The Missouri foot doctor is a private practitioner, an independent contractor, and a provider of podiatry services to various nursing homes in the St. Louis area.
By pleading guilty to felony fraud charges brought against him, the good doctor admitted that on thousands of occasions, he billed Medicare, Medicaid and private insurance companies for the incision and drainage of abscesses and hematomas when he actually only clipped the toenails of the patients.
Lawrence B. Iken, 65, agreed to a money judgment of $999,170, which is the amount of reimbursement that he and his company received for the health care claims.
Dr. Iken also faces a possible penalty of 10 years in prison and/or fines up to $250,000.
In other cases of health care fraud:
- Mansour Sanjar, 81, and Cyrus Sajadi, 67, physicians and the owners of Spectrum Care, a community mental health clinic in Houston, Texas, were each convicted of health care fraud and paying illegal kickbacks. According to the evidence, Sanjar and Sajadi orchestrated a scheme to defraud Medicare beginning in 2006 and continuing until their arrest in December 2011. Their company allegedly provides partial hospitalization program (PHP) services for severe mental illness. They signed documents certifying that patients qualified for PHP services, when in fact, the patients did not. Sanjar and Sajadi also billed Medicare for PHP services when the beneficiaries were actually watching movies, coloring and playing games, which are not activities covered by Medicare. They also paid kickbacks to group home operators and patient recruiters in exchange for delivering ineligible Medicare beneficiaries to Spectrum. In some cases, the patients received a portion of those kickbacks. Both doctors got long prison sentences and must pay millions in restitution.
- A Florida man has pleaded guilty to health care fraud and money laundering. He agreed to forfeit a $60,000 platinum and diamond engagement ring purchased with health care fraud proceeds. Gregory J. Sylvestri, 44, formerly of Lake Worth, Florida, submitted over $12 million in fraudulent claims to Medicare through three alleged health clinics: Cornerstone Health Specialists of Lakeland, Florida, Summit Health Specialists of Tampa, Florida, and Coastal Health Specialists of Lakeland and Melbourne, Florida. The fraudulent claims were for radiology, audiology, neurology and cardiology services that were never rendered. Some of the services were provided to Medicare beneficiaries who had died before the supposed date of service. Medicare paid over $2,500,000 in reimbursement on the claims.