MORRISTOWN, NJ – A 54-year-old Morristown doctor will spend four years in prison for his participation in a scheme to defraud Medicare and Medicaid of $30 million dollars, according to United States Attorney for the Southern District of New York Geoffrey S. Berman.
Paul J. Mathieu was sentenced Wednesday by U.S. District Judge Lorna G. Schofield to 48 months in prison for his participation in a $30 million scheme to defraud Medicare and the New York State Medicaid Program, officials said.
“Corrupt doctors and therapists who defraud Medicare and Medicaid betray their medical training, their professions, their patients, and the taxpayers. These taxpayer-funded programs are designed to provide essential medical services to the elderly and the needy, not to enrich corrupt doctors and other fraudsters,” Berman said. “Paul Mathieu’s sentence sends a clear message that those who cheat Medicare and Medicaid will be held accountable.”
Between 2007 and 2013, Mathieu falsely posed as the owner of three medical clinics, which were actually owned a by corrupt businessman, and falsely claimed that he had examined and treated thousands of patients whom he had not in fact seen, according to authorities.
In addition, occupational therapist Lina Zhitnik was sentenced by Judge Schofield on Dec. 3 to 14 months in prison for her role in the same scheme, which included falsifying medical records in order to claim that she had provided therapy services that she had not in fact provided, officials said.
Mathieu was convicted in May 2019, following a six-week trial, on charges of health care fraud, wire fraud, mail fraud, conspiracy to commit those offenses, and conspiracy to make false statements in connection with a federal health care program. Zhitnik pled guilty to health care fraud and conspiracy to commit health care fraud, mail fraud and wire fraud in April 2019, during jury selection for trial.
According to the evidence presented at trial and other public documents, including Zhitnik’s guilty plea transcript:
- Between 2007 and 2013, Aleksandr Burman – who is currently serving a 10-year prison term for his participation in this scheme – owned and operated six medical clinics in Brooklyn (the “Clinics”) that fraudulently billed Medicare and Medicaid approximately $30 million for medical services and supplies that were not provided, were provided without regard to medical necessity, or were otherwise fraudulently billed. Under New York State law, professional medical corporations must be owned by a medical professional.
- To circumvent this requirement, Burman and Mathieu agreed to have Mathieu pose as the true owner of a succession of three different clinics, which Burman owned and operated for more than five years, from 2007 through 2013.
- Throughout those years, Mathieu signed a variety of fraudulent documents that falsely represented to banks, Medicare, Medicaid, and others that Mathieu was the sole owner of The Medical Office of Paul J. Mathieu, P.C.; Sunlight Medical, P.C.; and Ocean View Medical of Brooklyn, P.C. Burman also hired two other doctors, Ewald J. Antoine and Mustak Y. Vaid, to pose fraudulently as the owners of three additional, related clinics.
- Mathieu also came weekly to several of the clinics, where he signed stacks of false and fraudulent medical charts, and issued referrals for expensive additional testing, occupational therapy, and physical therapy.
- For the last 3½ years of the scheme, Mathieu saw no patients at all, simply falsifying enormous stacks of phony medical records falsely stating that he had seen and treated such patients.
- In addition to his role in the clinics, Mathieu also wrote unneeded prescriptions for adult diapers and other incontinence products, which prescriptions were filled at Universal Supply Depot, a medical supply company also owned by Aleksandr Burman.
- Mathieu was so prolific in this regard that, throughout the period of the fraud, he was the No. 1 top prescriber of adult diapers in the State of New York. The only year Mathieu ranked second, he ranked behind another member of the same criminal scheme.
- Mathieu continued to write such prescriptions, even after the medical clinics closed after Medicare stopped paying any of the clinics’ claims.
Mathieu is the tenth defendant, and the third physician, who has been sentenced in this case and a related case. One additional defendant awaits sentencing, physical therapist Hatem Behiry, who was convicted at trial with Mathieu.
In addition to the prison term, Mathieu was sentenced to three years of supervised release. Schofield also ordered Mathieu to pay restitution and forfeiture. Zhitnik, 52, of Brooklyn, New York, was also sentenced to three years of supervised release, ordered to pay restitution of $1,369,554, and to forfeit $89,682.