Topics
More on Compliance & Legal

Brooklyn doctor gets two years in prison for $13 million billing fraud

Okon Umana admitted to fraudulently billing Medicare for physician office visits, physical therapy and diagnostic tests among other things.

Susan Morse, Executive Editor

Okon Umana admitted to fraudulently billing Medicare for physician office visits, physical therapy and diagnostic tests among other things.

A doctor at a Brooklyn, New York, clinic was sentenced Friday to two years in prison for his role in a $13 million healthcare fraud scheme, according to the U.S. Department of Justice.

Okon Umana, 68, of West Haven, Connecticut, was also ordered to pay $6.4 million in restitution and to give up $6.5 million.

From 2009 to 2012, Umana was the medical director of Cropsey Medical Care in Brooklyn. During those years, the medical clinic submitted more than $13 million in claims to Medicare and Medicaid for a variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests, according to the Justice Department.

[Also: Running list of notable 2015 healthcare frauds]

Medicare and Medicaid reimbursed Cropsey more than $6 million for the claimed services and procedures.

Umana admitted that many of Cropsey's medical services were provided by a physician's assistant who was acting without supervision by a medical doctor, and that Cropsey billed Medicare and Medicaid for the services using Umana's provider number.

In addition, Umana admitted that in seeking reimbursement for costs purportedly incurred transporting certain beneficiaries to and from Cropsey by ambulance, he falsely certified that transportation by ambulance was medically necessary, according to authorities.

Umana had pleaded guilty in December to conspiracy to commit healthcare fraud.

Like Healthcare Finance on Facebook

Eight other people charged in connection with the scheme previously pleaded guilty.

Since its start in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,300 defendants who have collectively billed the Medicare program for over $7 billion. 

Twitter: @SusanMorseHFN