Fraud Cases

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

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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.

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.

NJ Chiropractor Charged with Fraud

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Press Release NJ Division of Criminal Justice TRENTON - Division of Criminal Justice Director Vaughn L. McKoy announced that the Division of Criminal Justice - Office of Insurance Fraud Prosecutor has charged an Essex County chiropractor and office manager for allegedly paying “runners” to illegally secure patients and to fraudulently increase the amount of money obtained from insurance companies. The “runners” were under cover State Investigators assigned to the Office of Insurance Fraud Prosecutor.

FL Assisted Living Facility Owner Arrested on Medicaid Fraud Charges

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FL Attorney General Press Release TALLAHASSEE - Attorney General Charlie Crist today announced the arrest of the owner of two Volusia County assisted living facilities on criminal charges of defrauding the state’s Medicaid program of more than $69,000. The Attorney General’s Office also filed a separate civil action against Vidya Bhoolai, 42, of Holly Hill, seeking more than $800,000 in damages for numerous violations of Florida’s False Claims Act. Bhoolai is the owner of Radiant Star Manor and Rising Sun Manor, both of which are assisted living facilities. According to an investigation conducted by the Attorney General’s Medicaid Fraud Control Unit, Bhoolai allegedly filed claims for 25 Medicaid recipients who either never resided in her facilities or resided there for fewer days than she reported when seeking Medicaid reimbursements. This improper billing defrauded the program of $69,145. Bhoolai faces criminal charges for 26 counts of Medicaid fraud and one count of scheme to defraud.

Massachusetts Physician Pleads Guilty

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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

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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.

New York Insurance Fraud Ring Busted

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Manhattan District Attorney Robert M. Morgenthau announced today the indictment of 15 people, including four doctors, a dentist, a psychologist, and an acupuncturist, on charges of participating in an insurance scam in which the New York City Transit Authority which is self-insured and private insurance companies were falsely billed for professional medical services that were never provided. A medical billing company, two heath care clinics that were also professional medical corporations and three other professional medical corporations were also indicted today.

The two-part investigation leading to today’s indictment began 18-months ago when insurance investigators from the New York City Transit Authority’s Special Investigation Unit, working with the Manhattan District Attorney’s Rackets Bureau, began an undercover investigation into PREMIER MEDICAL CARE, PC. Ten months later, investigators from the New York Police Department’s Fraudulent Accident Investigation Squad began an undercover operation at the OMNI MEDICAL CARE.

Huge Billing Fraud Is Cited by Health Plans at California Clinics

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Huge Billing Fraud Is Cited by Health Plans at California Clinics - Insurers, working with the F.B.I., said they have broken up an elaborate scam in which doctors filed more than $1 billion of fraudulent insurance claims. [New York Times Healthcare News]

Sound familiar? This problem has been in the news before. It was exposed by ABC Primetime Live in March 2004. Now Blue Cross and Blue Shield plans have filed a civil lawsuit accusing clinics in Southern California of using runners to recruit many employees from a single workplace to received over-priced and unnecessary services in return for cash.

Texas Medical Supply Business Owner Sentenced for Medicare Fraud

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SAN ANTONIO - A medical supply company owner was sentenced to a year and a half in jail and ordered to pay $1.3 million in restitution. In December he pleaded guilty to falsifying Certificates of Need for medical supplies.

Physician Identity Theft in Tennessee

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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.
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