DOJ: Florida Doctor Sentenced for Making False Statements in Connection with Multi-Million-Dollar Health Care Fraud Scheme

• The doctor was ordered to pay $3,160,809.43 in restitution and received four years of probation with six months home confinement.
• Medicare paid more than $3.1 million in claims for unnecessary genetic testing and durable medical equipment based on false documentation.

A Florida-based doctor, Simon Grinshteyn, was sentenced in federal court for making false statements related to a health care fraud scheme involving unnecessary genetic testing and durable medical equipment. He received four years of probation, six months of home confinement, and was ordered to pay $3,160,809.43 in restitution.

Between February 2020 and June 2020, Grinshteyn signed pre-populated medical documentation for a telemedicine company, falsely indicating legitimate consultations with Medicare beneficiaries. These actions led to Medicare paying more than $3.1 million in claims based on fraudulent documentation.

• $3,160,809.43 restitution ordered
• 400 hours of community service
• more than $3.1 million Medicare claims paid

• Review claims involving genetic testing and durable medical equipment for documentation signed by Simon Grinshteyn.
• Audit telemedicine company records from February 2020 to June 2020 for pre-populated medical documentation and doctors’ orders.
• Verify provider-patient relationships in Medicare claims to ensure legitimate consultations and examinations occurred.

This case highlights the risks of fraudulent medical documentation and telemedicine schemes targeting Medicare. Compliance officers must ensure that provider-patient relationships are genuine and that medical orders are not pre-populated or falsified. The significant financial impact—more than $3.1 million in improper claims—demonstrates the need for robust controls and audits to detect and prevent similar fraud, especially in telemedicine and DME sectors.