Corporate Compliance

Virginia couple charged with Medicaid fraud

Compliance Monitor, February 27, 2008

A Virginia couple allegedly defrauded the state's Medicaid agency of $14 million, according to a Department of Justice (DOJ) press release.

A federal grand jury charged Ilya Zavelsky, 46, a physician, and his wife, Rina Zavelsky, 40, a nurse, with conspiracy to commit healthcare fraud and money laundering since 2002. The couple provided respite care and other services to Russian-speaking communities in Virginia through Renaissance Inc.

They allegedly billed for services at an unauthorized, higher reimbursement rate (upcoding), billed for services not provided, used uncertified aides and recipients, and falsified employment records, according to the DOJ.

According to the indictment, the Zavelskys billed Medicaid for, and received, a total of approximately $14,356,204.00, in Medicaid funds.

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