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Long IslandCrime

Prosecutors: East Hampton doctor admits Medicaid larceny

Ringers were paid to undergo unnecessary medical tests — that then were billed to Medicaid — by an East Hampton doctor and his confreres who have all pleaded guilty to larceny and will repay $27.9 million, prosecutors said Friday.

Dr. Bernard Bentley, 61, of East Hampton, will restitute $2.5 million by selling his Hamptons home, two Tesla cars, and his holdings in six bank and brokerage accounts, they said. Two other schemers — Tea Kaganovich, 47, and Ramazi Mitaishvili, 58, both of Brooklyn — will restitute $18.5 million, they said.

On Wednesday, federal prosecutors also extracted guilty pleas from Kaganovich and Mitaishvili, who they said are married.

The couple, who co-owned diagnostic testing centers,said in state Supreme Court in Manhattan they paid kickbacks totaling about $18.5 million to obtain referrals for individuals "who submitted themselves to diagnostic testing and other purported medical services," Richard P. Donoghue, U.S. attorney for the Eastern District of New York, said in a statement. 

The duo then claimed the kickbacks as business expenses, underreporting their business income and falsely claiming deductions, he said.

A spokesman for Donoghue said by email they will restitute $18.5 million for the health care fraud and forfeit $7 million.

He added the husband will pay about $950,000 for conspiring to defraud the Internal Revenue Service; the wife will pay about  $7.8 million in restitution.

"Dr. Bentley made a decision to enter into this plea agreement in order to resolve this case and put this matter behind him," Bentley's attorney Alexander G. Bateman said in a statement Friday, adding they were hopeful the attorney general and the court would take into consideration Bentley's "professional and personal life in its entirety, including all the good he has done."

Attorneys for the others had no immediate comment. 

The three submitted $8 million of fraudulent bills to Medicaid, sometimes for tests never even carried out, state Attorney General Letitia James said in a statement. 

Bentley was reimbursed for more than $16 million from Medicaid and HealthFirst, a Medicaid funded managed care organization, from Jan. 1, 2014, to Oct. 31, 2017, she said. The doctor then paid more than $13 million to Kaganovich and Mitaishvili, she said. 

In state court, Bentley pleaded guilty to grand larceny in the first and third degrees, James said. Both charges are felonies. The couple pleaded guilty to grand larceny in the first degree, she said.

On July 26, Kaganovich and Mitaishvili are expected to be sentenced to 1½ to 4½ years in state prison, James said. Their sentences will be concurrent with the terms the federal court is expected to order later, she said. Bentley's sentence will be set later.

The trio's firms all pleaded guilty to grand larceny in the first degree, she said. Kaganovich's corporations are Sophisticated Imaging Inc. and East Coast Diagnostic Inc.; Mitaishvili owns East West Management Inc.; and Bentley owns Bentley Medical PLLC.

“These individuals preyed on unsuspecting patients and stole government funds to line their own pockets,” James said. “New Yorkers put their trust and health in the hands of medical professionals and providers and we expect them to fulfill their basic duty to provide real and sound care."

The convictions sprang from a multiyear probe of a medical mill, called Multi-Specialty, which had locations in the Bronx and Manhattan.

Such outfits often pay patients enrolled in Medicaid  between $20 and $50 for agreeing to be evaluated and tested — a violation of both state and federal law, James said.

To find patients, the schemers employed recruiters, and Azu Ajudua,  formerly a licensed physician, who acted as the owner of Multi-Specialty and signed referral forms for medical tests without seeing patients, she said.

Ajudua, who also signed blank referral forms, earlier pleaded guilty to second- and third-degree grand larceny, James said. This defendant, who ordered more than $5.5 million of unjustified tests, will be sentenced later, she said.

An unlicensed “physician” Zheng Dong, hired by one of the Multi-Specialty clinics, already pleaded guilty to unauthorized practice of a profession, a felony, for his role in the fraud, James said. So did Johanna Ubiera, another employee of Multi-Specialty.

Both Bentley and Ajudua are surrendering their medical licenses, officials said. 

And, said James: "Everyone convicted agreed to be excluded from further participation in the State Medicaid and federal Medicare programs as a provider of any type of goods or services."

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