Macomb County Hearing Aid Dealer Sentenced for Executing Health Care Fraud.

Macomb County Hearing Aid Dealer Sentenced for Executing Health Care Fraud.

A hearing aid dealer from Macomb County accepted the indictments and pleaded guilty of charges in Detroit’s Federal Court on 8th June 2020. The dealer was charged with the counts of conspiring to execute a Health care Fraud. Matthew Schneider U.S. Attorney announced on 9th June 2020. This was after conviction on the same charge on 18th March 2020, this conviction involved a hearing aid salesman who used to work for the dealer.

Special Agent in Charge of the Detroit FBI Field Office Steven M. D’Antuono, Special Agent in Charge of U.S. Labor Department Office of Inspector General Irene Lindlow, Chicago Region (DOL-OIG), and L. Joe Rivers Regional Director Cincinnati Region Office (DOL-EBSA)., U.S. Labor Employee Benefits Security Administration Department.

Milija Perkovic, alias Mike, age 28, and Rasko Djordjevic, alias Ron, age 44, each admitted guilt to one conspiracy count indicted in an accusation that charged them with conspiracy to execute a health care fraud.  The evidence provided in the courtroom uncovered that Djordjevic operated and had the legal title to Sterling Hearing Care, Inc., which was advertised as an aid hearing business with several destinations in Southeast Michigan, from the period between February 2015 to April 2017. Perkovic (Djordjevic’s brother in law), acted as a salesman selling hearing aids and controlling the hearing evaluations strictly under the instructions of Djordjevic.

Petkovic and Djordjevic successfully carried out a fraud scheme defrauding Blue Cross Blue Shield into fraudulently paying claims worthy over 600,000 million US dollars for hearing aid services and products, during this particular time.

Blue Cross Blue Shield had a set of conditions before paying a claim for an aid hearing device. Perkovic and Djordjevic would at times cause unauthorized billings to Blue Shield for hearing services and aid. They billed Blue Shield for two hearing aid devices after providing a single aid hearing device and, to some extent, they billed Blue Shield for unordered service or free services already offered to customers who seek free hearing tests in their facility.

Perkovic and Djordjevic, on several occasions, did sell unnecessary hearing services and aids (not medically required) to clients which included clients with slight or no hearing problems.

Furthermore, Perkovic and Djordjevic were selling hearing services and aids through fraudulent practices. A good example is when they did send claims to Blue Shield under an insurance policy of a spouse for services that were not offered to the spouse, they altered a former client’s medical clearance to and made it look the new client had a legit medical clearance. Perkovic, with Djordjevic awareness, impersonated himself as an audiologist or doctor and helped with fake x-ray images obtained from the internet to deceive clients seeking hearing aid that they had a damaged ear.

Besides, Djordjevic swindled out American Hearing Benefits, a health insurance company, over 132,000 million U.S dollars. American Hearing Benefits (AHB) makes contracts with companies, like AudioNet, that covers retired and active members of UAW, in providing discount hearing aid services and products. AHB expected dealers of hearing aids to have a certified AHB audiologist staff to be certifying the client’s needs and bill for services and products. AHB expected from Sterling Hearing Care and Djordjevic did not adhere to the requirements. He alternatively chose to submit falsified documents for reimbursement and that included false certifications that a certified audiologist, Perkovic, had evaluated a client while it was not true.

U.S. Attorney Schneider clearly stated that the Attorney’s office will always have zero tolerance to health care providers who intentionally trick clients into buying medical service or product and, at the same time, bill insurance providers for the undelivered products and services. Further add that is annoying, specifically, when the providers scam the vulnerable aging clients and also encouraged to trust their instincts and not be afraid of seeking a second option.

Special Agent in Charge of the Detroit FBI Field Office Steven M. D’Antuono said that Perkovic and Djordjevic misused the advantage of the patients’ trust in their hearing care facility to fraudulent medical service with aim of increasing their net income. Further states that the betrayal was far much greater because the majority of the scammed patients were the elderly and assured that they will investigate with intense energy any medical providers seeking to scam the aging population through health care fraud schemes jointly with the help of FBI and other law enforcement partners.

Special Agent Irene Lindlow in Charge of the U.S Labor Department Office of Inspector General, Chicago Region, said the accused falsely billed for hearing aids devices and services that were based on fraudulent marketing practices, unnecessary, or not provided defrauding health benefits programs and union plans. The accused did value illegal profits over the patients’ interests. She further assured that her department will work tirelessly with the help of other law enforcers to protect labor unions’ benefit plans and their integrity.

Regional Director L. Joe Rivers of the Department of Employees Benefits and Security Administration, Cincinnati Regional Office said that criminal acts similar to this case compromise the coverage of health benefits and erode funds required to pay for essential medical treatments impacting shareholders in the health care benefits. Further assured that the U.S. Labor Employee Benefits Security Administration Department is focused to protect the employee benefit programs and curb scams against sponsored employee health benefit programs.

The Special Agents of the FBI and the U.S Labor Department Office of Inspector General conducted this case investigation. U.S Assistant Attorney Andrew Lievense and John Engstrom are the prosecutors who handled this prosecution.

Individuals who commit Health Care Fraud may face severe penalties. This is because health care fraud is a serious criminal offense that is severely punished under the law. In case you are accused of this fraud, you must look for legal assistance to pursue and protect your rights. The Healthcare Fraud Group comprises the best criminal defense attorneys with extensive experience and provides the best possible service to achieve the result. Our team clearly understands the need to prove innocence after accusation of health care fraud. Contact us today at 888-402-4054 for any legal assistance you may need.

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