Mathias Consulting - Medicare Fraud Cases

Florida Businessman Sentenced in Health Care Fraud Scheme

Thu, 29 May 2008 17:57:46 -0700

Florida Businessman Sentenced in Health Care Fraud Scheme - Leonardo Pita, the owner of a durable medical equipment company based in Miami-Dade County, Florida, was sentenced to 42 months in prison, followed by three years of supervised release, and ordered to pay over $519,000 in restitution following his convictions for Medicare fraud and money laundering. [Google Reader]

Alabama Couple to Plead Guilty to Medicare Fraud

Thu, 29 May 2008 17:46:35 -0700

Alabama Couple to Plead Guilty to Medicare Fraud - William Lloyd King, Jr. and Marie Weller King, both of Birmingham, Alabama, have each agreed to plead guilty to their involvement in a Medicare fraud scheme.

What's a Little Medicare Fraud Between Friends? (newtimesbpb.com)

Fri, 7 Apr 2006 09:51:00 -0700

Here’s an interesting article I ran across about a politician who may have some connections to Medicare fraud. I don’t have inside information on this one, but I thought people would find it interesting.

newtimesbpb.com | News | What’s a Little Medicare Fraud Between Friends?

Coconut Creek Commissioner Jim Waldman is running for the state House in a district dominated by senior voters.

Businessman guilty in wheelchair fraud case - abc13.com

Wed, 7 Dec 2005 14:23:43 -0800

Businessman guilty in wheelchair fraud case - abc13.com -
Businessman guilty in wheelchair fraud case
abc13.com, TX - 8 hours ago
… 24th for a San Antonio businessman convicted in a Medicare and Medicaid billing scheme. … He was convicted Friday on six counts of federal health care fraud. …

Four arrested in AIDS drug scam (Herald.com | 12/02/2005)

Tue, 6 Dec 2005 17:55:58 -0800

Herald.com | 12/02/2005 | Four arrested in AIDS drug scam

BY JOHN DORSCHNER

jdorschner@herald.com

In what could be the start of a massive crackdown on scams involving HIV/AIDS patients, law enforcement officials announced the arrest of four persons, including two doctors, charged with illegally diverting millions of dollars in drugs.

Nursing home fraud alleged in indictments (Jefferson City News Tribune)

Sun, 20 Nov 2005 11:41:14 -0800

Nursing home fraud alleged in indictments (Jefferson City News Tribune) - ST. LOUIS (AP) - A federal grand jury returned indictments Thursday on charges that several nursing home operators conspired to defraud Medicare and Medicaid by collecting payments for services they did not provide to their residents.

Burbank Couple Arrested, Charged in Multi-Million-Dollar Medicare Scam

Sun, 31 Jul 2005 15:13:20 -0700

LA COUNTY DISTRICT ATTORNEY’S OFFICE PRESS RELEASE

LOS ANGELES – A Burbank couple suspected of being the masterminds behind a Medicare scheme that took in $5.8 million in two years was arrested today on multiple counts of money laundering, tax fraud and other charges, the District Attorney’s office announced.

Deputy District Attorney Albert MacKenzie with the Fraud Interdiction Program said Sarkis Musoyan, 37 (dob 9-27-67), and his wife, Azatui Dilboyan, 37 (dob 3-31-68), were arrested at their Burbank home by investigators with the D.A.’s Bureau of Investigation.

Massachusetts Physician Pleads Guilty

Fri, 3 Jun 2005 10:12:01 -0700
US Attorney Press Release Boston, MA… A Cambridge physician pleaded guilty late Friday, May 13, 2005 in federal court and admitted to submitting false billings to the Medicare program. United States Attorney Michael J. Sullivan and Kenneth W. Kaiser, Special Agent in Charge of the Federal Bureau of Investigation in New England, announced that DR. VLADIMIR SHURLAN, age 60, of 7 Channing Street, Cambridge, Massachusetts, pleaded guilty before U.S. District Judge Nathaniel M. Gorton to a one-count criminal Information that charged him with engaging in a scheme to commit health care fraud.

Bayonne Medical Center Agrees to Pay $242,000 to Settle Medicare Over Billing

Fri, 17 Jun 2005 14:33:51 -0700
NJ US Attorney Press Release NEWARK - Bayonne Medical Center, a hospital in Hudson County, today agreed to pay over $242,000 to settle claims that it overcharged Medicare, U.S. Attorney Christopher J. Christie announced. A settlement agreement signed today provides that Bayonne will pay the government $242,340 to settle claims that from 1992 through 1998 it wrongfully submitted claims for inpatient hospital stays for patients who received outpatient services. As a result of Bayonne’s conduct, it received higher reimbursement than it would have had it billed properly, according to Assistant U.S. Attorney Stuart A. Minkowitz.

Physician Identity Theft in Tennessee

Fri, 3 Jun 2005 10:42:15 -0700
GREENEVILLE, Tenn. — Mailee Renae Lodge (AKA Mailee Renae Reed) was ordered to pay $1.3 million in restitution for cheating Medicare by filing false claims. She was sentenced to five years in prison. She and her husband used a stolen provider id to fraudulently bill for home examinations, sleep studies, pulmonary studies and other procedures.

United Healthcare Settles for $3.5 Million

Fri, 3 Jun 2005 10:27:09 -0700
United Healthcare Insurance Company paid $3.5 million to settle a case that alleged that they defrauded Medicare by falsifying reports of how they handled phone inquiries. United Healthcare was acting as a Durable Medical Equipment Regional Carrier, responsible for processing DME claims submitted by Medicare providers and beneficiaries. United Healthcare did not admit any of the allegations. The case was the result of a qui tam lawsuit brought by a former United Healthcare employee. The whistleblower will receive $647,500 of the settlement. “This settlement demonstrates our continuing commitment to pursue vigorously allegations of fraud and abuse in Medicare,” said Peter Keisler, Assistant Attorney General for the Department’s Civil Division.

Maine Urologist Receives Light Sentence for Lupron Scam

Fri, 3 Jun 2005 10:06:12 -0700

Dr. Joseph Olstein helped the government get a $1.2 billion settlement from TAP Pharmaceutical and AstraZeneca. In return he received only a light sentence for his part in the scam. The US Attorney announced that Olstein was sentenced this week to one year probation and a $20,000 fine (in addition to a previous $50,000 restitution payment).

Dr. Olstein pleaded guilty in 2001 to billing insurance companies for free samples of Lupron, which he received from TAP sales people. Lupron is an injectible drug used for treating prostate cancer. Physicians can bill Medicare and other insurers for injectible drugs. Because the free samples were given as a way for physicians to enhance their income, the samples are considered a kick-back. Without the kickbacks that TAP offered to urologists, an equivalent drug that is cheaper than Lupron would probably have been prescribed.

Costs and Savings in Medicare Change on Wheelchairs

Fri, 3 Jun 2005 10:28:45 -0700
Costs and Savings in Medicare Change on Wheelchairs - Medicare administrators late last fall began to take a closer look at reimbursement requests for power wheelchairs, an effort now saving the government millions of dollars. [New York Times Healthcare News] The beginning of this article talks about the hardships of small businesses and patients who are having trouble getting Medicare to pay for power wheelchairs. Sure, new rules may make it more difficult for everyone to get Medicare to pay for power wheelchairs, but the rules were enacted to control terrible abuse of the system.