Policy: Entitlements

$77m Medicare fraud earns scheme leader 15 years in prison

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Watchdog,Medicare and Medicaid,Entitlements,Waste and Fraud,Follow the Money,Justice Department,Ethan Barton

After living as a fugitive in Ukraine for two years, Irina Shelikhova was sentenced Nov. 12 to 15 years in federal prison for leading a $77 million Medicare fraud scheme involving bribery, falsified records and money laundering over a five-year period.

Shelikhova, 50, of Brooklyn, N.Y., pleaded guilty to one count of conspiracy to commit money laundering in December 2012.

She was fined more than $36 million and ordered to pay nearly $51 million in restitution for ordering the falsification of medical notes, bribing beneficiaries and using their names to bill Medicare more than $77 million for services that were either unnecessary or never provided.

The investigation of the scheme included concealed audio and video surveillance in a room at Shelikhova’s Bay Medical Clinic, which uncovered conspirators paying more than $500,000 in bribes over a six-week period.

The room “featured a Soviet-era poster of a woman with a finger to her lips and the words ‘Don’t Gossip’ in Russian,” according to the Justice Department.

Shelikhova was arrested at Kennedy International Airport in June 2012, after spending nearly two years on the run in Ukraine.

Shelikhova hired a medically unlicensed person to impersonate a doctor and ordered her employees to falsify medical notes and forge doctor’s signatures in an attempt to make her fraudulent billing look legitimate.

She also offered kickbacks to fake patients and generated the cash for the kickbacks by writing clinic checks to fake companies controlled by money launderers. The launderers cashed the checks and returned the money to her.

“The purpose of the kickbacks was to induce the beneficiaries to receive unnecessary medical services or to stay silent when services not provided to patients were billed to Medicare,” the press release said.

Along with Shelikhova, 13 others were convicted in relation to the fraud scheme that lasted from 2005 to 2010.

After her prison sentence is completed, Shelikhova faces possible deportation, according to the DOJ.

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Ethan Barton

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