Telemedicine Owner Gets 2 Years in Prison for $110M Medicare Brace Fraud Scheme

BOSTON — A Florida man who operated a pair of telemedicine companies was sentenced to two years in federal prison Tuesday for his role in a $110 million scheme that flooded Medicare with fraudulent orders for medically unnecessary back and knee braces.

Steven Richardson, 42, of Port St. Lucie, Florida, was sentenced by U.S. District Judge Nathaniel M. Gorton to 24 months behind bars, followed by two years of supervised release. Richardson pleaded guilty in April 2024 to one count of conspiracy to commit health care fraud, more than a year after his initial indictment in February 2024.

Between March 2016 and January 2023, Richardson, through his companies Expansion Media and Hybrid Management Group, allegedly orchestrated a complex scheme that exploited Medicare beneficiaries nationwide. According to court documents, Richardson entered into business arrangements with telemarketing companies that generated leads by targeting Medicare recipients. The telemarketers paid Richardson’s companies on a per-order basis to generate orders for durable medical equipment, primarily orthotic braces.

To secure signed orders, Richardson worked with medical staffing firms—including one based in Massachusetts—to recruit doctors and nurses willing to review and sign prepopulated medical orders, typically without any direct contact with the patients. The resulting records falsely portrayed the medical providers as having performed legitimate examinations of the beneficiaries.

Richardson then supplied the signed orders to the telemarketing companies, which sold them to DME suppliers. Prosecutors said Richardson knew those suppliers would use the fraudulent documentation to submit claims to Medicare for equipment that was medically unnecessary and tainted by illegal kickbacks.

“Mr. Richardson profited handsomely from a system designed to exploit Medicare beneficiaries and circumvent basic medical safeguards,” prosecutors wrote in court filings.

“This sentence holds Richardson accountable for his central role in a massive fraud that drained taxpayer dollars and compromised the integrity of Medicare,” said U.S. Attorney Leah B. Foley, whose office announced the sentencing.

Richardson is the latest individual convicted in a growing wave of federal prosecutions targeting telemedicine fraud, which has cost Medicare billions in recent years. His sentence was met with criticism from some watchdog groups who noted that the $110 million in fraudulent claims far outweighed the two-year prison term. However, federal sentencing guidelines and Richardson’s cooperation likely factored into the judge’s decision.

Pennsylvania Home Care Owner Sentenced to Prison for $1.76M Medicaid Fraud Scheme

HARRISBURG, Pa. — The former owner of a Montgomery County home health care agency was sentenced to state prison Wednesday for orchestrating a $1.76 million Medicaid fraud scheme that involved kickbacks, phony caregiver assignments, and recruiting clients to participate in the deception.

Stephanie Mobley, 54, of King of Prussia, who owned ComfortZone Home Health Care LLC between 2020 and 2023, pleaded guilty to Medicaid fraud and theft by deception. A Montgomery County judge handed down a sentence of 17 months to 10 years in state prison and ordered restitution in the full amount of $1.76 million.

According to prosecutors, Mobley made fraud a routine part of her business operations, approving specific kickback arrangements, assigning fictitious caregivers to clients, and actively recruiting clients to join the scheme. The fraudulent claims submitted to Medicaid sought reimbursement for services that were never actually provided.

A two-year joint investigation by the Pennsylvania Office of Attorney General Medicaid Fraud Control Section and the FBI uncovered a broader conspiracy involving Mobley, her daughter Naya Campbell—who served as the agency’s CEO—and 18 other co-defendants. All but one of the defendants have pleaded guilty.

“The defendant made these criminal acts a part of her routine business practices, while also employing others to steal from a program intended to provide critical care to vulnerable Pennsylvanians,” said Attorney General Dave Sunday in announcing the sentence. “Those who exploit Medicaid programs as a means to fulfill personal greed will be held accountable.”

ComfortZone Home Health Care operated in Montgomery County, providing in-home care services to Medicaid beneficiaries who rely on the program for essential daily living assistance. Investigators determined that the company systematically billed for services that were never rendered, defrauding the state and federal government of millions intended for the care of elderly and disabled residents.

Mobley’s sentencing marks the latest conviction in a series of prosecutions targeting home care fraud in Pennsylvania, where state and federal authorities have intensified oversight of Medicaid-funded personal care services amid growing concerns about waste and abuse.

Restitution payments will be directed to the Medicaid program to recover taxpayer losses from the scheme.

Illinois AG, DOJ Intervene in Lawsuit Alleging Podiatrist Billed Medicaid Under Fake Provider Names After Termination

CHICAGO — Illinois Attorney General Kwame Raoul and the U.S. Department of Justice have filed a joint complaint alleging that a Chicago-area podiatry practice, its owner, and two billing companies knowingly submitted more than $5 million in fraudulent Medicaid claims by using other physicians’ names and provider numbers to conceal that the treating doctor had been terminated from the program.

