Category Archives: Whistleblower News

Seventeen arrests were made on November 2nd in clinics based in Brooklyn and Queens. These health clinics allegedly defrauded the Government of $95 million in Medicare dollars. The fraud scheme namely involved trading free spa treatments, dance lessons, and other freebies for personal information provided by Medicare beneficiaries. In addition, the clinics never performed procedures that were billed to Medicare and gave cash kickbacks to patients to undergo unnecessary treatments and tests.

Read more at: http://www.nbcnewyork.com/news/local/Medicare-Arrest-US-Brooklyn-Attorney-Indictment-Federal-Charge-Fraud-133065208.html

A federal judge has imposed a 50-year prison sentence on a Florida executive, Lawrence Duran, for targeting patients with dementia in a $205 million Medicare fraud scheme. According to the Department of Justice, Duran’s sentence is the longest Medicare Fraud Strike Force sentence ever given. Assistant Attorney General Lanny A. Breuer of the Criminal Division states, “[f]or years, Mr. Duran stole millions of taxpayer dollars by defrauding Medicare and preying upon vulnerable citizens suffering from Alzheimer’s disease, dementia and substance abuse.”

Read more at: http://www.mcknights.com/life-in-prison-for-fraudulent-company-exec/article/215461/

New York City has agreed on a $70 million settlement with the Department of Justice for overbilling Medicaid’s Personal-Care Services Program. The program provides basic essentials for selected Medicaid patients, such as cleaning, shopping, and medical aid. The settlement acknowledges that for almost a decade, the city’s personal-care services allowed people to receive the 24-hour personal care program without proper assessments from medical personnel. Although individuals like U.S. Attorney Preet Bharara believe that the settlement is fair, especially after how much was defrauded, others like NY City Corporation Counsel Michael Cardozo state, “[t]he City remains deeply concerned about the use of the False Claims Act to resolve funding disputes among governmental entities.”
Read more at: http://newyork.ibtimes.com/articles/241406/20111101/new-york-pays-70-million-false-medicaid.htm

During a raid conducted by federal authorities, sixteen people within the Los Angeles area were arrested for an $18 million Medicare fraud scheme. One of the doctors arrested worked at Manor Medical Imaging Clinic of Glendale, where he wrote prescriptions for anti-psychotic drugs that were billed to Medicare and Medi-Cal, but never sent to patients. If convicted, the sixteen individuals could face up to 30 years in federal prison.

Read more at: http://www.businessweek.com/ap/financialnews/D9QLANFG0.htm

The Centers for Medicare & Medicaid Services (CMS) has yet to impose a single moratorium on new Medicare providers and suppliers, an authority CMS officials were given by President Obama’s health care reform eight months ago. Concerned about CMS’ inaction,  Senators Chuck Grassley (R-Iowa) and Orrin Hatch (R-Utah) have written a letter to Heath & Human Services (HHS) Secretary Kathleen Sebelius. In the letter, they note that “[i]t is not reasonable to suggest that CMS needs more time to study whether there is need to impose a temporary moratoria … when ample evidence exists from the strike force activities to justify moratoria in these high fraud areas.”

 
Read more: http://www.fiercehealthcare.com/story/congress-urges-cms-fight-medicare-fraud-moratoriums/2011-10-27#ixzz1cMxxoWqc