Natalia Dochim Allegedly Induced Patients Into Fake Substance Abuse Treatment, Then Pocketed Millions Of Dollars
Schneiderman: We Will Continue To Root Those Who Prey On New Yorkers In Need Of Substance Abuse And Addiction Treatment
Attorney General Eric T. Schneiderman today announced the indictment and arraignment of Natalia Dochim, 39, of Nyack, New York, and corporate entities Miromedical P.C. (“Miromedical”) and Ferrara Medical Care, P.C. (“Ferrara”), on charges of Grand Larceny in the First Degree, Grand Larceny in the Second Degree, Health Care Fraud in the Second Degree, Money Laundering in the Second Degree, and Grand Larceny in the Fourth Degree. Prosecutors allege that Dochim, Miromedical, and Ferrara submitted claims for reimbursement for substance abuse treatment services to Medicaid and to MetroPlus, a state-funded managed care organization (“MCO”), when they were not certified to provide such services and for medical services allegedly rendered to MFCU undercover investigators that never occurred.
“The opioid epidemic should not serve as an excuse for unscrupulous individuals to illegally line their own pockets,” said Attorney General Schneiderman. “Medicaid is intended to protect some of our most vulnerable citizens, and we will continue to root out those who prey on New Yorkers in need of substance abuse and addiction treatment.”
Prosecutors allege that Dochim, aided by co-conspirators in her scheme, lured Medicaid patients to Miromedical and Ferrara by paying kickbacks and offering prescriptions of Suboxone, a narcotic drug used to treat opioid addiction. Once recruited, patients at Miromedical and Ferrara, prosecutors allege, encountered the façade of a substance abuse treatment program. Medically appropriate and necessary medical histories were not always obtained, physicals were not taken, initial counseling did not occur, and there was a complete lack of appropriate follow-up and monitoring. Consequently, all patients were treated the same; mandated to enroll in one particular MCO (MetroPlus), sent to a purported “detox” program, and prescribed Suboxone at the maximum dosage in lieu of legitimate substance abuse treatment. If actually provided, prosecutors allege, the so-called “detox” treatment that patients were required to obtain was, according to the claims submitted by Miromedical and Ferrara, merely vitamin injections, which is not an approved treatment for opioid addiction.
Thereafter, prosecutors charge, Dochim, through Miromedical and Ferrara, submitted claims to MCOs and to Medicaid that bore little to no resemblance to the medical services actually rendered. Prosecutors allege services such as spirometry, a pulmonary function test, and allergy testing, were routinely billed but never provided. Patient “recruiters” working inside Miromedical and Ferrara, it is alleged, also openly offered to buy back patient’s Suboxone prescriptions for cash.
Relying on the accuracy of substance abuse treatment claims submitted by Dochim, prosecutors allege that MetroPlus paid over $2.3 million and that Medicaid paid over $330,000 to Dochim, Miromedical and Ferrara, funds to which they were not entitled and which Dochim is alleged to have then laundered through various shell companies.
Bronx County Supreme Court Justice William Mogulescu arraigned Dochim, Miromedical and Ferrara Medical Care on the charges and adjourned the matter to December 9. If convicted, the defendant faces up to twenty-five years in prison.
Bail was set at $250,000 bond over $100,000 cash, with a condition that the defendant must wear an ankle monitoring bracelet should she make bail.
The Attorney General previously obtained an order freezing the bank accounts and other property held by the defendants and attaching up to $7,743,013.71 of those assets. The Attorney General also obtained a temporary restraining order preventing dissipation or transfer of the property controlled by the defendants.
The Attorney General would like to thank the New York City Human Resources Administration (“HRA”), notably the work of HRA’s Medicaid Provider Investigations and Audit Unit, and the New York State Office of Alcoholism and Substance Abuse Services for their partnership and valuable assistance throughout the investigation. In addition, the Attorney General thanks the United States Department of Health and Human Services-Office of the Inspector General and the New York State Office of the Medicaid Inspector General, MFCU’s partners in combatting fraud against the Medicaid program. The Attorney General also thanks MetroPlus and Healthfirst for their cooperation in this investigation.
The investigation was led by Senior Investigator Albert Maiorano and Investigators David Ryan and Julie Clancy with the assistance of Supervising Investigators Dominick DiGennaro and Michael Casado under the supervision of Deputy Chief Investigator Kenneth Morgan. Audit support was provided by Principal Auditor-Investigator Patricia Iemma and Auditor-Investigator Coleman Williams under the supervision of MFCU NYC Chief Auditor Thomasina Smith. Investigative support was provided by Confidential Legal Analyst Nicole Maher.
The criminal case is being prosecuted by Special Assistant Attorneys General Erin Kelsh and David Arias with the assistance of MFCU NYC Regional Director Christopher M. Shaw. Thomas O’Hanlon is MFCU’s Chief of Criminal Investigations-Downstate. The civil case is being handled by Special Assistant Attorneys General David Abrams, Gerri Gold and Elizabeth Silverman with the assistance of MFCU Civil Enforcement Chief Carolyn Ellis. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney.
The charges filed in this case are merely accusations. The defendants are presumed innocent unless and until proven guilty in a court of law.
No comments:
Post a Comment