August 1, 2025 | JacobiJournal.com — A federal investigation has unveiled a massive Medicare Advantage fraud scheme involving a Sunnyvale medical supply executive who allegedly submitted thousands of false claims using stolen identities and unneeded medical equipment.
According to the U.S. Department of Justice, Sevendik Huseynov, CEO of Vonyes, Inc., was charged with orchestrating a billing operation that funneled more than $137 million in fraudulent claims to multiple Medicare Advantage Organizations (MAOs). From January to June 2025, Huseynov allegedly submitted over 7,200 claims for durable medical equipment (DME), including orthopedic braces and wound care items—most of which were never requested, medically necessary, or even delivered to beneficiaries.
Massive Fraud Uncovered in Medicare Advantage DME Claims
Federal prosecutors allege that Huseynov relied on a network of stolen beneficiary identities to populate fabricated patient files. The company submitted detailed billing codes to at least eight separate Medicare Advantage plans. Investigators say that while only $761,000 was paid before the fraud was flagged, the total scope of attempted fraud is one of the largest recent busts involving Medicare Advantage billing.
Court records describe the operation as a “bust-out fraud”—a scheme where perpetrators flood insurers with claims in a short period before detection systems can flag anomalies. Authorities say there was no physician oversight, medical necessity documentation, or evidence the patients had ever spoken with the company.
Medicare Advantage Plans Targeted Through System Gaps
Unlike traditional Medicare, Medicare Advantage plans rely on private insurers to process and pay claims. Critics argue that the decentralized nature of MAOs leaves vulnerabilities in place for vendors to exploit gaps in documentation, encounter data validation, and claims auditing—particularly for high-volume services like DME.
“Medicare Advantage fraud involving DME has become increasingly sophisticated, exploiting lagging controls in encounter data systems,” noted federal prosecutors in their filing.
The complaint also suggests the company leveraged software tools to mass-generate claim forms, auto-fill billing codes, and route submissions to different carriers to avoid detection.
FAQs: Understanding Medicare Advantage Fraud and Your Rights
What is Medicare Advantage fraud involving DME?
Medicare Advantage fraud occurs when vendors, providers, or third parties submit false claims to MAOs for services or equipment that were not medically necessary, not delivered, or never ordered. In this case, durable medical equipment like braces and dressings were fraudulently billed under stolen identities.
How does this type of fraud affect beneficiaries?
Victims may find false entries in their medical records or Explanation of Benefits (EOB) statements, potentially harming their future care or eligibility. It may also raise flags during audits and result in billing disputes, even if the person did not knowingly participate.
Where can suspected Medicare Advantage fraud be reported?
Consumers can report suspected fraud directly to the Office of Inspector General (OIG) or through the Medicare Fraud Hotline at 1-800-MEDICARE. You may also file a complaint online via the OIG Fraud Reporting Portal — a legitimate federal resource for patients and professionals.
For more updates on Medicare compliance, legal enforcement, and healthcare fraud investigations, subscribe to JacobiJournal.com.
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