Source: US FBI
NEWARK, N.J. – Two Florida men were arraigned today on charges relating to their roles in a multimillion-dollar durable medical equipment (DME) and prescription drug health care fraud and kickback scheme, Attorney for the United States Vikas Khanna announced.
Nicholas A. Alberino, 61, of Boca Raton, Florida, and his son, Nicholas P. Alberino, 34, of Parkland, Florida, are each charged in a seven-count indictment with conspiracy to commit health care fraud and wire fraud, wire fraud, conspiracy to violate the federal Anti-Kickback Statute, and four counts of violating the Anti-Kickback Statute. The defendants were each arraigned today before U.S. District Judge Esther Salas in Newark federal court, and each pleaded not guilty.
According to documents filed in this case and statements made in court:
From February 2018 to April 2019, the Alberinos operated five Florida companies, each of which generated medically unnecessary prescriptions for certain expensive medications as well as DME such as orthotic braces through a telemarketing and telemedicine scheme. The Alberinos specifically sought to identify and target Medicare beneficiaries. Call centers contacted the beneficiaries by telephone and pressured them to accept the expensive medications and DME. The Alberinos then transmitted the beneficiaries’ personal information, as well as pre-written doctor’s orders and prescriptions, to RediDoc LLC, a purported telemedicine company. The Alberinos pre-selected prescription medications and DME for beneficiaries based on the potential for high reimbursement payments from insurance payers such as Medicare, and not based on the beneficiaries’ medical needs.
RediDoc, in turn, sent the information and documents the Alberinos provided to doctors. The doctors then typically signed the prescriptions despite not having any contact with the patients or conducting a bona fide assessment of the patients’ medical needs from which the doctors could have deemed that it was medically necessary to order the DME or medications. Once the doctors signed the prescriptions, the Alberinos directed RediDoc to steer them to third parties with which the Alberinos had illicit kickback and bribe arrangements. DME suppliers and pharmacies ultimately fulfilled these fraudulent orders and submitted claims for reimbursement to health care benefit programs, including Medicare. The Alberinos also fulfilled fraudulent orders using DME supply companies that they owned and controlled.
The Alberinos paid over $6 million in kickbacks and bribes to RediDoc in exchange for the fraudulent orders and received over $27 million in kickbacks and bribes from third parties in return for fraudulent orders. The Alberinos also received over $1.7 million from Medicare for fraudulent claims that they submitted directly to Medicare through DME supply companies they owned and controlled. Medicare ultimately paid at least $27 million to DME suppliers and pharmacies based on the fraudulent orders that originated with the Alberinos.
The health care fraud and wire fraud conspiracy count and wire fraud count each carry a maximum potential penalty of 20 years in prison. The charge of conspiracy to violate the Anti-Kickback Statute carries a maximum potential penalty of five years in prison. The four counts of violating the Anti-Kickback Statute are each punishable by 10 years in prison. Each of the seven counts in the indictment is also punishable by a fine of $250,000, or twice the gain or loss from the offense, whichever is greatest.
Attorney for the United States Khanna credited special agents of the U.S. Department of Health and Human Services Office of Inspector General, under the direction of Special Agent in Charge Naomi Gruchacz, the U.S. Department of Defense, Office of Inspector General, Defense Criminal Investigative Service, Northeast Field Office, under the direction of Special Agent in Charge Patrick J. Hegarty, and the FBI, under the direction of Acting Special Agent in Charge Nelson I. Delgado in Newark, with the investigation.
The government is represented by Assistant U.S. Attorneys Katherine M. Romano and Garrett J. Schuman of the Health Care Fraud Unit in Newark.
The charges and allegations contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.