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May 10, 2019 8:43 PMPublication: The Southampton Press

AG: East Hampton Doctor Pleads Guilty In Medicaid Fraud Scheme

May 14, 2019 12:29 PM

An East Hampton doctor is among 12 people convicted in a multimillion-dollar Medicaid fraud case, New York State Attorney General Letitia James announced on Friday.

Dr. Bernard Bentley, 61, a diagnostic radiologist, was part of a medical mill scheme that fraudulently billed Medicaid for more than $8 million in diagnostic testing services, prosecutors said.

As part of a guilty plea, he admitted to engaging in “a systematic scheme to subject Medicaid recipients to a battery of diagnostic tests” that were not medically necessary and were fraudulently referred, the attorney general’s office said. He and Tea Kaganovich, 47, and Ramazi Mitaishvili, 58, a married couple from Brooklyn, would then submit claims for Medicaid reimbursement. In some cases, the services not only were unnecessary, they weren’t even performed.

The attorney general’s office explained that the medical mill scheme works by offering Medicaid recipients kickbacks, usually between $20 and $50, for agreeing to submit to medical screening and testing—an unlawful practice.

The convictions are the result of a multi-year investigation into such a medical mill, known as Multi-Specialty. The attorney general’s Medicaid Fraud Control Unit conducted undercover operations and executed search warrants at Multi-Specialty locations in Manhattan and the Bronx.

The investigation revealed that between January 1, 2014, and October 31, 2017, Dr. Bentley received more than $16 million in reimbursement from Medicaid and HealthFirst, a Medicaid-funded managed care organization, of which more than $5.5 million was for unnecessary diagnostic services. Dr. Bentley, through Bentley Medical PLLC, transferred more than $13 million of this money to Ms. Kaganovich and Mr. Mitaishvili, prosecutors said, and, in turn, they paid illegal kickbacks for the referral of patients.

Dr. Bentley pleaded guilty to grand larceny in both the third degree and first degree, and his company, Bentley Medical PLLC, pleaded guilty to grand larceny in the first degree. Additionally, he entered into a civil settlement in which he agreed to pay restitution totaling $2.5 million to the New York State Medicaid program.

The attorney general’s office said he would come up with the money by selling his East Hampton home and two Tesla cars, and by handing over the proceeds from six bank and brokerage accounts. He also agreed to give up his medical license and be excluded from participation in the New York State Medicaid and federal Medicare programs as a provider.

“These individuals preyed on unsuspecting patients and stole government funds to line their own pockets,” Ms. James said in a statement. “New Yorkers put their trust and health in the hands of medical professionals and providers, and we expect them to fulfill their basic duty to provide real and sound care. Medicaid fraud is a serious crime and we will take action against anyone who seeks to cheat our system or our patients.”

Dr. Bentley’s sentence will be determined by the court at a later date.

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