Healthcare Executive and Telemarketing Company Owner Sentenced to Prison for Exploiting Elderly Medicare Advantage Beneficiaries in $35 Million Fraud Scheme

MIAMI - Two South Florida men, a healthcare executive and a telemarketing company owner, have been sentenced to federal prison for their roles in a scheme that resulted in the submission of approximately $35 million in false and fraudulent claims to Medicare Advantage plans for medically unnecessary durable medical equipment, including back, knee, shoulder, and ankle braces.

Senior U.S. District Judge Donald L. Graham sentenced Michael Kochen, 42, of Aventura, Florida, to 204 months in federal prison and Sandro Herek, 56, of Coral Springs, Florida, to 92 months in federal prison after they were convicted at trial. Kochen was found guilty of one count of conspiracy to commit health care and wire fraud, six counts of health care fraud, one count of conspiracy to pay and receive health care kickbacks, and three counts of payment of health care kickbacks. Herek was found guilty of one count of conspiracy to commit health care and wire fraud, one count of health care fraud, one count of conspiracy to pay and receive health care kickbacks, and three counts of receiving health care kickbacks.

"These defendants targeted elderly Medicare Advantage beneficiaries with relentless telemarketing and unnecessary medical equipment, generating approximately $35 million in fraudulent claims and more than $19 million in payments," said U.S. Attorney Jason A. Reding Quiñones for the Southern District of Florida. "Michael Kochen and Sandro Herek treated vulnerable seniors as profit centers and federal health care programs as personal bank accounts. These substantial prison sentences hold them accountable, and we will pursue the forfeiture and recovery of their ill-gotten gains."

"These sentencings underscore the commitment of HHS-OIG to protecting the integrity of federal health care programs as well as the health and well-being of the many Americans who rely on those programs," said Special Agent in Charge Isaac M. Bledsoe of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). "Exploiting Medicare Advantage beneficiaries through deceptive telemarketing and fraudulent claims is not only illegal, it is reprehensible. These outcomes send a clear message: those who engage in health care fraud will be held accountable."

According to court documents and evidence presented at trial, Kochen and Herek targeted Medicare Advantage beneficiaries through deceptive telemarketing practices, pressuring elderly individuals to accept medical equipment they did not need - and in some cases, did not want. Over the course of the scheme, Medicare Advantage plans paid more than $19 million on fraudulent claims.

Kochen owned dozens of companies that sold durable medical equipment supplies, such as braces, and paid illegal kickbacks to Herek and others to recruit Medicare beneficiaries to receive these braces. Herek oversaw and directed overseas call centers, including in Egypt and other foreign jurisdictions, which aggressively cold-called Medicare beneficiaries without prior requests for services. Call-center representatives repeatedly contacted beneficiaries - often after initial refusals - and used high-pressure tactics to induce them to accept braces regardless of medical necessity.

Evidence further showed that physicians frequently issued standardized or boilerplate medical authorizations for braces based solely on call recordings rather than individualized medical evaluations. In many instances, doctors did not speak with beneficiaries at all. When calls did occur, they were often brief, lasted only minutes, and did not include a meaningful assessment of medical necessity. Kochen paid kickbacks to telemedicine companies to obtain prescription orders for braces for Medicare Advantage beneficiaries, which were then used to submit claims for unnecessary equipment.

U.S. Attorney Reding Quiñones; Acting Special Agent in Charge Isaac Bledsoe of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Miami Regional Office; and Special Agent in Charge Brett D. Skiles of the FBI, Miami Field Office, made the announcement.

HHS-OIG Miami and FBI Miami investigated the case.

Assistant U.S. Attorneys Roger Cruz, David Turken, and Robert F. Moore prosecuted the case. Assistant U.S. Attorney Sandra Demici is handling asset forfeiture.

On April 7, the Department of Justice announced the creation of the Fraud Division. The Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department's work to combat fraud supports President Trump's Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs.

The Department of Justice, HHS-OIG, and the FBI encourage members of the public to remain vigilant against any signs of identity theft or suspicious claims submitted to their health insurance plans, including Medicare. Individuals should carefully review their explanation of benefits ("EOB") documents, and if they see any sign of suspicious or unauthorized claims in their Medicare records, they should call 1-800-MEDICARE (1-800-633-4227) or Report Medicare Fraud online at https://oig.hhs.gov/fraud/report-fraud/Links to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link..

Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.govLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link. or at http://pacer.flsd.uscourts.govLinks to other government and non-government sites will typically appear with the "external link" icon to indicate that you are leaving the Department of Justice website when you click the link., under case number 24-cr-20078.

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