Consumer Fraud

Maryland Woman Pleads Guilty to Medicare, Medicaid Fraud

Pills Stethascope on Money 435x289 Maryland Woman Pleads Guilty to Medicare, Medicaid FraudA Maryland woman pleaded guilty to federal health care fraud charges for a scheme in which she falsely represented herself to be a medical equipment vendor for New York-based Medicare and Medicaid management programs.

According to the U.S. Department of Justice, Suzanna Meliksetyan, 28, of Gaithersburg, Maryland, purported to operate multiple durable medical equipment companies so that she could submit bogus claims to Healthfirst, a non-profit, New York-based health maintenance organization that administers Medicare Advantage plans and New York Medicaid Managed Care plans.

As part of her guilty plea, Ms. Meliksetyan admitted that she operated a number of scam medical equipment companies that never provided any medical equipment to Medicare and Medicaid beneficiaries.

She also admitted that she and others called Healthfirst and falsely represented themselves as vendors in Healthfirst’s network to make the sales. These bogus companies Meliksetyan operated submitted nearly $1 million in false claims to Healthfirst. Of those false claims, Ms. Meliksetyan admitted to receiving more than $300,000 from the Medicare and New York Medicaid programs.

Ms. Meliksetyan’s health care fraud scheme was uncovered by the Medicare Fraud Strike Force, a collaborative effort between the Justice Department and the Department of Health and Human Services. The Strike Force combines the data-analysis capabilities of the Centers for Medicare and Medicaid Services, the investigative resources of the FBI, and the prosecutorial resources of the Justice Department and the U.S. Attorneys’ Offices.

The Medicare Fraud Strike Force operates in nine cities across the country. Since its inception in 2007, it has charged nearly 3,500 defendants who have collectively billed the Medicare program for more than $12.5 billion.

Ms. Meliksetyan’s sentencing is scheduled for March 21 before federal Judge Alynne R. Ross, Eastern District of New York.