Inspections, Compliance, Enforcement, and Criminal Investigations
January 24, 2012: R.I. Medical Equipment Sales Representative to Plead Guilty to Health Care Fraud
Sonja Ascoli of Woonsocket sold medical equipment for Illinois based company whose owner previously pled guilty to shipping unwanted and unneeded medical supplies and “erectile pumps” to Medicare beneficiaries at government expense
PROVIDENCE, R.I. – A Woonsocket, R.I., woman who allegedly promised custom fit shoes for diabetics and medical equipment for arthritis sufferers “at no cost” to Medicare beneficiaries at Rhode Island senior centers, housing complexes and assisted living centers, has agreed to plead guilty to defrauding Medicare of more than $70,000, announced U.S. Attorney Peter F. Neronha.
Sonja Ascoli, 59, of Woonsocket, R.I, is charged in an Information filed with the U.S. District Court in Providence on Monday with allegedly participating in a scheme to entice Medicare beneficiaries to order products and medical equipment from the company she represented, Planned Eldercare, of Illinois, by promising that the products would be provided “at no cost” to them. The Medicare Program does not permit copayments to be waived.
According to the Information, it is alleged that once Ascoli obtained some beneficiaries Medicare and physician information, she ordered as many products as possible without regard to whether the beneficiaries actually requested the products or had medical need for the equipment. When beneficiaries complained about receiving items they did not order, it is alleged that Ascoli responded by telling them, “keep the products in the closet until you need them.”
The Information also alleges that as part of the scheme, Ascoli, upon receiving products and equipment returned to her by beneficiaries, did not send the items back to Planned Eldercare, but kept them and gave them to individuals who would not otherwise have qualified for the products. These actions resulted in Medicare paying for products that were not received by beneficiaries and Ascoli allegedly keeping any commissions she had earned on the products sold.
The Information alleges that Ascoli was the highest paid outside sales representative employed by Planned Eldercare for the years 2007 and 2008, who, like other sales representatives working for the company, was paid on a commission basis.
According to the Information, is alleged that Ascoli defrauded Medicare of a total of $70, 354.
On November 17, 2011, Gary Winner, 49, of Northbrook, Ill., owner of Planned Eldercare, pled guilty in U.S. District Court in Providence to two counts of health care fraud, and one count each of money laundering and the introduction of an adulterated and misbranded medical device into interstate commerce.
Winner admitted to the court that from 2005 through early 2009 he instructed Planned Eldercare employees, upon successfully reaching individuals as a result of unsolicited telemarketing calls, to inform recipients that Planned Eldercare could provide them with products to help with their diabetes or arthritis ailments “at no cost to you” by waiving copayments required by Medicare. Winner admitted that he instructed employees to order as many products as possible whether or not the beneficiaries requested them or had a medical need for the equipment. Winner admitted that Medicare was billed for thousands of products that beneficiaries did not order.
Winner also admitted that he instructed his employees to falsely inform male diabetic beneficiaries that an “erectile pump” was good for prostate problems, and was designed to help blood circulation exclusively in the urinary tract and prostate region. Winner admitted that as part of the scheme, he actually ordered penis enlargers from an x-rated website for $26.00 each, repackaged them and shipped them to Medicare beneficiaries for which he received reimbursement from Medicare on average of $284 per item.
Winner is scheduled to be sentence in U.S. District Court in Providence on February 10, 2012. He has agreed to forfeit approximately $2 million in proceeds derived by defrauding the Medicare program.
The cases are being prosecuted by Assistant U.S Attorney Dulce Donovan.
The matter was investigated by Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; the Internal Revenue Service, Criminal Investigations; the United States Railroad Retirement Board, Office of Inspector General; and the Food and Drug Administration, Office of Criminal Investigations.
An Information is merely an allegation and is not evidence of guilt. A defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.