The complaint, filed Monday in U.S. District Court in Chicago, names Foot & Ankle Health Care Centre Ltd., European Foot & Ankle Surgical Care Ltd., their owner Dr. Vadim Goshko, and billing companies Atlantic Wave Holdings LLC and Atlantic Wave II LLC as defendants.

According to the filing, the Illinois Department of Healthcare and Family Services Office of Inspector General terminated Goshko’s Medicaid participation in May 2019. To circumvent the exclusion and continue billing, the defendants allegedly directed billing personnel to submit claims under the national provider identifiers of other podiatrists who did not actually render the services.

The scheme also involved using fake service locations in electronic medical records and billing systems to track which services were performed by which physicians, while submitting claims under other doctors’ names. Prosecutors further allege that the defendants billed for services performed by new physicians under established providers’ NPIs specifically to avoid credentialing costs.

The fraudulent billing continued even after Atlantic Wave acquired the practice’s previous billing vendor, PhysicianDS, in 2020. The complaint asserts that Atlantic Wave leadership was repeatedly notified of the illegal practices but continued processing and submitting claims that masked the identity of rendering providers.

Medicare later revoked Goshko’s privileges effective September 2022 after eventually learning of his Medicaid exclusion. The combined false claims paid by Medicare and Medicaid totaled more than $5 million.

“Millions of Illinoisans rely on Medicaid for access to lifesaving and life-improving care. It is unacceptable that a provider and billing companies would submit fraudulent claims to conceal that care was administered by a doctor who was not allowed to participate in the program and providers who were not properly credentialed,” Raoul said in a statement. “My office’s Medicaid Fraud Control Unit will continue to partner with state and federal agencies to hold individuals who cheat our systems accountable.”

The intervention stems from a whistleblower lawsuit originally filed under seal by Payrhealth LLC, a successor billing company that acquired PhysicianDS and later discovered the fraudulent conduct. Payrhealth terminated the Goshko entities as clients and notified the government, triggering the investigation.

Raoul and the DOJ are seeking treble damages and civil penalties under the federal False Claims Act, the Illinois False Claims Act, and common-law claims for payment by mistake and unjust enrichment.

The public is reminded that civil allegations are accusations only, and there has been no determination of liability.

Buffalo Nursing Homes to Pay $6 Million for Years-Long Fraud That Inflated Medicaid Reimbursement Rates

BUFFALO, N.Y. — Three nursing homes in the Buffalo region have agreed to pay $6 million to settle allegations that they submitted tens of thousands of fraudulent claims to Medicaid by artificially inflating residents’ rehabilitation needs to boost reimbursement rates, New York Attorney General Letitia James announced Wednesday.

Safire Rehabilitation of Northtowns, Safire Rehabilitation of Southtowns, and Williamsville Suburban Nursing Home — collectively known as the Safire homes — will also pay an additional $3 million to the federal government for defrauding Medicare under the settlements with the Attorney General’s Medicaid Fraud Control Unit and the U.S. Attorney’s Office for the Western District of New York.

A joint investigation revealed that from July 1, 2016, through December 31, 2020, the Safire homes submitted false data that artificially increased their Medicaid reimbursement rates, allowing them to earn millions of dollars more than they should have.

According to investigators, nursing homes in New York are required to submit accurate data reflecting the care required by residents to the state Department of Health, which uses that information to calculate reimbursement rates for all claims submitted within the following six months. The Safire homes allegedly inflated the amount of rehabilitative services certain residents needed during periods that affected their reimbursement rates, then reduced services during periods that did not impact rates — regardless of actual resident need.

“Nursing homes that commit financial fraud are stealing funds meant to provide care for our most vulnerable,” said Attorney General James. “The Safire homes used fraudulent data to rake in millions of dollars from Medicaid without regard for the needs of the residents they were supposed to be serving. My office has rooted out fraud and resident neglect in nursing homes throughout New York, and we will continue to investigate Medicaid fraud to protect New Yorkers.”

Under the settlement, the Safire homes admit wrongdoing and will pay $6 million to Medicaid, with $3.6 million going directly to New York State and $2.4 million to the federal government. Additionally, the facilities must adopt new policies and procedures to ensure residents receive all necessary services and that documentation is properly maintained to prevent future fraud.

“Medicare and Medicaid fraud drains taxpayer funds and weakens these vital government programs,” said U.S. Attorney Michael DiGiacomo for the Western District of New York. “This settlement reinforces our commitment to safeguarding federal funds and ensuring seniors receive the care they deserve.”

The investigation began after a whistleblower filed a complaint in December 2020 under the qui tam provisions of the New York and federal False Claims Acts, which allow private individuals to file actions on behalf of the government and share in any recovery.

The facilities have not publicly commented on the settlement.