Medicare fraud results in billions of dollars being stolen from the government each year. It takes a surprising amount of hubris to think that you can charge the government for services that were either never rendered or were unnecessary. Recently that hubris has caught up with a former lawyer Margarita Grishkoff, who for other reasons was disbarred in 1997.
Grishkoff is a 59 year old resident of Charlotte, N.C. and is originally from southwest Florida. She worked with a network of physical therapy clinics and other businesses to submit approximately $28.3 million worth of false claims, of which approximately $14.4 million were paid, to medicare during the period from 2005 through 2009.
“Submitting false claims for payment to the government is an issue of growing concern for everyone because, ultimately, the businesses and people defrauding the government are stealing from taxpayers,” commented Christopher Paulos and attorney with the Levin, Papantonio law firm who practices in the areas of qui tam or whistleblower and false claims act litigation.
Last Friday, the Department of Justice announced that Grishkoff had pleaded guilty for her involvement in the scheme. So how did it work?
Along with her co-conspirators, a major participant being the company Ulysses Acquisitions, they paid kickbacks to Medicare beneficiaries to get their identifying information and similarly obtained the information of physicians. They would then send submit false claims for payment to Medicare through clinics purchased by Ulysses. When the well started to run dry, Ulysses would sell the clinics to straw owners – all of whom were immigrants to the United States with no expertise in the healthcare industry.
According to the DOJ, Grishkoff did this in an effort to separate themselves from the fraud of the clinics.
Having pleaded guilty, Grishkoff faces a maximum of 10 years in prison. Her sentencing date has yet to be set by the court.