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Medicare fraud mastermind sentenced to 15 years in prison

B’klyn clinic owner supervised phony claims, no-show doctors

November 14, 2013 From U.S. Attorney's Office, Eastern District of New York
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On Wednesday, Irina Shelikhova, 50, of Brooklyn, was sentenced to 15 years in prison for her leadership role in a $77 million Medicare fraud scheme. 

In addition to the prison term, U.S. District Judge Nina Gershon of the Eastern District of New York sentenced Shelikhova to three years of supervised release with a concurrent exclusion from Medicare, Medicaid and all Federal health programs, ordered her to forfeit $36,241,545, and ordered her to pay restitution in the amount of $50,943,386.

Shelikhova has been in custody since June 15, 2012, when she was arrested at JFK Airport after living as a fugitive in the Ukraine for almost two years. After serving her sentence, she faces deportation from the United States.

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Shelikhova pleaded guilty on Dec. 18, 2012 to conspiracy to commit money laundering. Including Shelikhova, 13 individuals have been convicted of the massive fraud scheme, either through guilty plea or trial conviction.

“Irina Shelikova used fake doctors and forged documents to defraud Medicare out of millions of dollars of very real money. As the owner and operator of three medical clinics, Shelikova engaged in a brazen scheme of fraudulent billing and kickbacks, going so far as to pay kickbacks to elderly patients in exchange for their Medicare numbers and their silence.

“She relied upon her web of payoffs, kickbacks and Russian propaganda to support her criminal scheme, but the truth caught up with her and justice has now been served,” stated Loretta Lynch, U.S. attorney for the Eastern District, based in Brooklyn.

According to court documents, from 2005 to 2010, Shelikhova owned and operated a clinic in Brooklyn that billed Medicare under three corporate names: Bay Medical Care PC, SVS Wellcare Medical PLLC and SZS Medical Care PLLC (Bay Medical clinic).

Shelikhova and her employees at the Bay Medical clinic paid cash kickbacks to Medicare beneficiaries and used the beneficiaries’ names to bill Medicare for more than $77 million in services that were medically unnecessary or never provided.

The defendants billed Medicare for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests.

According to testimony at the trial of her co-defendants, Shelikhova masterminded the health care fraud at the Bay Medical clinic, which included hiring a medically unlicensed co-defendant to impersonate the clinic’s “no-show” doctor and render phony medical “care” to such patients.

Shelikhova also directed employees to create fake medical notes in an attempt to back up the false billing and to forge doctors’ names on prescriptions and charts.

The government’s investigation included the use of a court-ordered audio/video recording device hidden in a room at the clinic, in which the conspirators paid cash kickbacks to corrupt Medicare beneficiaries. The conspirators were recorded paying approximately $500,000 in cash kickbacks during a period of approximately six weeks from April to June 2010.

This room was marked “PRIVATE” and featured a Soviet-era poster of a woman with a finger to her lips and the words “Don’t Gossip” in Russian. The purpose of the kickbacks was to induce the beneficiaries to receive unnecessary medical services or to stay silent when services not provided to the patients were billed to Medicare.

To generate the large amounts of cash needed to pay the patients, Shelikhova directed the recruitment and operation of a network of external money launderers who cashed checks for the clinic. Shelikhova wrote clinic checks payable to various shell companies controlled by the money launderers. The money launderers cashed these checks and gave the cash back to the clinic.

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