In January of 2023, Dr. Dean Zusmer and Dr. Lawrence Alexander, both of Miami, were convicted for being part of a scheme where they submitted $31 million in fraudulent claims. The doctors conspired with others to file claims for expensive but unnecessary medical equipment that beneficiaries did not want or need. The equipment purchases also involved money kickbacks.
A chiropractor by trade, Zusmer headed up a scam as the owner of four durable medical equipment (DME) companies that unnecessarily billed Medicare. Zusmer and co-conspirators secured patient referrals and signed doctors’ orders by employing overseas call centers to target patients and telemedicine companies that encouraged targets to get unneeded braces for patients.
Alexander, an orthopedic surgeon, and business partner Jeremy Waxman, also had DME companies that did the same scheme while hiding their ownership roles by listing family members as owners of the companies. Waxman was sentenced to 15 years in prison for his roles working with Zusmer and Alexander. Although convicted, Alexander is not sentenced yet. Zusmer was convicted of multiple healthcare fraud charges and making false statements about healthcare matters. He will pay $1,404,200.97 in restitution and serve eight years and one month in jail.
An FBI and HHS-OIG case
The DOJ’s Criminal Division’s Fraud Section and House and Human Services Office of Inspector General did the investigation, while the Fraud Section prosecuted the case. This legal action was part of the Health Care Fraud Strike Force Program launched in 2007. Since then, it has charged more than 5,000 defendants who charged Medicare and taxpayers $24 billion. Those looking to provide tips and evidence for a new or ongoing healthcare fraud case can learn more here.