BROOKLYN, NY—Earlier today, defendant Dr. Okon Umana, 68, was sentenced to 24 months in prison for his role as the “no show” doctor in a $13 million health care fraud scheme. Umana previously pleaded guilty to health care fraud conspiracy on December 1, 2014. As part of the sentence, the court entered an order directing Umana to pay $6,429,330 in restitution and to forfeit $6,550,036. The sentencing proceeding was held before U.S. District Judge John Gleeson.

The sentence was announced by Kelly T. Currie, Acting United States Attorney for the Eastern District of New York; Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division; Scott Lampert, Special Agent-in-Charge, Health of Human Services, Office of Inspector General (HHS-OIG), New York Region; and Diego Rodriguez, Assistant Director-in-Charge, Federal Bureau of Investigation, New York Field Office (FBI).

From 2009 to 2012, Umana was the medical director of Cropsey Medical Care PLLC (Cropsey), a health care clinic located in Bensonhurst, Brooklyn. In connection with his guilty plea, Umana admitted that many of Cropsey’s medical services were provided by a physician’s assistant who was acting without supervision by a medical doctor, and that Cropsey nevertheless billed Medicare and Medicaid for the services using Umana’s provider number. In addition, Umana admitted that in seeking reimbursement for costs purportedly incurred transporting certain beneficiaries to and from Cropsey by ambulette, he falsely certified that transportation by ambulette was medically necessary.

Between November 2009 and October 2012, Cropsey submitted more than $13 million in claims to Medicare and Medicaid for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests. Medicare and Medicaid reimbursed Cropsey more than $6 million for the claimed services and procedures. Eight other individuals charged in connection with the scheme previously pleaded guilty. To date, one other individual has been sentenced.

“Rather than using his license to practice medicine, Dr. Umana used it to fraudulently bill Medicare and Medicaid for services he did not provide,” stated Acting United States Attorney Currie. “Protecting taxpayer funded programs such as Medicaid and Medicare is a priority of this Office and the Department of Justice.” Mr. Currie extended his grateful appreciation to HHS-OIG and the FBI for their work on the investigation.

The government’s case is being prosecuted by Assistant U.S. Attorney Shannon C. Jones of the Eastern District of New York and Trial Attorney Sarah M. Hall of the Criminal Division’s Fraud Section.

This case is being 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.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 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.

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

The Defendant:

• OKON UMANA
• Age: 68
• West Haven, Connecticut
• E.D.N.Y. Docket No. 12 CR 617 (S-1)(JG)