A federal indictment was unsealed earlier this week, charging Rasko “Ron” Djordjevic and Milija “Mike” Perkovic with health care fraud, conspiracy to commit health care fraud, and aggravated identity theft, U.S. Attorney Matthew Schneider announced.
The announcement was made by US Attorney Matthew Schneider, who was joined in the announcement by Special Agent in Charge Timothy Slater, of the FBI’s Detroit Division; Special Agent in Charge James Vanderberg of the Department of Labor’s Office of Inspector General, Chicago Regional Office; and Regional Director Joseph Rivers of the Department of Labor’s Employee Benefit Security Administration.
According to the indictment, Djordjevic has been in charge of Sterling Hearing Care, Inc. and Sterling Hearing Center, Inc., (collectively referred to as SHC) since November 2014, with approximately fifteen hearing aid offices located throughout southeast Michigan. Milija Perkovic, who was also charged in the indictment, was one of several hearing aid dispensers working for Djordjevic.
It is alleged that Djordjevic, Perkovic and other unnamed individuals conspired to defraud both Blue Cross Blue Shield and American Health Benefits by submitting reimbursement claims for hearing aids and related services that were: (1) not provided, (2) provided, but medically unnecessary; and (3) predicated on fraudulent claim submissions and fraudulent marketing practices.
Among the allegations, the indictment specifically describes how SHC “would entice potential customers with offers of free hearing assessments” that were then billed to Blue Cross Blue Shield (BCBS). The office was said to employ high pressure sales tactics, “sometimes at the expense of medical necessity,” according to the indictment.
Among several shocking claims in the indictment, it is alleged that Perkovic would show potential customers fake xrays and tell them that the results revealed cochlear damage in the customer’s inner ear. SHC salespersons were also reportedly “taught that after determining the extent of a potential customer’s insurance coverage and conducting a soft credit check, the sales price of a hearing aid should be based upon what the customer can afford, not on a set market price”.
Identities of Medical Doctor, Audiologist, Used Fraudulently
The indictment also alleges that Djordjevic misused the identity of a specific Michigan audiologist in committing health care fraud by signing her name, and certifying all SHC claims submitted to American Hearing Benefits. The indictment further charges that Perkovic misused the specific identity of a Michigan doctor in committing health care fraud by falsifying her signature on a medical clearance form required by BCBS.
“Our office has no tolerance for health care providers that deliberately mislead customers in order to sell a medical product or service and then bill insurance companies for services and products not delivered. It is especially troublesome when a provider deals with elderly customers that may be particularly vulnerable to scams.” –U.S. Attorney Matthew Schneider
The case was investigated by Special Agents of the FBI and Department of Labor.
An indictment is only a charge and is not evidence of guilt. Each of the defendants in the case is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt. If convicted of a health care fraud charge, the defendants could face a maximum sentence of imprisonment of ten years, and fine up to $250,000. Additionally, the defendants face a mandatory and consecutive two-year sentence if convicted of aggravated identity theft.