Doctors Convicted In $31 Million Medicare Fraud Scheme: A federal jury convicted two Florida doctors on January 30, 2023 for their roles in a scheme to defraud Medicare by submitting over $31 million in claims for expensive durable medical equipment (DME) that Medicare beneficiaries did not need and that were procured through the payment of kickbacks.

According to court documents and evidence presented at trial, Dean Zusmer, 54, of Miami, was a chiropractor who conspired with others to steal millions of dollars from Medicare. Zusmer owned one of four DME companies that collectively billed Medicare over $31 million for medically unnecessary DME, of which over $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. 

Court documents and evidence presented at trial further demonstrated that Lawrence Alexander, M.D., 45, of Miami, 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. 

Zusmer was convicted of conspiracy to commit health care fraud, health care fraud, conspiracy to pay illegal health care kickbacks, paying illegal health care kickbacks, and false statements relating to health care matters. He is scheduled to be sentenced on April 20 and faces a maximum penalty of 10 years in prison on each of the following counts: conspiracy to commit health care fraud; health care fraud; and paying illegal health care kickbacks. Zusmer faces a maximum penalty of five years in prison for the following counts: conspiracy to pay illegal health care kickbacks and false statements relating to health care matters.Preventing healthcare fraud and abuse requires a collaborative effort from healthcare professionals, government agencies, patients, and revenue cycle management (RCM) services.

Alexander was convicted of false statements relating to health care matters. He is scheduled to be sentenced on April 20 and faces a maximum penalty of five years in prison. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Waxman was previously sentenced to over 15 years in prison for his role in the scheme.

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If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publicly known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.

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