a personal care aide, but he later increased the size of the cash payments to $150. Levine’s prescriptions, or “intakes,” typically included a diagnosis such as “chronic severe back pain” and called for services for eight hours a day, seven days a week, for six months.
During the course of the fraud scheme, Levine signed hundreds of prescriptions and plans of care, and in exchange collected at least $50,260 in cash payments from D.C. Medicaid beneficiaries and personal care aides. Home care agencies used Levine’s prescriptions and plans of care to support and justify their claims for payment to Medicaid – even though the paperwork was invalid on its face because it was not prescribed or signed by a physician as required.
This investigation was conducted by the FBI’s Washington Field Office and the U.S. Department of Health and Human Services, Office of Inspector General. Assistance was provided by the District of Columbia’s Department of Health Care Finance and other agencies.
This case is being prosecuted by Assistant U.S. Attorneys Ted Radway, Lionel André, and Michael Friedman, and Special Assistant U.S. Attorney Dangkhoa Nguyen, of the office’s Fraud and Public Corruption Section, and Assistant U.S. Attorney Anthony Saler of the office’s Asset Forfeiture and Money Laundering Section.
The FBI has set up a hotline number to report suspected incidents of Medicaid fraud: 855-281-1242. People can also provide information by e-mail to HealthCareFraud@ic.fbi.gov.
HHS-OIG also has a hotline that can be reached at 800-HHS-TIPS or by visiting the agency’s website at http://oig.hhs.gov/ and clicking on the “Report Fraud” tab.
Numerous agencies are participating in the broader investigation into Medicaid fraud, including the U.S. Secret Service; the Medicaid Fraud Control Unit of the District of Columbia’s Office of the Inspector General; the Internal Revenue Service-Criminal Investigation; the U.S. Immigration and Customs Enforcement (ICE) Office of Homeland Security Investigations (HSI); the Office of Labor Racketeering and Fraud Investigations, Office of Inspector General, Department of Labor; the Social Security Administration, Office of Inspector General, and the Medicaid Fraud Control Unit of the Maryland Attorney General’s Office.