2 Sentenced in $35M Medicare Advantage Scheme

MIAMI—Michael Kochen, 42, of Aventura, Florida, and Sandro Herek, 56, of Coral Springs, Florida, Two South Florida men, a healthcare executive and a telemarketing company owner, have been sentenced to federal prison for their alleged roles in a Medicare Advantage scheme. The fraudulent scheme resulted in the submission of approximately $35 million in false and fraudulent claims to Medicare Advantage plans for medically unnecessary durable medical equipment (DME), including back, knee, shoulder and ankle braces.

Kochen, a healthcare executive, was sentenced to 204 months in federal prison and Herek, a telemarketing company owner, to 92 months in federal prison after they were convicted at trial. Kochen was found guilty of one count of conspiracy to commit healthcare and wire fraud, six counts of healthcare fraud, one count of conspiracy to pay and receive healthcare kickbacks and three counts of payment of healthcare kickbacks. Herek was found guilty of one count of conspiracy to commit healthcare and wire fraud, one count of healthcare fraud, one count of conspiracy to pay and receive healthcare kickbacks and three counts of receiving healthcare kickbacks.

“These defendants targeted elderly Medicare Advantage beneficiaries with relentless telemarketing and unnecessary medical equipment, generating approximately $35 million in fraudulent claims and more than $19 million in payments,” said U.S. Attorney Jason A. Reding Quiñones for the Southern District of Florida. “Michael Kochen and Sandro Herek treated vulnerable seniors as profit centers and federal healthcare programs as personal bank accounts. These substantial prison sentences hold them accountable, and we will pursue the forfeiture and recovery of their ill-gotten gains.”

According to court documents and evidence presented at trial, Kochen and Herek targeted Medicare Advantage beneficiaries through deceptive telemarketing practices, pressuring elderly individuals to accept medical equipment they did not need—and in some cases, did not want. Over the course of the scheme, Medicare Advantage plans paid more than $19 million on fraudulent claims.

Kochen owned dozens of companies that sold DME supplies, such as braces, and paid illegal kickbacks to Herek and others to recruit Medicare beneficiaries to receive these braces. Herek oversaw and directed overseas call centers, including in Egypt and other foreign jurisdictions, which aggressively cold-called Medicare beneficiaries without prior requests for services. Call-center representatives repeatedly contacted beneficiaries—often after initial refusals—and used high-pressure tactics to induce them to accept braces regardless of medical necessity.

Evidence further showed that physicians frequently issued standardized or boilerplate medical authorizations for braces based solely on call recordings rather than individualized medical evaluations. In many instances, doctors did not speak with beneficiaries at all. When calls did occur, they were often brief, lasted only minutes and did not include a meaningful assessment of medical necessity. Kochen paid kickbacks to telemedicine companies to obtain prescription orders for braces for Medicare Advantage beneficiaries, which were then used to submit claims for unnecessary equipment.