Three People Arrested in Puerto Rico in a Contractor Major Scheme to Defraud the U.S. Department Of Veterans Affairs

On June 3, 2015, a federal grand jury in the District of Puerto Rico returned a five count indictment charging Jose A. Rosa-Colon, his brother and business partner, Ivan Rosa-Colon and Louis Enrique Torres with a multi-million dollar Service-Disabled Veteran-Owned Small Business (SDVOSB) scheme to defraud the U.S. Department of Veteran Affairs.  The charges include major fraud against the United States and wire fraud.  This investigation was conducted by Special Agents from the U.S. Department of Veteran Affairs, Office of Inspector General, Criminal Investigations Division.

The indictment unsealed in federal court today alleges that from on or about 2007 to 2014, Ivan Rosa-Colon, Jose Rosa-Colon and Torres conspired to use Jose Rosa-Colon’s service-disabled veteran status to create BELKRO General Contractors, which was a pass- through or front company for Ivan Rosa-Colon’s other business, IRC Air Contractors.

The indictment alleges that Ivan Rosa-Colon and Louis Torres used Jose Rosa-Colon’s service-disabled veteran status to certify and register BELKRO General Contractors in various government databases as a SDVOSB after Ivan Rosa- Colon learned that President George W. Bush would be signing a government stimulus package encouraging the use of SDVOSB.  The stimulus package would allow for government agencies to award non-competitive, set-aside or sole-source government contracts to SDVOSB like BELKRO General Contractors.

The indictment further alleges that Jose Rosa-Colon, owner of BELKRO General Contractors, was employed as a full-time U.S. Postal Service Carrier; he was not in charge of the day to day operations of BELKRO General Contractors.  Jose Rosa-Colon was simply a figurehead or “rent-a-vet”, who was being used for his service-disabled veteran status to obtain contracts for his brother Ivan Rosa-Colon’s company.  As a result of the scheme, BELKRO General Contractors unlawfully received set-aside and/or sole-source SDVOSB contracts from the U.S. Department of Veterans Affairs, including contracts involving American Recovery and Reinvestment Act (ARRA) funds.

If convicted, they face a term of 20 years in prison as to each wire fraud charge and up to ten years in prison for the charges of major fraud against the United States.  Additionally, they face fines of up to $250,000 and up to three years of supervised release as to each count.

This indictment was announced today by U.S. Attorney Rosa Emilia Rodríguez-Vélez for the District of Puerto Rico, Special Agent in Charge Monty Stokes for the Southeast Field Office, Department of Veterans Affairs, Office of Inspector General, Criminal Investigations Division and Acting Special Agent in Charge Sharon Johnson for the Eastern Regional Office, Small Business Administration, Office of Inspector General.  The government is represented by Assistant U.S. Attorney Julia Diaz-Rex.

Members of the public are reminded that an indictment constitutes only charges and that every person is presumed innocent until their guilt has been proven beyond a reasonable doubt.

Biomet Companies to Pay Over $6 Million to Resolve False Claims Act Allegations Concerning Bone Growth Stimulators

EBI LLC, doing business as Biomet Spine and Bone Healing Technologies and Biomet Inc. have agreed to pay $6.07 million to resolve allegations that EBI violated the False Claims Act by paying kickbacks to induce use of its bone growth stimulators and billing federal health care programs for refurbished stimulators, the Department of Justice announced today.  EBI is a medical device company located in Parsippany, New Jersey, that sells bone growth stimulators, which are used to repair fractures that are slow to heal.  It is a subsidiary of Biomet, which is based in Warsaw, Indiana.

“Medical device companies must not use improper financial incentives to influence the decision to use their products,” said Acting Deputy Assistant Attorney General August Flentje of the Justice Department’s Civil Division.  “This settlement demonstrates the department’s commitment to protect patients, and the taxpayers who fund their care, by ensuring that medical decisions are based on the patients’ medical needs rather than the financial interests of others.”

The United States alleged that, from 2001 to 2008, EBI paid staff at doctors’ offices to influence doctors to order its bone growth stimulators.  These payments were allegedly provided pursuant to personal service agreements with staff members. The United States concluded that these payments violated the Anti-Kickback Act and resulted in false billings to various federal health care programs, including Medicare.  The settlement also resolves EBI’s disclosure that it received federal reimbursements for bone growth stimulators that had been refurbished.

“This settlement demonstrates our resolve in ensuring that patients receive, and the government pays for, health care that is based on sound medical judgment, and not compromised by kickbacks,” said U.S. Attorney Carmen M. Ortiz of the District of Massachusetts.

“Kickbacks taint medical decision-making, cause overutilization of services, and lead to increased taxpayer and patient costs,” said Special Agent in Charge Phillip Coyne of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG).  “These improper inducements have no place in government health programs relied on by millions of Americans.”

The settlement resolves in part an allegation filed in a lawsuit by Yu Yue, a former product manager for EBI, in federal court in New Jersey.  The lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private individuals to sue on behalf of the government for false claims and to share in any recovery.  Yu’s share has not yet been determined.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $23 billion through False Claims Act cases, with more than $14.8 billion of that amount recovered in cases involving fraud against federal health care programs.

