Detroit-Area Doc, Patient Recruiter Convicted in Medicare Fraud Scheme

After a week-long trial, West Bloomfield, MI, physician Alan Silber and an accomplice were convicted by a federal jury on Friday for their roles in a $1 million Medicare fraud scheme, the Department of Justice announced.

A U.S. District Court jury convicted Silber of six counts of healthcare fraud, which each carry a maximum 10-year prison sentence and a $250,000 fine. Sentencing is Aug. 6.

Hassan Reeves, an accomplice who was described by prosecutors as a patient recruiter, was convicted of one count of conspiracy to commit healthcare fraud and one count of conspiracy to pay healthcare kickbacks. Each count carries a 10-year prison term, and a $250,000 fine.

Prosecutors had charged that Silber and Reeves operated a sham infusion clinic called RDM Center Inc. Between December 2006 and March 2007, Silber, Reeves, and co-conspirators Denisse and Jose Martinez, of Miami, submitted $970,631 in false claims to Medicare, and were paid about $649,000.

Prosecutors said the Martinezes, owners of RDM Center, opened the clinic in Michigan because of a crackdown on Medicare fraud in South Florida. The Martinezes have already pleaded guilty in the scheme, DOJ said in a media release.

Evidence in the week-long trial revealed that Silber was hired to be the physician at the clinic, and Reeves was hired to recruit and pay kickbacks to Medicare beneficiaries. RDM Center reportedly billed Medicare for services that were medically unnecessary and/or never provided. The Martinezes bought a fraction of the medications for which they billed Medicare, and many medications were prescribed based not on medical need, but on what would generate reimbursements, according to DOJ.

Denisse Martinez, with no medical training, completed the clinic's patient records by filling in the "diagnosis" and "treatment" sections, which Silber signed, even though he made no diagnosis or made any medical judgment about the treatment, according to DOJ. Prosecutors showed there was no legitimate medical basis for the medications that Silber prescribed, and that in several instances the medications could have harmed patients, said DOJ.

Medicare beneficiaries at RDM Center were recruited by Reeves in downtown Detroit and driven 27 miles to the clinic. In exchange for the kickbacks—which included cash, and prescriptions for controlled substances—the beneficiaries signed documents indicating that they had received the services, said DOJ.