Two Men Charged With Schemes To Defraud Medicare As Part Of Nationwide Health Care Fraud Takedown

The Two Men Are Responsible For More Than $1 Million In Losses To Medicare

  Geoffrey S. Berman, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge for the New York Office of Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”), announced charges today against JAMES WOODSON and ANTHONY PALMIERI for their participation in separate fraudulent schemes that resulted in more than $1 million in losses to the Medicare program.  These charges are part of a nationwide health care fraud takedown, which resulted in criminal charges against 601 individuals for their alleged participation in health care fraud schemes involving approximately $2 billion in fraudulent claims. 

Manhattan U.S. Attorney Geoffrey S. Berman said:  “By allegedly falsely obtaining HIV medication, and by billing Medicare for diagnostic tests that were never provided, these individuals have cost American taxpayers more than $1 million, and, in the case of the HIV medicine, also endangered the lives of those who unwittingly bought medication that had been re-sold on the black market.  These prosecutions show that those who defraud our nation’s health care programs will be brought to justice.”   

HHS-OIG Special Agent in Charge Scott J. Lampert said:  “Health care fraud is costly to vulnerable patients and the federal health care programs that serve them.  Working closely with our law enforcement partners, we are sending a clear message that actions can have serious consequences.”

According to the allegations in the Complaint[1] in United States v. James Woodson (“WOODSON”), unsealed on Monday in Manhattan federal court, WOODSON obtained prescriptions for complete regimens of human immunodeficiency virus (“HIV”) medications from both the Veterans Administration (“VA”), and the Medicare Part D (“Medicare”) program.  WOODSON allegedly sold the excess medication on the black market.  In an effort to avoid detection, WOODSON changed Medicare plans at least 16 times.  He also utilized at least 34 different pharmacies and 40 different doctors, to maximize the amount of HIV medication he could obtain.  As a result of these actions, WOODSON defrauded the Medicare program by at least $815,000.

According to the allegations in the Complaint in United States v. Anthony Palmieri (“PALMIERI”), which was unsealed on Tuesday in Manhattan federal court, from November 2014 through May 2016, PALMIERI conspired with others to use his company’s position as an enrolled participant in Medicare to submit, or cause to be submitted, to Medicare numerous claims that falsely represented that certain health care services, such as ultrasounds, had been provided to patients.  As a result of the fraudulent scheme, Medicare paid for services that were never performed.  As a result of these actions, PALMIERI and his co-conspirators defrauded the Medicare program by at least $481,000.

WOODSON, 54, of Manhattan, New York, is charged with one count of health care fraud, which carries a maximum penalty of 10 years in prison.  PALMIERI, 40 of Holmdel, New Jersey, is charged with one count of conspiracy to commit health care fraud, and one count of health care fraud, each of which carries a maximum penalty of 10 years in prison.  The maximum potential sentences in these cases are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendants will be determined by the judge. 

These cases, he Office’s General Crimes Unit.  Assistant United States Attorney Louis A. Pellegrino is in charge of United States v. Woodson, and Assistant United States Attorney Timothy V. Capozzi is in charge of United States v. Palma part of the Department of Justice’s National Healthcare Fraud Takedown, are being handled by tieri.        

The charges contained in the Complaints are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

[1] As the introductory phase signifies, the entirety of the text of the Complaints, and the description of the Complaints set forth herein, constitute only allegations, and every fact described should be treated as an allegation.