Prescription Drug Fraud

Flu Shot Fraud Indictment in Texas

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Press Release: US Dept of Justice, US Attorney, Southern District of Texas, Chuck Rosenberg

November 17, 2005

John Yembrick
Public Affairs Specialist
P. O. Box 61129 Houston, TX 77208
Phone: 713/567-9388 Fax: 713/718-3389
CONTACT US

GRAND JURY INDICTS TWO FOR FAKE FLU VACCINE

(HOUSTON, TX) – United States Attorney Chuck Rosenberg today announced the unsealing of a 14-count federal indictment charging Iyad Abu El Hawa, 35, of Houston, and Martha Denise Gonzales, 48, of Baytown, with conspiracy and tampering with a consumer product. These charges stem from an investigation into a scheme to administer fake flu vaccines at several Houston-area locations. The investigation began in October 2005 after the FBI received information that fake flu vaccines may have been given at a health fair sponsored by ExxonMobil for its Baytown refinery employees.

Texas Conviction of Physical Therapist

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Press Release: US Dept of Justice, US Attorney, Southern District of Texas, Chuck Rosenberg

November 17, 2005

John Yembrick
Public Affairs Specialist
P. O. Box 61129 Houston, TX 77208
Phone: 713/567-9388 Fax: 713/718-3389

(HOUSTON, TX) United States Attorney Chuck Rosenberg today announced the verdicts of a federal jury convicting Dr. Anant Mauskar, 72, of conspiracy to commit health care fraud and receiving kickbacks as a result of a scheme that cost Medicare and Medicaid health care benefit programs millions of dollars in losses due to fraudulent claims. Charged with a total of 24 counts of health care fraud in connection with Medicare and Medicaid claims for physical therapy services and durable medical equipment, Mauskar was convicted of 20 of those counts and acquitted of four.

Waging War on Prescription Drug Abuse: New Medco Analysis Reveals Prescription Drug Abusers Engage in Doctor Shopping and Script

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  • Half of all documented cases of prescription drug abuse and drug seeking (fraud) are aged 40-49 years old
  • Monthly drug costs nearly 7 times that of average patient
  • Medco deterrent program decreased abuse by 32 percent; costs by 20 percent

FRANKLIN LAKES, N.J., Sept. 29 /PRNewswire-FirstCall/ — A new data analysis released today by Medco Health Solutions, Inc. (NYSE: MHS) provides a striking profile of people who file excessive prescription claims for drugs of potential abuse and how their risky habits are bilking the healthcare system.

TX Attorney General Sues Fraudulent Mail-order Prescription Drug Service

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Texas Attorney General Press Release AUSTIN - Texas Attorney General Greg Abbott today sued a mail-order prescription drug service for exploiting seniors who need reduced-cost drugs by asking them to commit fraud by lying to drug companies about their income. Drug companies offer programs in which qualifying seniors can obtain free prescription drugs. Each drug company has different income qualifications for their programs, but these are not solely dependent upon the person’s Social Security income.

Robin Mathias Quoted in Modern Healthcare

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First of many? Vaccine probe may extend beyond Connecticut

Byline: Mark Taylor

This is an excerpt. Click the link to view the full document.

Last week’s settlement by a Connecticut hospital could be just the first as state Medicaid fraud-control units explore allegations that hospitals, physicians and other providers may be billing Medicaid and private insurers for children’s vaccines they received free, according to government sources and healthcare fraud experts.

Healthcare billing fraud consultant Robin Mathias, former director of data analysis and budget for Indiana’s Medicaid program, said the vaccine billing scheme has likely spread beyond Connecticut’s borders.

“Regardless of what the federal agencies are saying, I suspect that other Medicaid programs will be looking into whether they’ve been billed for the VFC free immunizations,” said Mathias, who advises health plans about fraud schemes. “Whether or not it was fraud or an honest error, those providers would have been essentially paid twice for the same service, and that’s illegal.”

She said hospitals, many of which operate outpatient, immunization and community clinics, could face liability.

“MyRxForLess” Owners Guilty of Importing Phony Phamaceuticals from Mexico

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United States Attorney Carol C. Lam announced today that three of the principals of an Internet pharmacy business known as “MyRxForLess” pled guilty in federal district court in San Diego before United States District Judge Jeffrey T. Miller to federal charges related to their roles in an Internet pharmacy scheme. Charles William Naron pled guilty to conspiracy, conspiracy to launder money and to criminal forfeiture. In his plea, Naron admitted that beginning in December 2002, and continuing up to the time of his arrest on November 5, 2004, he, together with Stephen Lewis and Pamela Lewis, operated an Internet pharmacy business, known as MyRxForLess, located in Lake Worth, Florida. Naron acknowledged that MyRxForLess had a website by which customers could order prescription drugs without having a prior prescription. The website falsely stated that all the drugs were obtained from a reputable Mexican pharmacy, and falsely indicated that individuals could lawfully import a 90-day supply of prescription pharmaceuticals into the United States from Mexico.

Computers blamed for billing woes (Republican American)

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Computers blamed for billing woes (Republican American) - Two doctors who must pay more than $500,000 to Medicaid and private insurers after billing for free vaccines blamed the improper bills on a computer system installed in their offices before they owned the practice. [Yahoo News! Healthcare Fraud]

However, these doctors were double-paid for many services. If their patients noticed this, shouldn’t the doctors have noticed as well?

CT Pediatricians Settle in Operation Free Shot

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“Kevin J. O’Connor, United States Attorney for the District of Connecticut, and Richard Blumenthal, Connecticut Attorney General, announced that TORRINGTON-WINSTED PEDIATRIC ASSOCIATES, P.C. , located at 538 Litchfield Street, Torrington, Connecticut, and 49 Spencer Street, Winsted, Connecticut; and PEDIATRIC & ADOLESCENT HEALTHCARE, P.C., located at 400 Main Street, Ansonia, Connecticut, and its former owner, WILLIAM SILBERBERG, M.D., have entered into two separate civil settlement agreements with the Government to resolve allegations that they violated the False Claims Act by submitting fa

Another Lupron Guilty Plea

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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.

Maine Urologist Receives Light Sentence for Lupron Scam

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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.

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