Andrew Chmiel, $100M Medicare Fraud, South Carolina 2019

COLUMBIA, S.C. – Andrew Chmiel, 48, of Mt. Pleasant, was sentenced to nine years in federal prison yesterday for his role in a nearly $100 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary durable medical equipment (DME) orders.

Chmiel’s charges were brought in 2019 as part of Operation Brace Yourself, an investigation that originated in South Carolina. Operation Brace Yourself, which was prosecuted in conjunction with the Criminal Division Fraud Section, was a multi-jurisdictional investigation that involved the execution of more than 80 search warrants in 17 federal districts.

As for Chmiel’s criminal conduct, evidence presented to the court showed that Chmiel controlled and operated at least 10 DME companies, which were located throughout the United States. These DME companies were used by Chmiel and his coconspirators to submit false and fraudulent claims to Medicare for braces that were not medically necessary and/or were obtained through the payment of kickbacks and bribes.

To effectuate the scheme, these DME companies entered into agreements with an offshore call center to purchase completed doctors’ orders so the DME companies could bill Medicare. This offshore call center was advertising through television and internet advertisements. Once a Medicare beneficiary called a 1-800 number that was on the advertisements, that Medicare beneficiary would be screened for eligibility and then convinced that he or she needed a brace, and oftentimes upsold on other braces.

The call center would then contact a telemedicine company whose physician and/or nurse practitioner would issue a prescription without regard to the medical necessity. Throughout the investigation, the evidence revealed that beneficiaries were prescribed braces without ever being examined by, seeing, or, in some instances, even speaking to a medical professional. Evidence presented showed that Chmiel was attempting to hide that he was purchasing completed doctors’ orders by creating fraudulent and false invoices for alleged marketing and business processing services.

Throughout the health care fraud scheme, Chmiel’s companies, which included 10 DME companies, two dropship companies, and two additional companies that were used to facilitate the fraud – D.O. Delivery and Pain Center – billed Medicare in excess of $200 million and Medicare paid Chmiel’s companies in excess of $95 million.

Chmiel was also held accountable at sentencing for an obstruction of justice enhancement pursuant to the United States Sentencing Commission Guidelines. Based on evidence presented by the Government during the sentencing, the court held that when Chmiel testified as a government witness in a trial in the Eastern District of New York against a coconspirator, he knowingly gave false testimony on matters material to the health care fraud scheme, violating the terms of his plea agreement.

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