An Omaha man is accused of bilking Medicare of more than $674,000 in Nebraska, Iowa, Kansas, Missouri and a dozen other states, allegedly throwing pizza parties at nursing homes and going to homeless shelters promising them all freebies in order to get Social Security information to further the scam.
Nereus Sutko has been charged in U.S. District Court with health care fraud starting Nov. 1, 2010, and continuing into this month.
In a 19-page affidavit, Paul Vaccaro, a special agent with the U.S. Department of Health and Human Services Office of Inspector General, said Sutko submitted more than 1,666 false claims while managing Better Lives MedGroup LLC.
Vaccaro said the business has moved several times since it opened in November 2010, but most recently had an address on Millard Avenue in Omaha, moving out at the end of February.
During the investigation, he said, agents learned through witnesses that Sutko visited assisted-living facilities, retirement centers and low-income housing complexes in Nebraska and neighboring states and set up pizza parties to show people eligible for Medicare and Medicaid the products Better Lives offered.
Vaccaro said Sutko told them they could receive free health care-related products they could pick out from a Better Lives brochure and offered them gift cards for their personal information, including doctors' names, which allowed Sutko to bill Medicare or Medicaid for the products, which he never delivered.
Investigators interviewed 16 Medicare beneficiaries, including a Lincoln woman, who identified Sutko in a photo lineup. Vaccaro said she was shown a list of knee, ankle and back braces that his company billed on her behalf between 2014 and 2015 and said she hadn't received any of them.
Better Lives billed Medicare $4,359.05 and received $3,120.38. The Lincoln woman said she didn't receive any of the money, either.
Vaccaro said investigators talked to another Lincoln woman who recalled Better Lives doing a presentation at her senior living facility. She said company representatives showed her and other residents braces and back pillows they could order.
She was having trouble with her knees and was told her doctor could prescribe knee braces. She got them later in the mail. But she never saw the diabetic shoes she was promised by Better Lives. And, she said, it never responded to the messages she left asking about them.
Vaccaro said the documents show the company billed Medicare $3,273.19 for the woman's knee, back and wrist braces, the shoes and a heating pad. Medicare paid out $2,351.14.
Others in the Kansas City area said a representative of Better Lives came to high-rise complexes, handed out free ice cream sandwiches, got residents' information and ordered diabetic shoes, but billed Medicare for far more.
In Iowa, investigators learned about pizza parties at low-income senior housing complexes, where people were promised free items that would be covered by their insurance. Vaccaro said they gave their names, Medicaid ID numbers and doctors' names, and got Walmart gift cards for referrals.
In all, Sutko is alleged to have filed 1,666 claims, charging Medicare $1,172,802 and getting $674,106. Many of the claims — 700 — involved Nebraskans.
Vaccaro said after concerns came up that Sutko may have a gambling problem, investigators served subpoenas on three casinos in the Council Bluffs, Iowa, area.
Through them, they learned that Sutko had lost more than $350,000 between 2013 and September 2018, he said.
Sutko made his first court appearance last week on the allegations.