The settlement was the result of a coordinated effort by the Commercial Litigation Branch of the Civil Division; the U.S. Attorney’s Office for the District of Massachusetts; HHS-OIG; the U.S. Postal Service Office of Inspector General; the Defense Criminal Investigative Service; the U.S. Department of Veterans Affairs, Office of Inspector General and the U.S. Food and Drug Administration, Office of Criminal Investigations.

Ms. Yu’s case is captioned United States ex rel. Yu v. Biomet, Inc., Civil Action No. 09-1731 (D.N.J.).  The claims resolved by the settlement are allegations only; there has been no determination of liability.

Former Veterans Affairs Psychiatrist Sentenced for Medicare Fraud

A licensed psychiatrist formerly employed by the Department of Veterans Affairs (VA) was sentenced today to serve 18 months in prison for falsely claiming to provide at-home services to Medicare beneficiaries.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta E. Lynch of the Eastern District of New York and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
Dr. Mikhail L. Presman, 56, of Brooklyn, N.Y., was sentenced by Judge I. Leo Glasser in the Eastern District of New York.   Presman was sentenced to serve three years of supervised release following his prison term and ordered to forfeit $1.2 million and pay restitution to Medicare.
According to court documents, from Jan. 1, 2006, through May 10, 2013, Presman submitted approximately $4 million in Medicare claims for home treatment of Medicare beneficiaries notwithstanding his full-time salaried position as a psychiatrist at the VA hospital in Brooklyn.   Presman did not provide any treatment to a substantial number of the beneficiaries he claimed to have treated.   For example, Presman submitted claims to Medicare for home medical visits at locations within New York City even though he was physically located in China at the time of these purported home visits.   Presman also submitted claims to Medicare for 55 home medical visits to beneficiaries who were hospitalized on the date of the purported visits.
The case was investigated by the HHS-OIG, with assistance from the  HHS’s Centers for Medicare & Medicaid Services,, and brought as part of the Medicare Fraud Strike Force, under the supervision of the U.S. Attorney’s Office for the Eastern District of New York and the Criminal Division’s Fraud Section.   The case was prosecuted by Trial Attorney Bryan D. Fields of the Fraud Section and Assistant United States Attorney Patricia E. Notopoulos of 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 more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion.   In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

FORMER CONTRACTOR OF A FLORIDA PROPERTY MANAGEMENT COMPANY SENTENCED TO SERVE TIME IN PRISON FOR WIRE FRAUD

WASHINGTON —A former repair contractor of a  Florida property management company was sentenced to serve time in prison for his  participation in a wire fraud scheme related to housing repairs made under a  contract between Ocwen Loan Servicing LLC, and the U.S. Department of Veterans  Affairs (VA), the Department of Justice announced today.

Ronald B. Hurst was sentenced by  Judge Philip G. Reinhard of the U.S. District Court for the Northern District  of Illinois in Rockford to serve 24 months in prison for his role in the  conspiracy.

In addition, a second former repair  contractor, Bryant A. Carbonell, was sentenced by Judge Reinhard to serve six  months of home confinement for his role in the conspiracy.  Hurst and Carbonell were sentenced to pay $147,825  jointly and severally in restitution to the VA.  Hurst pleaded guilty on Feb. 15, 2013, to two  wire fraud counts of a 10-count indictment and Carbonell pleaded guilty on  Sept. 21, 2012, to the same charges.

An indictment, originally filed in  January 2012, charged Hurst, Carbonell and Ryan J. Piana with conspiring to  commit bribery and wire fraud from at least January 2006 until as late as  September 2007.  Hurst, Carbonell and Piana  were also charged with bribery and wire fraud.  As part of the plea agreements, the United  States agreed to dismiss the remaining counts against Hurst and Carbonell at  the time of their sentencing.
“By paying kickbacks in exchange for  contracts to companies they secretly owned or with which they were affiliated,  the conspirators created the illusion of competition while illegally steering  contracts to themselves,” said Bill Baer, Assistant Attorney General in charge  of the Department of Justice’s Antitrust Division.  “Today’s sentencing reaffirms the Antitrust  Division’s commitment to prosecuting schemes that undermine competition in the  VA Mortgage Guarantee Program.”
Hurst and Carbonell were former  contractors for West Palm Beach, Fla.-based Ocwen Loan Servicing LLC. Piana was  a former residential sales manager at Ocwen.  According to court documents, Ocwen managed  foreclosed properties under contract with the VA, which guaranteed qualifying residential  mortgages for veterans.  Under the  contract between the VA and Ocwen, if a veteran defaulted, Ocwen completed  necessary repairs and re-sold the property.  Proceeds from the re-sale of VA-acquired  properties directly benefit the VA by reducing the cost of guaranteeing  residential mortgages to veterans.
According to the charges, Hurst and  Carbonell paid Piana to steer housing repair work to companies affiliated with Hurst  and Carbonell.  Piana recruited other  Ocwen employees into the scheme and paid them on behalf of himself and the  other conspirators.  The department said  in order to execute the scheme, the conspirators sent, or caused to be sent,  various transmissions via wire communication.
This is the third case involving  properties managed by Ocwen under contract with the VA. On Dec. 3, 2010,  Benjamin K. Graves, also a former Ocwen employee, pleaded guilty in U.S.  District Court in Orlando, Fla., to wire fraud in connection with the VA contract.   On Jan. 25, 2012, Joshua R. Nusbaum,  another former Ocwen employee, and Andrew J. Nusbaum, a former Ocwen  contractor, pleaded guilty in U.S. District Court in Orlando, Fla., to wire  fraud in connection with the same VA contract.  Piana pleaded guilty to the same counts as  Carbonell and Hurst on July 16, 2013, in U.S. District Court in Orlando, Fla.  Piana was sentenced on Sept. 30, 2013, to serve  24 months in prison and to pay $147,285 in restitution to the VA.

