A man from Florida was sentenced today to 12 years in prison along with three years of supervised release for his role in a scheme to defraud Medicare through false reimbursement claims related to durable medical equipment (DME). Additionally, he was ordered to pay restitution of $21,195,540.18 and a forfeiture amounting to $2,514,040.
Court documents reveal that Peter Roussonicolos, 64, from Port Saint Lucie, Florida, was a silent partner in five DME suppliers. He concealed his involvement from Medicare due to having one or more felony convictions, which disqualified him from enrolling in the government program. To further hide his participation, he enlisted and compensated co-conspirators to act as nominal owners of the DME suppliers and orchestrated the falsification of Medicare enrollment forms, bank records, and other documents to obscure the actual ownership and control of the DME suppliers. He was also aware that a co-conspirator was paying kickbacks and bribes to patient recruiters in return for beneficiary referrals. As part of this fraudulent operation, the DME companies submitted around $61.5 million in false claims to Medicare for medically unnecessary DME that was not eligible for reimbursement, ultimately receiving approximately $26.7 million from these claims.
“Through lies and deceit, the defendant and his co-conspirators orchestrated a $61 million fraud on Medicare,” said Matthew R. Galeotti, Head of the Justice Department’s Criminal Division. “The defendant’s fraud drained critical government resources that could have been used to help vulnerable Americans. Today’s sentencing demonstrates the Department’s steadfast commitment to protecting taxpayer dollars and ensuring accountability for those who seek to defraud our health care programs.”
“Today’s sentence underscores HHS-OIG’s firm commitment to thoroughly investigating individuals who engage in illegal kickback schemes to prescribe medically unnecessary durable medical equipment for their own personal financial gain,” said Deputy Inspector General for Investigations Christian J. Schrank with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “We remain steadfast in our mission to protect the integrity of Medicare and other federal healthcare programs as well as the people served by those programs.”
“This defendant and his co-conspirators orchestrated an elaborate scheme to steal millions from Medicare through kickbacks and sham billing,” said Assistant Director Jose A. Perez of the FBI Criminal Investigative Division. “Today’s sentencing demonstrates that those who exploit our healthcare system for personal gain will be held accountable. The FBI is committed to working with our partners to protect taxpayer dollars and ensure the integrity of healthcare programs.”
In November 2024, Roussonicolos pleaded guilty to conspiracy to commit health care fraud and wire fraud.
