Two Miami healthcare executives were convicted for orchestrating a $34 million fraud scheme that exploited elderly Medicare Advantage beneficiaries through deceptive telemarketing calls and sham medical orders for unnecessary braces.
Story Highlights
- Michael Kochen and Sandro Herek convicted on December 22, 2025, for $34 million Medicare Advantage brace fraud
- Scheme targeted vulnerable seniors through aggressive telemarketing and fake telemedicine consultations
- Over $17 million in taxpayer funds fraudulently paid out to conspirators
- Case highlights ongoing government overreach in healthcare while criminals exploit federal programs
Federal Jury Delivers Justice Against Medicare Fraudsters
A Miami federal jury convicted Michael Kochen, 42, and Sandro Herek, 56, on healthcare fraud charges for their roles in a sophisticated scheme targeting Medicare Advantage beneficiaries. The executives submitted approximately $34 million in false claims for medically unnecessary durable medical equipment braces, including back, knee, shoulder, and ankle supports. Medicare Advantage plans paid over $17 million on these fraudulent claims, representing a direct theft from taxpayer-funded healthcare programs.
The conviction demonstrates the ongoing vulnerability of federal healthcare programs to criminal exploitation. South Florida has become a notorious hotspot for healthcare fraud, with the U.S. Attorney’s Office for the Southern District of Florida regularly prosecuting major cases involving Medicare and Medicaid abuse. This pattern reflects broader concerns about government program integrity and oversight failures that allow criminals to siphon taxpayer dollars.
Predatory Tactics Target America’s Seniors
The defendants employed deceptive telemarketing operations to target elderly Medicare Advantage beneficiaries, pressuring vulnerable seniors into accepting medical equipment they neither needed nor wanted. Telemarketers used high-pressure sales tactics and misrepresented benefits to harvest personal information from unsuspecting seniors. The scheme involved pre-completed medical order forms that sham telemedicine physicians would sign without conducting proper examinations or determining medical necessity.
This predatory approach undermines the trust seniors place in legitimate healthcare providers and Medicare-related communications. The defendants exploited the complexity of Medicare Advantage plans and the growing telehealth industry to create an appearance of legitimacy while systematically defrauding both beneficiaries and taxpayers. Such schemes erode confidence in telemedicine services that many seniors legitimately need, particularly in rural or underserved areas.
Broader Implications for Healthcare Fraud Enforcement
The Department of Justice and HHS Office of Inspector General have identified telemarketing combined with telemedicine and durable medical equipment as a high-risk configuration for fraud. This case represents part of a broader enforcement pattern targeting DME brace fraud schemes that have cost federal programs billions of dollars. The conviction sends a clear message about federal commitment to prosecuting mid-sized healthcare fraud operations, not just headline-grabbing cases involving hundreds of millions.
The case highlights concerning vulnerabilities in Medicare Advantage claims processing and oversight mechanisms. While legitimate DME providers and telehealth companies serve essential roles in healthcare delivery, fraudulent operators exploit gaps in utilization management and real-time claims analytics. This creates additional compliance costs and regulatory burdens for honest businesses while criminals profit from inadequate government oversight of taxpayer-funded programs.
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Two South Florida health care executives convicted of $34M Medicare fraud
Miami healthcare execs convicted in $34 million Medicare Advantage fraud
Miami Healthcare Executives Convicted in $34 Million Medicare Fraud Targeting Seniors
Two Healthcare Executives Convicted for Exploiting Elderly Medicare Advantage
