A pair of Miami-Dade doctors - orthopedic surgeon Lawrence Alexander and chiropractor Dean Zusmer - were found guilty Monday of participating in a network of medical equipment companies that submitted more than $31 million of false bills to Medicare for orthotic braces that patients did not need.
Miami federal jurors convicted Alexander, 45, of making false statements about his durable medical equipment business on a Medicare enrollment application, and Zusmer, 54, of committing healthcare fraud by filing bogus claims through his own DME company that he also managed.
The doctors collaborated with other business people, including two who pleaded guilty and one who is at large, in a scheme revolving around four durable medical equipment companies in Florida. Those four companies, located in Miami-Dade, Broward and Pinellas counties, were partly owned by Miami-Dade businessman Jeremy Waxman, who pleaded guilty and testified against the doctors at trial. Alexander had an ownership interest in one of those DME companies and Zusmer in another.
Justice Department lawyers said the network of DME companies depended on marketing firms that recruited Medicare patients and received kickbacks in an elaborate telemedicine racket. Medicare, the federal insurance program for senior citizens, paid out a total of $15 million based on the four companies' fraudulent claims for orthotic braces, jurors found after a two-week trial.
The DME scheme was reminiscent of Medicare fraud in South Florida in the 1990s before it spread to other areas of medicine, such as physical therapy, diabetic injections and mental health services.
Both Alexander and Zusmer, who are free on bail, face prison terms at their April 20 sentencings before U.S. District Judge K. Michael Moore. Alexander is expected to receive far less prison time than Zusmer. Whatver their punishment, both defendants plan to appeal the jury's guilty verdicts.
According to trial evidence, Zusmer collaborated with Waxman through their joint ownership and management of Active Assist DME in Pinellas County.
Justice Department lawyers said Zusmer and Waxman obtained patient referrals and doctors' signed orders by paying kickbacks to marketing firms that used overseas call centers to solicit patients. They also paid kickbacks to telemedicine companies that procured prescriptions from doctors for the unnecessary orthotic braces. The braces were purportedly needed for knee, back, shoulder and wrist injuries, according to federal agents with the FBI and Health and Human Services-Office of Inspector General.
Zusmer, who had his chiropractor practice in Miami Lakes, was convicted of conspiracy to commit healthcare fraud, health care fraud, conspiracy to pay illegal healthcare kickbacks, paying illegal healthcare kickbacks, and false statements relating to healthcare matters. But he was also found not guilty of two anti-kickback counts.
One of his defense attorneys, Barry Wax, said the trial pivoted on the testimony of the government's main witness: Waxman.
"We are extremely surprised and disappointed with the jury's verdict," Wax told the Miami Herald Tuesday. "This case had a significant amount of reasonable doubt, primarily based on the testimony of one of the co-defendants, Jeremy Waxman. We expected a much different verdict."
Trial evidence also showed that Alexander concealed both his and Waxman's roles in the scheme by putting their DME company in the name of one of Alexander's family members, Justice Department lawyers said. The company was called Silent Hill Bracing and Orthopedic Supplies, located in Bay Harbor Islands. Court records show that Alexander's mother appears as the firm's owner on the 2019 Medicare Application Enrollment form, which is signed by her in 2019.
Alexander, who had his medical practice in Hialeah, was convicted of making false statements relating to healthcare matters. But he was acquitted of the more serious charge of conspiring to defraud Medicare by paying illegal healthcare kickbacks.
Alexander's defense attorneys, Jose Quinon and Frank Quintero, questioned the jury's sole guilty verdict and plan to appeal.
"There was no evidence to convict Dr. Alexander," Quintero said.
He said Alexander was not involved in running the DME company, Silent Hill; did not fill out the Medicare Enrollment Application and that his mother's signature was forged on the form, which provides details about the company's services, including a change in its hours of operation. He added that Waxman managed Silent Hill, not Alexander.
During his testimony at trial, Waxman said that he and his staff filled out the Medicare Enrollment Application for Silent Hill and as a matter of routine would have shown it to Alexander. But he also said he couldn't remember if he did so in this instance.
Waxman testified that initial signature on the form belonged to Alexander's mother. But he further testified that the second signature on the form also belonged to Alexander's mother, alongside her fingerprints. Then he admitted under oath that the two signatures didn't match.
When Alexander's defense attorney, Quinon, accused him of "faking signatures" on the form, Waxman testified: "Never without the direction of Dr. Alexander. Not once."
"We have to take your word for that, correct?" Quinon said.
"At this very moment, yes," Waxman said. "There's evidence that backs that up, too."
Waxman, who pleaded guilty to healthcare fraud conspiracy and wire fraud, was sentenced before trial to more than 15 years in prison. But he is expected to receive a reduction for his cooperation as a witness against Alexander and Zusmer.
Ronald Davidovic, an owner of a Broward marketing company, also pleaded guilty to healthcare fraud conspiracy. He was sentenced to almost six years.
Umut Vardar, a managing partner of Davidovic's marketing company, is a resident of Turkey. He is at large, court records show.