The sentence announced today resulted  from a federal investigation of housing repair contracts performed under  contract with the VA.  The investigation  is being conducted by the Antitrust Division’s Chicago Office and the Central  Field Office of the U.S. Department of Veterans Affairs, Office of Inspector  General, Criminal Investigations Division, located in Hines, Ill. Anyone with  information concerning suspicious activity relating to housing repairs  performed under a contract with the VA should contact the Antitrust Division’s Chicago Office at 312-353-7530 or visit  www.justice.gov/atr/contact/newcase.htm.

Former Employee of Florida Property Management Company Sentenced to Serve Time in Prison for Wire Fraud

A former residential sales manager of a Florida property management company was sentenced to serve 24 months in prison today in the U.S. District Court for the Middle District of Florida, in Orlando, for his participation in a wire fraud scheme involving housing repair contracts for the U.S. Department of Veterans Affairs (VA), the Department of Justice announced.

Ryan J. Piana pleaded guilty on July 16, 2013, to two wire fraud counts of a 10-count indictment. In addition to his prison sentence, U.S. District Court Judge Roy B. Dalton Jr. also sentenced Piana to pay $147,285 in restitution to the VA.

The indictment, originally filed in January 2012, in the U.S. District Court for the Northern District of Illinois, in Rockford, charged Piana, Ronald B. Hurst and Bryant A. Carbonell with conspiring to commit bribery and wire fraud from beginning at least as early as January 2006 continuing until as late as September 2007.  Piana, Hurst and Carbonell were also charged with bribery and wire fraud.  As part of the plea agreement, the United States agreed to dismiss the remaining counts against Piana at the time of his sentencing.

“Steering contracts to a company in return for kickbacks distorts the competitive process and harms consumers,” said Bill Baer, Assistant Attorney General in charge of the Department of Justice’s Antitrust Division.  “The Antitrust Division will not tolerate anticompetitive activity that defrauds the Department of Veterans Affairs.”

Piana is a former residential sales manager at West Palm Beach, Fla.-based Ocwen Loan Servicing LLC, and Hurst and Carbonell are former contractors for Ocwen.  According to court documents, Ocwen managed foreclosed properties under contract with the VA, which guaranteed qualifying residential mortgages for veterans.  Under the contract between the VA and Ocwen, if a veteran defaulted, Ocwen completed necessary repairs and re-sold the property.  Proceeds from the re-sale of VA-acquired properties directly benefit the VA by reducing the cost of guaranteeing residential mortgages to veterans.

According to the charges, Hurst and Carbonell paid Piana to steer housing repair work to companies affiliated with Hurst and Carbonell.  Piana recruited other Ocwen employees into the scheme and paid them on behalf of himself and the other conspirators.  The department said in order to execute the scheme, the conspirators sent, or caused to be sent, various transmissions via wire communication.

Carbonell pleaded guilty to the wire fraud counts on Sept. 21, 2012.  Hurst pleaded guilty to the same counts on Feb. 15, 2013.  Both Hurst and Carbonell entered their guilty pleas in the U.S. District Court in Rockford. Their sentencing dates are scheduled for Dec. 5 and 6, 2013, respectively.

This is the third case involving properties managed by Ocwen under contract with the VA. On Dec. 3, 2010, Benjamin K. Graves, also a former Ocwen employee, pleaded guilty in U.S. District Court in Orlando to wire fraud in connection with the VA contract.  On Jan. 25, 2012, Joshua R. Nusbaum, another a former Ocwen employee, and Andrew J. Nusbaum, a former Ocwen contractor, pleaded guilty in U.S. District Court in Orlando to wire fraud in connection with the same VA contract.

The sentence announced today resulted from an ongoing federal investigation of housing repair contracts performed under contract with the VA.  The investigation is being conducted by the Antitrust Division’s Chicago Office and the Central Field Office of the U.S. Department of Veterans Affairs, Office of Inspector General, Criminal Investigations Division, located in Hines, Ill.