Two operators of a New Jersey-based marketing company were sentenced to prison for their roles in a $127 million healthcare fraud and kickback scheme.
Four things to know:
1. Eric Karlewicz, 46, of Rockland County, N.Y., was sentenced to 51 months in prison, according to an April 21 Justice Department news release. Nicco Romanowski, 33, of Roswell, Ga., was sentenced to 80 months in prison. Both men were sentenced after pleading guilty to conspiracy to violate the Federal Anti-Kickback statute and conspiracy to commit health care fraud charges.
2. The men operated a marketing company through which they and their co-conspirators identified Medicare and Tricare beneficiaries to target for durable medical equipment. Employees of the company called beneficiaries to pressure them into accepting the equipment. They paid the employees to encourage them to convince as many beneficiaries as possible to accept the equipment, regardless of medical necessity.
3. The operators paid kickbacks to telemedicine companies, which in turn paid kickbacks to physicians in order to obtain orders for the equipment. They then steered the orders to DME companies, with which the marketing company had additional kickback arrangements. The companies submitted the claims for reimbursement and then sent a portion of the proceeds to the marketing company. The company received more than $63 million from DME suppliers in exchange for the referrals. In total the men caused the submission of more than $127 million in false claims for DME in the scheme that ran from June 2017 through May 2019.
4. In addition to the prison sentences, the two men were ordered to pay $127.6 million in restitution. Mr. Karlewicz was ordered to forfeit more than $63 million. Mr. Romanowski was ordered to forfeit more than $5.5 million.
