A federal jury convicted a Michigan man last Friday for his role in devising and executing a $1.8 million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program.
The defendant, Dr. Kenneth Mitchell, 60, of Oakland County, Michigan, was also convicted for falsification of records designed to prevent detection of this fraud and aggravated identity theft for falsely corresponding with Medicare under the name of another physician.
According to court documents and evidence presented at trial, Mitchell was revoked from participating in the Medicare program in January 2015. Shortly thereafter, he convinced his then-partner to enroll in Medicare and assist in opening a new clinic called Urban Health Care Group PLLC. Once the new business was set up, Mitchell continued to bill Medicare for services just as he had prior to his revocation, only now exclusively under the name of his partner. Upon law enforcement’s discovery of this scheme, Medicare suspended payments to Urban Health Care Group PLLC. Mitchell subsequently submitted false statements to Medicare regarding the fraud allegations (again, under his partner’s name) in an effort to undermine the government’s investigation and ensure the release of Medicare funds to the bank account he controlled.
Mitchell was convicted of one count of conspiracy to commit health care fraud and wire fraud; three counts of health care fraud; one count of falsification of records in a federal investigation; and one count of aggravated identity theft. He is scheduled to be sentenced on Jan. 26, 2023 and faces a maximum penalty of imprisonment of 20 years for conspiracy to commit wire fraud and wire fraud, 10 years for health care fraud, 20 years for falsification of records, and two years for aggravated identity theft (to be served consecutive to any other sentence). A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division; Special Agent in Charge Mario Pinto and Assistant Special Agent in Charge Darren Bartnik of the Department of Health and Human Services, Office of Inspector General (HHS-OIG); and Special Agent in Charge Angie Salazar of the Department of Homeland Security, Homeland Security Investigations (HSI) made the announcement.
The HHS-OIG and HSI investigated the case.
Trial Attorneys Kathleen Cooperstein and Shankar Ramamurthy of the Justice Department’s Fraud Section are prosecuting the case.
Any patients who believe they may have been treated by a doctor who billed improperly services should report this conduct to HHS-OIG at 1-800-HHS-TIPS.
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