By the Constantine Cannon Whistleblower Team

The government continues to prioritize healthcare fraud enforcement. As we detailed in our round-up of top healthcare-related False Claims Act recoveries from 2024, more than $1.67 billion (58% of all FCA recoveries that year) came from healthcare fraud cases alone. With several settlements already announced this year, 2025 is shaping up to be another active year in healthcare enforcement.

On April 21, the government announced that two operators of New Jersey’s Empire Pain Center Holdings LLC (“Empire”) were sentenced to prison for their roles in a $127 million healthcare fraud and kickback scheme. Eric Karlewicz a/k/a “Anthony Mazza,” 46, of Rockland County, New York, and Nicco Romanowski, 33, of Roswell, Georgia, pled guilty to the charges. They also agreed to settle related False Claims Act allegations.

According to prosecutors, from June 2017 and May 2019, Karlewicz and Romanowski orchestrated a wide-ranging conspiracy involving durable medical equipment (“DME”) companies, telemedicine providers, and doctors. As part of the scheme, Empire directed its employees to pressure Medicare and TRICARE beneficiaries into accepting unnecessary DME items, such as body braces. Empire paid its employees commissions and bonuses to incentivize them to convince as many beneficiaries as possible to accept DME, regardless of medical necessity.

Empire also paid kickbacks to telemedicine companies, which then paid kickbacks to doctors for DME prescriptions. The national DME suppliers likewise had kickback arrangements with Empire in exchange for patient referrals, generating over $63 million for Empire. In total, Karlewicz and Romanowski caused the submission of over $127 million in false claims to federal healthcare programs for DME.

As part of the criminal case, Karlewicz was sentenced to 51 months in prison and ordered to forfeit over $63 million. Romanowski was sentenced to 80 months in prison and ordered to forfeit over $5.5 million.

To settle the civil charges, Karlewicz and Romanowski admitted to violating the False Claims Act and agreed to the entry of a consent judgment against them in the amount of $63.8 million.

This case was brought by a whistleblower Robert Jackson Tyler Jr., who filed suit under the qui tam, or the whistleblower provision of the False Claims Act.  Under the FCA, private parties (or relators) can file lawsuits on behalf of the United States and share a percentage of the government’s recovery. In successful cases, whistleblowers may receive up to 30% of the government’s recovery. Tyler’s award has not yet been disclosed.

What Role Do Whistleblowers Play in Exposing Healthcare Fraud?

Whistleblower attorney Ginger Buck commented: “Whistleblowers, such as the relator in this case, are often the only ones who can expose healthcare fraud schemes from the inside. Their willingness to come forward is critical to uncovering healthcare fraud, safeguarding public funding, and strengthening trust in our healthcare system.”

Fraud affects healthcare programs funded by the United States and individual states. Individuals can blow the whistle on bad actors attempting to defraud Medicare, Medicaid, TRICARE/CHAMPUS (a health care program for individuals and dependents affiliated with the armed forces), and other types of misconduct such as kickback schemes.

Our Firm Helps Healthcare Fraud Whistleblowers

Whistleblowers are key in uncovering fraud and helping ensure the integrity of government healthcare programs. If you would like more information on what it means to be a whistleblower, believe you have information relating to False Claims Act violations or healthcare fraud, please contact us so we can connect you with a member of the experienced Constantine Cannon whistleblower lawyer team for a free and confidential consultation.

 

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United States Attorney’s Office, District of New Jersey Press Release

Read $127M Health Care Fraud and Kickback Scheme: Business Operators Sentenced, Settle False Claim Act Allegations at constantinecannon.com