Two US Doctors Convicted of $30m Medicare Fraud

Two Florida medical professionals have been found guilty of various offenses by a federal jury after defrauding the government Medicare scheme out of tens of millions of dollars.

Chiropractor Dean Zusmer, 54, of Miami, was convicted of conspiracy to commit health care fraud, health care fraud, conspiracy to pay illegal health care kickbacks, paying illegal health care kickbacks and false statements relating to health care matters.

Orthopedic surgeon, Lawrence Alexander, 45, also of Miami, was convicted of false statements relating to health care matters.

Zusmer owned one of four durable medical equipment (DME) companies that billed Medicare for $31m of unnecessary DME, around half of which was paid out by the scheme, according to the Department of Justice (DoJ).

Alexander owned another of the DME companies with a third doctor, Jeremy Waxman, but is said to have concealed their involvement in the scam by putting the firm in the name of a family member.

The conspirators then paid kickbacks to marketers who used overseas call centers to solicit patients, and they paid bribes to telemedicine companies to elicit prescriptions for body braces that patients didn’t need, the DoJ said.

Alexander and Zusmer are due to be sentenced on April 20 and face a potentially long stretch behind bars. Alexander could get up to five years while Zusmer could get as much as 40 years. Waxman has already been sentenced to 15 years in jail.

The case was investigated by the FBI and the Office of Inspector General’s Medicare Fraud Strike Force. According to the DoJ, investigators working across 15 strike forces in 24 federal districts have charged more than 4200 defendants who fraudulently billed Medicare for over $19bn since March 2007.

Medicare remains a popular target for scammers looking to exploit America’s labyrinthine healthcare system. In October 2022 an Illinois couple were jailed for several years after running a near decade-long fraud scheme that made them $7m.

In that case, they also paid kickbacks to marketers in return for patient referrals to their home health companies.