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Southern California Sleep Study Clinic Owner Sentenced After U.S. Department of Labor Uncovers Healthcare Fraud
LOS ANGELES, CA – After an investigation by the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) and the Office of Inspector General, a federal court has sentenced Anna Vishnevsky to 37 months in prison, and ordered her to make $2,747,071 in restitution for defrauding the healthcare benefit plans of UPS Inc. and Costco Wholesale Corp.
The joint investigation found that Vishnevsky – former owner of Atlas Diagnostic Services Inc. and ADA Services Inc. – and co-defendant Eddie Hernandez engaged in a scheme to defraud the healthcare benefit plans by submitting approximately $11 million in fraudulent claims for medically unnecessary sleep studies. Vishnevsky and Hernandez each pleaded in 2018 to one count of health care fraud.
In April 2019, U.S. District Court for the Central District Judge George H. Wu sentenced Hernandez, a former UPS employee, to 30 months in prison. In a subsequent Aug. 8, 2019 hearing, Judge Wu ordered Hernandez to pay $545,977 in restitution.
Vishnevsky and Hernandez recruited patients by offering cash in exchange for participating in sleep study testing. They also offered additional cash to those who brought dependents and referred co-workers to participate in the scheme. Vishnevsky and Hernandez recruited patients knowing that no doctor had prescribed sleep study testing for them, and regardless of whether the testing was medically necessary.
Vishnevsky failed to score or interpret the data from the testing, or provide it to anyone who could score or interpret it, which is necessary for diagnosis and treatment. She also billed the healthcare benefit plans for two sleep studies for many patients, even though they were only at her clinic for one night.
“Inflating healthcare bills for medically unnecessary treatments and billing for services that were never received increase the costs of insurance for individuals and for the community,” said Employee Benefits Security Administration Regional Director Crisanta Johnson, in Los Angeles, California. “EBSA will continue to work vigorously with our law enforcement partners to combat fraud involving health plans.”
“Vishnevsky and Hernandez stole money set aside for union members’ health benefit plans by fraudulently billing union trust funds for sleep study services not performed. By defrauding the health plans, the defendants betrayed and abused the trust of their fellow workers. We will continue to work with our law enforcement partners to protect the integrity of labor unions and their benefit plans,” said Quentin Heiden, Special Agent-in-Charge, Los Angeles Region, U.S. Department of Labor Office of Inspector General.
EBSA, the department’s Office of Inspector General, the FBI and the Office of Personnel Management jointly investigated the case; and the U.S. Attorney’s Office for the Central District of California prosecuted the case.
Employers and workers can reach EBSA toll-free at 866-444-3272 for help with problems related to private sector retirement and health plans. Additional information can be found at http://www.dol.gov/ebsa
EBSA’s mission is to assure the security of the retirement, health and other workplace related benefits of America's workers and their families. EBSA accomplishes this mission by developing effective regulations; assisting and educating workers, plan sponsors, fiduciaries and service providers; and vigorously enforcing the law.
The OIG conducts criminal, civil and administrative investigations into alleged violations of federal laws relating to Department of Labor programs, operations and personnel. In addition, the OIG conducts criminal investigations to combat the influence of labor racketeering and organized crime in the nation’s labor unions. Such matters should be referred promptly to the OIG Hotline (https://www.oig.dol.gov/hotlinecontact.htm) or 1-800-347-3756.
The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights.