Ishpeming nurse practitioner pleads guilty after telemedicine fraud investigation by feds
GRAND RAPIDS — U.S. Attorney Andrew B. Birge announced a series of criminal and civil enforcement actions taken as part of a joint-agency health care fraud operation in the Western District of Michigan, which included an Ishpeming man.
Richard Laksonen, a nurse practitioner from Ishpeming, pleaded guilty on Aug. 6 to one count of making a false statement relating to health care matters. As part of his guilty plea, Laksonen admitted that he signed orders for medical braces and cancer genetic testing, attesting that he had performed the assessments and verifying that the orders were reasonably and medically necessary, when, in fact, he typically executed the orders without reviewing the records, according to the U.S. Attorney’s office.
For example, officials said that Laksonen admitted that, in a one-week period, he signed around 335 separate single-patient files, many containing multiple types of braces, spending on average 18 seconds from the time he opened the record to the time he executed it. Laksonen continued to approve these orders, “even after an investigator for a health insurer warned him that the patient referrals were the result of aggressive telemarketing,” according to a news release.
The investigation further established that many of these braces and tests were not medically necessary, officials said. As part of his plea agreement, Laksonen admitted that Medicare paid over $5.7 million for the orders he approved and signed.
The court will sentence Laksonen on Nov. 15.
The operation concerned investigating medical practitioners who signed off on illegitimate orders for medical braces and cancer genetic testing promoted by telemarketers.
The ongoing investigation — dubbed Operation Happy Clickers to reflect many of the practitioners’ habits of approving these orders “with little to no review” — resolves alleged fraud losses to date to the Medicare program of over $7.3 million, according to the release.
These actions follow nationwide takedowns of “so-called marketers and owners of durable medical equipment supply companies and cancer genetic testing laboratories who conducted large-scale fraud schemes designed to defraud the Medicare program,” the release states. The marketers called Medicare beneficiaries, often through overseas call centers, soliciting them for “medically unnecessary braces” and cancer genetic testing for screening purposes, according to officials.
“The marketers paid medical practitioners to purportedly review and sign these orders under the guise of telemedicine and then sold those signed orders to the owners of the DME supply companies and laboratories in violation of the federal anti-kickback statute,” the release states.
The resolutions Birge announced involved four of the Michigan practitioners who approved and signed these orders on behalf of the marketers, who in addition to Laksonen, were:
Hugh G. Deery II, M.D., of downstate Petoskey; Colleen Browne, D.O., formerly of downstate Portland; and Mosab Deen, D.O., of downstate Royal Oak. They resolved civil liability for alleged violations of the False Claims Act by entering into civil settlements with the United States.
“These physicians approved orders for medically unnecessary braces and cancer genetic testing despite many red flags that these items and services were illegitimate,” according to Birge’s office.
Medicare beneficiaries targeted by this fraud scheme complained of being “bombarded” by overseas telemarketing calls offering “free” braces.
“If the doctors took the time to listen to these recorded phone calls, they would have known that the calls were run by telemarketers and not medical professionals,” Birge said. “The orders the physicians signed resulted in hundreds of thousands of dollars paid by Medicare for medically unnecessary braces, which beneficiaries often did not want or use.”
Deery has agreed to pay $301,140, Browne has agreed to pay $42,000 and Deen has agreed to pay $28,545. Browne’s settlement agreement also resolved allegations that she ordered medically unnecessary cancer genetic testing for Medicare beneficiaries for cancer screening purposes. Generally, Medicare does not cover genetic testing solely for the purpose of screening for cancer, according to Birge.
“Given that their approval and signatures are necessary for Medicare to pay for these braces and testing, medical practitioners are the professional backstop against these fraud schemes,” Birge said in a statement. “And when medical practitioners ignore their professional responsibilities, facilitating these fraud schemes in our district, they will be held accountable.”
Operation Happy Clickers is an ongoing initiative by the U.S. Health and Human services inspector general, the FBI and the U.S. Attorney’s Office for the Western District of Michigan. Assistant U.S. Attorney Raymond E. Beckering III is overseeing and prosecuting the criminal investigation, and Assistant U.S. Attorney Andrew J. Hull is representing the United States in the parallel civil investigations.
Individuals who are aware of past or ongoing conduct involving solicitation and fraudulent approval of medical braces and cancer genetic testing through purported telemedicine services can call the U.S. Attorney’s Office health care fraud investigator at 616-808-7572 or submit an online complaint at oig.hhs.gov/fraud/report-fraud/.