GRAND RAPIDS – U.S. attorney Andrew B. Birge has announced a series of criminal and civil enforcement actions taken in connection with a joint health care fraud operation in the Western District of Michigan, which included a Ishpeming man.
Richard Laksonen, a nurse practitioner from Ishpeming, pleaded guilty on August 6 to one count of making a false statement regarding health care matters. As part of his guilty plea, Laksonen admitted that he signed prescriptions for medical devices and genetic cancer tests, attesting that he performed the assessments and verifying that the prescriptions were reasonably and medically necessary, so that in fact, he usually executed them without reviewing the files, according to the US attorney’s office.
For example, officials said Laksonen admitted that in a week he signed around 335 separate records for a single patient, many of which contained multiple types of braces, spending an average of 18 seconds between when he was opened the case and when he executed it. Laksonen continued to approve these orders, “even after a health insurer investigator warned him that the patient referrals were the result of aggressive telemarketing,” according to a press release.
The investigation further established that many of these braces and tests were not medically necessary, officials said. As part of his plea deal, Laksonen admitted that Medicare paid more than $ 5.7 million for the orders he approved and signed.
The court will convict Laksonen on November 15.
The operation involved the investigation of doctors who signed illegitimate orders for medical devices and cancer genetic tests promoted by telemarketers.
The ongoing investigation – dubbed Operation Happy Clickers to reflect many practitioners’ habits of approving these orders “With little or no opinion” – resolves alleged fraud losses to date to the Medicare program of more than $ 7.3 million, the statement said.
These actions follow nationwide deletions of “The so-called traders and owners of sustainable medical equipment supply companies and cancer genetic testing labs who have carried out large-scale fraud schemes designed to defraud the Medicare program” states of liberation. Merchants called Medicare beneficiaries, often through overseas call centers, asking them to “Medically unnecessary orthodontic appliances” and genetic cancer testing for screening purposes, officials said.
“The traders paid doctors to review and sign these prescriptions under the guise of telemedicine, then sold those signed orders to the owners of the EMR supply companies and laboratories in violation of federal anti-kickback law.” , he added. states of liberation.
The resolutions announced by Birge involved four of the Michigan practitioners who approved and signed these ordinances on behalf of the traders, who, in addition to Laksonen, were:
Hugh G. Deery II, MD, from northern Petoskey State; Colleen Browne, DO, formerly from downstate Portland; and Mosab Deen, DO, of upstate Royal Oak. They resolved civil liability for alleged violations of the False Claims Act by making civil settlements with the United States.
“These doctors have approved orders for medically unnecessary braces and genetic cancer testing despite numerous red flags indicating that these items and services were illegitimate,” he added. according to Birge’s office.
Medicare beneficiaries targeted by this fraud scheme have complained that they are “Bombed” by offering telemarketing calls abroad “free” braces.
“If the doctors had taken the time to listen to these recorded phone calls, they would have known that the calls were being handled by telemarketers and not medical professionals. said Birge. “Prescriptions signed by doctors generated hundreds of thousands of dollars Medicare paid for medically unnecessary braces, which recipients often did not want or use. “
Deery agreed to pay $ 301,140, Browne agreed to pay $ 42,000, and Deen agreed to pay $ 28,545. Browne’s settlement agreement also resolved allegations that she ordered medically unnecessary cancer genetic testing for Medicare beneficiaries for cancer screening purposes. Typically, Medicare doesn’t cover genetic testing just for the purpose of finding cancer, according to Birge.
“Since their approval and signatures are required for Medicare to pay for these braces and tests, doctors are the professional backing against these fraud schemes.” Birge said in a statement. “And when doctors ignore their professional responsibilities, facilitating these fraud schemes in our district, they will be held accountable. “
Operation Happy Clickers is an ongoing initiative of the United States Inspector General of Health and Human Services, the FBI, and the United States Attorney’s Office for the Western District of Michigan. Assistant US Prosecutor Raymond E. Beckering III oversees and continues the criminal investigation, and Assistant US Prosecutor Andrew J. Hull represents the United States in parallel civil investigations.
Individuals who are aware of past or current conduct involving the fraudulent solicitation and approval of medical devices and cancer genetic testing through purported telemedicine services may call the Fraud Investigator. Department of the Attorney General’s Office at 616-808-7572 or submit a complaint online at oig.hhs .gov / fraud / report-fraud /.