A Detroit-area physician pleaded guilty today for his role in a $5.4 million Medicare fraud scheme involving phony physician visits and drug prescriptions.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.
Aaron Goldfein, 52, of Bloomfield Hills, Michigan, pleaded guilty to one count of conspiracy to commit health care and wire fraud. Previously, on Jan. 19, 2017, co-conspirators, William Sokoll, 61, of Royal Oak, Michigan, and William Binder, 60, of Ypsilanti, Michigan, each pleaded guilty to one count of conspiracy to commit health care and wire fraud. Sokoll was a physician who lost his medical license in 2008 and Binder was a licensed physician who surrendered his DEA license in March 2011. Both worked at Tri-City Medical Center (Tri-City) in Livonia, Michigan, for Goldfein.
As part of his plea, Goldfein admitted to being part of a scheme in which his co-conspirators would hold themselves out as licensed physicians and purport to perform physician home visits and other services for Medicare beneficiaries, although these co-conspirators were not licensed to practice medicine in Michigan. Goldfein would then bill Medicare, through Tri City, as if he himself had completed these visits. Goldfein also admitted to being part of a scheme in which he received kickbacks in exchange for writing home health prescriptions.
In his plea agreement, Sokoll admitted to being one of the unlicensed physicians employed at Tri City. Sokoll admitted that he and this co-conspirator prepared medical documentation purportedly evidencing licensed physician home visits and other services provided to beneficiaries, when in fact the beneficiaries were not treated by a physician licensed in Michigan. In addition, third co-defendant and licensed physician, Goldfein signed the medical documentation completed by Sokoll and the other unlicensed co-conspirator for services the physician did not provide to beneficiaries.
Additionally, Sokoll, Binder and Goldfein admitted in connection with their guilty pleas that they and other unlicensed co-conspirators prescribed beneficiaries medications, including controlled substances, under Goldfein’s name and DEA registration number, when although Goldfein had not seen or diagnosed the beneficiaries. Medicare Part D ultimately paid for some of these prescriptions, which Goldfein ultimately signed.
In addition to writing prescriptions for controlled substances, Binder, as part of his guilty plea, admitted to being part of a scheme at Tri-City in which he and his co-conspirators would submit or cause the submission of false claims to Medicare by billing for physician home visits where referrals for the services were obtained through the payment and promise of payment of kickbacks. Members of the conspiracy, including Binder, would also bill for home health care services that were, at times, not provided and not medically necessary, and where referrals for services were obtained through the payment and promise of payment of kickbacks.
The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan. Fraud Section Trial Attorneys Dustin Davis, Amy Markopoulos and Jessica Collins are prosecuting the case.
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