Mount Pleasant Man Receives Nine-Year Sentence Over Role in $100 Million Healthcare Fraud Scheme

Mount Pleasant Man Receives Nine-Year Sentence Over Role in $100 Million Healthcare Fraud Scheme

Mount Pleasant resident, Andrew Chmiel, 48, has been sentenced by a federal court to a prison term of nine years for his involvement in a high-stakes healthcare fraud scheme worth around $100 million, according to the United States Department of Justice.

Reportedly, Chmiel’s fraudulent scheme involved the exchange of kickbacks and bribes to facilitate medically unnecessary durable medical equipment orders. “Chmiel’s scheme preyed on honest citizens in need of medical help. The implication of this sentence means the end of that exploitation,” declared U.S. Attorney Adair F. Boroughs. As a further sign of commitment to tackling these incidents, she added, “We will continue to dismantle healthcare fraud schemes in South Carolina and throughout the country.”

Mount Pleasant Fraud Case in Detail

According to data presented in court, this action against Chmiel was a part of a larger enforcement operation named “Operation Brace Yourself”, directed against healthcare fraud and initiated in 2019. Chmiel was found to be controlling and managing at least 10 durable medical equipment companies spread out across the United States.

The companies managed by Chmiel allegedly colluded with his accomplices to submit fraudulent claims to Medicare, claiming payment for unnecessary braces. These companies would then liaise with an offshore call center, to which they paid money for complete doctors’ orders aimed at billing Medicare.

The Fraud Modus Operandi

The offshore call center used by Chmiel would run television ads, presenting a contact number. Medicare beneficiaries who responded to the advertisement would then be screened for their eligibility and persuaded that they required a brace. The call center would subsequently contact a ‘telemedicine’ company. This company’s physicians or nurse practitioners would then issue a prescription not on the basis of medical necessity, but rather indiscriminately, according to information from the Department of Justice.

Notably, the probe unearthed substantial evidence indicating that beneficiaries of the scheme were frequently prescribed braces without having ever been examined by a medical professional. It was also discovered that Chmiel tried to mask the fact that he was purchasing doctors’ orders by creating fake invoices for services related to alleged marketing and business processing.

Significant Losses to Medicare

The Department of Justice documents revealed that Chmiel’s various companies fraudulently billed Medicare for over $200 million during the course of the scam, with Medicare paying out more than $95 million in response to these claims.

United States District Judge Joseph F. Anderson consequently sentenced Chmiel to 108 months of imprisonment, bolstered by an additional three-year term of court-ordered supervision. It’s important to note that there’s no parole in the federal system. The ruling also orders Chmiel to pay restitution amounting to $98.9 million.