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LEGAL & REGULATORY ISSUES
MARKETING COMPANY OPERATOR PLEADS GUILTY IN $127M FRAUD SCHEME
Andrew Cass - yesterday
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The operator of a marketing company pleaded guilty to his role in a scheme that
resulted in more than $127 million in fraudulent claims being submitted to
healthcare benefit programs for durable medical equipment.
Nicco Romanowski, 31, of Roswell, Ga., participated in a scheme involving
durable medical equipment companies, telemedicine companies and physicians that
submitted false claims to healthcare benefit programs including Medicare and
Tricare. The scheme was based on circular kickbacks and bribes, according to a
Dec. 19 Justice Department news release.
Mr. Romanowski operated a marketing company through which he and his
co-conspirators identified Medicare and Tricare beneficiaries to target for
durable medical equipment, according to the release. Employees of the company
called beneficiaries to pressure them into accepting the equipment. Mr.
Romanowski and others paid the company's employees to encourage them to convince
as many beneficiaries as possible to accept the equipment, regardless of medical
necessity.
His company also paid kickbacks to telemedicine companies, which in turn paid
kickbacks to physicians in order to obtain orders for the equipment, according
to the releases. Mr. Romanowski and his business partner, Eric Karlewicz, then
steered the orders to DME companies, with which the marketing company had
additional kickback arrangements. The companies submitted the claims for
reimbursement and then sent a portion of the proceeds to the Mr. Romanowski and
the company. The company received more than $63 million from DME suppliers in
exchange for the referrals.
The scheme ran from June 2017 through May 2019, according to the release. Mr.
Romanowski is scheduled to be sentenced May 21. Mr. Karlewicz previously pleaded
guilty to his role in the scheme.
Subscribe to the following topics: medicarehealthcare fraudtricare
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