Sleep Study Clinics

Health Care Fraud in Sleep Studies in the News!

“Former Owner of Sleep Study Businesses Convicted of Fraud Conspiracy”

As mentioned earlier in this article, Young Yi, the business owner of 1st Class Sleep Diagnostic Center and 1st Class Medical was convicted of seven counts of health care fraud. 

She misled patients, withheld information from physicians, and used doctors’ identifying information with their permission so she could steal millions from Medicare and private insurances. Furthermore, Yi misled patients and doctors and falsified records to cover it up. 

At trial, evidence was presented that Yi had over $83 million from Medicare and private insurance companies. She directed her employees to solicit patients who had been referred to her for actual sleep studies to run additional tests that were not medically necessary.

In addition, Yi had her own employees have sleep tests done and would be compensated. She made a game out of it by seeing who could refer the greatest number of friends and family members.

Lastly, the employees were instructed not to submit the results to the patients’ doctors and lied to the patients by telling them they did not have any copays or coinsurance. 

Once the falsifying records were complete, the insurance companies would get cross-billed by using not one, but both companies to cover up the repetition and receive out-of-network for in-network services.

They were investigated by HHS-OIG and the DOJ, (the Medicare Fraud Strike Force). 

“Two Charged with Running $11 Million Sleep Study Scam that Billed UPS and Costco Health Care Benefit Programs for Unneeded Tests”

Vishnevsky, the owner of Atlas Diagnostics Services (ADS) and Hernandez, the UPS driver recruited patients by offering cash in exchange for participating in sleep studies. Allegedly, they offered additional cash if these people could bring in relatives or co-workers to participate in the scheme as well. Nonetheless, none of these people had been prescribed a sleep study and was unnecessary.

Furthermore, ADS failed to score or interpret the data from the tests or provide it to anyone who could do so. Also, it was alleged that ADS had billed insurance providers for two sleep studies for many patients even though they only completed one. 

ADS and the UPS driver submitted more than $11 million in fraudulent claims, most of which related to beneficiaries of the UPS and Costco health care benefit program. Lastly, they were indicted on 11 counts of false claims. If convicted, each would face a statutory maximum sentence of 10 years in federal prison for each count. 

They were investigated by the OIG, DOL, and FBI. 

“United States Settles False Claims Act Allegations Against Florida-Based Sleep Clinic and Two Physicians; Joins Lawsuit Against Two Additional Doctors”

A whistleblower for the Florida company, Sleep Medicine Center brought a suit, alleging that the company intentionally billed the government for millions of dollars. The services being charged for were either not medically necessary or were never performed. 

Doctors Zachary and Restea ran the “Sleep Medicine Center” where rather than treating patients in accordance with Medicare and Tricare regulations; they did tests that were unnecessary, not conducted by appropriately licensed individuals, or not even performed. Nonetheless, they had agreed to supervise the clinic and failed to do so. 

In addition, two more doctors, Young and DeCerce were supposed to help supervise as well but claimed they lent their names in exchange for money. It is alleged that without them, they would not have been able to bill the federal healthcare programs. They signed durable medical equipment orders for patients never seen by them. Lastly, they interpreted the results of the sleep study even though the machine did not work. 

Four physicians violated the false claims act (FCA) by knowingly submitting false claims to the government for payments that were investigated by “HEAT.”