Healthcare Facility Fraud – Insurance Fraud
A federal jury convicted a New York man today for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed.
According to court documents and evidence presented at trial, Harold Bendelstein, 71, of Queens, billed Medicare and Medicaid for an incision procedure of the external ear for hundreds of patients, when in fact all he actually performed was an ear exam or ear wax removal. Specifically, between January 2014 and February 2018, Bendelstein, an ENT doctor, billed Medicare and Medicaid approximately $585,000 and was paid approximately $191,000. Medicare and Medicaid data demonstrated that Bendelstein was an outlier and the highest biller for this procedure in New York State.
Bendelstein was convicted of one count of health care fraud and one count of making a false claim. He is scheduled to be sentenced on Nov. 7, and faces a maximum penalty of 15 years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; U.S. Attorney Breon Peace for the Eastern District of New York; Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Office of Investigations; and Acting Medicaid Inspector General Frank T. Walsh of the Office of the Medicaid Inspector General (OMIG) made the announcement.
HHS-OIG and OMIG investigated the case.
Trial Attorneys Andrew Estes and Patrick J. Campbell of the Criminal Division’s Fraud Section and Assistant U.S. Attorney John Vagelatos of the Eastern District of New York are prosecuting the case.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at https://www.justice.gov/criminal-fraud/health-care-fraud-unit.
Tags: Arrests False Claims Healthcare Fraud