Press Release's blog
“Investigators believe that at least $10 million has been drained from a system whose costs are already harming our economy.” Insurance Commissioner John Garamendi
William Origel, Rebecca Benedict, and Robin Barney were charged with felony counts of insurance fraud, grand theft, and practicing medicine without certification. Origel is the owner of Med-1 Medical Center, P.C., and Unique Healthcare Management, Inc. Origel, with help from Bendict and Barney allegedly over-billed workers’ compensation and auto insurance carriers for services never rendered, services not medically necessary, and for services beyond the scope of their licensed authority to perform.
November 15, 2004, Boston. Dr. John Romano, a urologist in Massachusetts pleaded guilty to fraud for charging Medicare and Medicaid for free samples of Lupron. Sentencing is scheduled for February 2005.
According to the US Attorney’s Office in Massachusetts, four other urologists have been sentenced in connection with this investigation. Dr. Joseph Olstein (Maine), Dr. Rodney Mannion (Indiana), Dr. Jacob Zamstein (Connecticut), and Dr. Joseph Spinella (Connecticut) pleaded guilty healthcare fraud. These doctors were sentenced to probation, in exchange for their help with the Lupron investigation, which resulted in a $1.2 million settlement from TAP Pharmaceutical.
Dr. Alan I. Aronowitz was sentenced this week to four years in jail and ordered to pay $200,000 in restitution to United Concordia insurance after pleading guilty to using unlicensed assistants to perform root canals.
Aronowitz’s lawyer had argued that white-collar criminals should not get jail time.
There’s an attitude that poor people should go to jail, but wealthy educated people should do community service.
“The lawyer is implying that fraud isn’t so bad,” says Robin Mathias, a healthcare fraud control specialist. “There’s an attitude in this country that if a mother steals to feed her kids and pay the rent, she should go to jail, but if a wealthy person steals to get a vacation home, that person should just do community service. This attitude increases healthcare fraud not only because perpetrators think they are unlikely to go to jail if caught, but also because they often convince themselves that what they’re doing isn’t wrong.”
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.
Two owners of a South Florida treatment center for infectious diseases, a physician at the center and a nurse who served as its administrator, were arrested for their roles in a costly Medicaid fraud scheme, according to an October 1, 2004 press release from the Florida Attorney General. The scheme involved billing for prescriptions for medications that were never dispensed and the creation of false medical records to conceal the doctor’s absence from patient treatment and office supervision. Medicaid investigators seized over $1.6 million in illegally purchased assets, including a 40-foot boat, an ocean-view condominium, and a Cadillac SUV.