Chiropractor, Orthopedic Surgeon Jailed for Defrauding Medicare

A federal judge remanded two Florida doctors to prison for their respective roles in a $31 million Medicare fraud scheme.

Dean Zusmer, 54, received an eight-year, one-month jail term and must pay $1.4 million in restitution while Lawrence Alexander, M.D., 45, will spend the next two years and nine months in prison. Authorities will determine Alexander’s restitution at a later hearing.

Zusmer and Alexander submitted more than $31 million in claims for expensive durable medical equipment (DME) that Medicare beneficiaries did not want or need and were procured through kickbacks, according to court documents. Zusmer was a chiropractor who owned one of four DME companies that collectively billed Medicare for medically unnecessary DME, of which more than $15 million was paid. Zusmer and his co-conspirators, including Jeremy Waxman, acquired patient referrals and signed doctors’ orders by paying kickbacks to marketers who used overseas call centers to solicit patients and telemedicine companies to procure prescriptions for unnecessary braces for these patients. Alexander was an orthopedic surgeon who owned one of the DME companies with Waxman and concealed both his and Waxman’s roles in the scheme by putting the DME company in the name of one of Alexander’s family members.
 
A federal jury convicted Zusmer earlier this year of multiple healthcare fraud-related offenses and for making a false statement relating to healthcare matters; Alexander was found guilty of making a false statement relating to healthcare matters. Waxman pleaded guilty and testified against the two doctors at their trial. He is now serving a 15-year prison term for his role in the scheme.
 
The FBI and HHS-OIG investigated the case.
 
Trial Attorneys Catherine Wagner, Patrick Queenan, Meredith Hough, Jamie de Boer, and Keith Clouser of the Criminal Division’s Fraud Section prosecuted the case.
 
The Fraud Section leads the Criminal Division’s efforts to combat healthcare fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal healthcare programs and private insurers more than $24 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in healthcare fraud schemes.