Former Attorney Sentenced for Role in Medicare Fraud

A former attorney from Florida was sentenced to nearly six years in prison for her participation in a Medicare fraud scheme. Margarita Grishkoff purchased and owned physical rehabilitation facilities that she used to submit false claims to Medicare; she split the proceeds of the false claims with co-conspirators, according to Department of Justice press release. This case was investigated and prosecuted under a special Medicare Fraud Strike Force, the Health Care Fraud Prevention and Enforcement Team (HEAT), that is operating in Miami and eight other cities.

On January 24, 2014, Grishkoff pleaded guilty to conspiracy to commit health care fraud. Grishkoff and others submitted approximately $28.3 million in fraudulent claims to Medicare from 2005 to 2009, of which Medicare paid approximately $14.4 million. Grishkoff had a license to practice law in Florida but was disbarred in 1997.

Fraudulent Activities

Grishkoff was president and a director of Ulysses Acquisitions, Inc., which was a company she used to purchase comprehensive outpatient rehabilitation facilities and outpatient physical therapy providers. Grishkoff and her co-conspirators submitted false claims to Medicare on behalf of clinics they owned in exchange for a portion of the Medicare reimbursement received. Grishkoff and her co-conspirators kept 20 percent and the remaining 80 percent went to other clinic owners and co-conspirators. Grishkoff and her co-conspirators used patient recruiters to obtain identifying information on Medicare beneficiaries and physicians. The patient recruiters were paid kickbacks for this information. This information was then used to submit claims through the clinics Grishkoff and others owned. To distance herself from these activities, Grishkoff and her co-conspirators sold the clinics to nominee or straw owners, all of whom were recent immigrants to the United States with no background in health care.

Grishkoff was sentenced to 70 months in jail with three years’ supervised release upon the ending of her prison term and ordered to pay restitution of $14.4 million. The sentence was handed down by U.S. District Judge Susan C. Bucklew of the Middle District of Florida and investigated and prosecuted by members of the U.S. District Attorney’s office for the Middle District of Florida, HHS Office of Inspector General (OIG) and the FBI’s Tampa Field Office.

HEAT

This case was investigated as part of the special Medicare task force known as HEAT. Special HEAT task forces are operating in Brooklyn, N.Y.; Los Angeles, Calif.; Chicago, Ill.; Miami-Dade, Fla.; Tampa Bay Fla.; Houston Tex.; Dallas Tex.; Detroit Mich.; and Baton Rouge, La. HEAT teams are multi-agency teams comprised of federal, state, and local investigators designed to combat Medicare fraud. To date nearly 1,900 individuals have been charged who collectively billed Medicare for more than $6 billion since March of 2007 when HEAT began, according to the Department of Justice’s press release.

Comments

  1. Which facility will be incarcerating Grishkoff? Will this be one of these minimum security institutions for white collar criminals?

    • Danielle Capilla says:

      The Federal Bureau of Prisons website can give you information on where prisoners will serve their sentence.