COLUMBIA, S.C. — Andrew Chmiel, 48, of Mt. Pleasant, was sentenced to nine years for Medicare fraud in federal prison Tuesday 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.
Medicare Fraud
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 Department of Justice’s 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 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.
“Chmiel’s scheme preyed upon honest citizens seeking medical help and this sentence brings an end to that exploitation,“ said U.S. Attorney Adair F. Boroughs. “We will continue to pursue and dismantle health care fraud schemes in South Carolina, especially those that permeate throughout the country.”
“Fraudulent schemes, such as this, undermine the trust and confidence of the American people in our healthcare programs,” said Steve Jensen, Special Agent in Charge of the FBI Columbia Field Office. “This ruling should serve as a reminder that healthcare fraud remains a top priority for the FBI and our law enforcement partners and we remain committed to the vigilance and accountability in preserving healthcare integrity.”
“This outcome underscores our unwavering commitment to combat health care fraud and pursue those who exploit Medicare beneficiaries and defraud taxpayers for personal gain,” stated Tamala E. Miles, Special Agent in Charge at the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG takes pride in collaborating with our partners to ensure accountability for those seeking to illegitimately profit from federal health care programs.”
“Crimes against our health care system equates to billions of dollars in losses and degrades a system designed to help those in need,” said Donald “Trey” Eakins, IRS Criminal Investigation Special Agent in Charge. “We will continue to stand with our law enforcement partners to investigate and prosecute individuals who attempt to enrich themselves by fraudulent means, and to help end health care fraud.”
United States District Judge Joseph F. Anderson sentenced Chmiel to 108 months imprisonment, to be followed by a three-year term of court-ordered supervision. There is no parole in the federal system. The court also ordered that Chmiel pay $98,935,533.00 in restitution.
In addition to Chmiel’s sentence, two corporations were also sentenced by United States District Judge Joseph F. Anderson on Tuesday. D.O. Delivery, LLC and Pain Center, LLC, two entities that Chmiel owned and operated that were used to facilitate the health care fraud scheme. Each entity was sentenced to 12-months’ probation and ordered to pay $98,935,533.00 in restitution.
This Medicare fraud case was investigated by the FBI Columbia Field Office, Health and Human Services-Office of the Inspector General, and IRS-Criminal Investigation Division. Assistant U.S. Attorney Amy Bower prosecuted the case.