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Arrest of Philadelphia doctor and 22 others in $1 M insurance fraud

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“Attorney General Jerry Pappert today announced that agents of his Insurance Fraud Section have charged a Philadelphia chiropractor and 22 other suspects for allegedly participating in a massive insurance fraud scam that netted more than $1 million. Pappert said his agents have charged Dr. Richard Walinsky of Holland, Bucks County, who operated the All-Care chiropractic office at 6047 Castor Ave., in Philadelphia, from 1998 through 2003…”

Schering-Plough to pay $345 million to resolve criminal and civil cases

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“PHILADELPHIA – Patrick L. Meehan, United States Attorney for the Eastern District of Pennsylvania and Jerry Pappert, Pennsylvania Attorney General, announced today that Schering Sales Corporation, a subsidiary of drug manufacturer Schering-Plough Corporation, has agreed to plead guilty to criminal charges and to pay a fine of $52.5 million. Schering-Plough Corporation has agreed to pay more than $290 million to resolve its civil liabilities in connection with its illegal and fraudulent pricing of its blockbuster drug, Claritin.”

Medi-Cal Guilty Plea $725,000 Wheelchair Fraud

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“United States Attorney Carol C. Lam announced today that Dr. Romulo Valdez, a San Diego physician, has pleaded guilty in San Diego federal court to conspiracy to defraud Medicare and Medi-Cal of more than $725,000. In his guilty plea before the Honorable Anthony J. Battaglia, United States Magistrate Judge, Dr. Valdez admitted that he conspired with Benison Medical Supply, a San Diego medical equipment supplier, to defraud Medicare and Medi-Cal by submitting false claims for motorized wheelchairs. Valdez admitted that his role in the conspiracy was signing Certificates of Medical Necessity for motorized wheelchairs not needed by the beneficiaries, knowing that Benison would use Valdez’s false certifications to bill Medicare and Medi-Cal for the unneeded wheelchairs.

California Insurance Fraud Indictment

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“United States Attorney Carol C. Lam announced the unsealing today of a federal indictment charging William R. Fry, Geronimo Rubio, Debbie LaRue and John Ditredici with conspiracy, in violation of Title 18, United States Code, Section 371, and health care fraud, in violation of Title 18, United States Code, Section 1347. William Fry and Geronimo Rubio were also charged in the indictment with filing false tax returns, in violation of Title 26, United States Code, Section 7206(1) and Fry was further charged with structuring financial transactions, in violation of Title 31, United States Code, Se

Medi-Cal Crime Ring Stole $20 Million - 18 Year Sentence

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“(SANTA ANA) – Attorney General Bill Lockyer today obtained a prison sentence of more than 18 years for a key player in an organized crime ring that defrauded California’s Medi-Cal system of more than $20 million. The sentence is the longest in California history for Medi-Cal fraud. “This record sentence is the result of an intensive, five-year investigation into and prosecution of a sophisticated criminal operation that stole patient and physician identify information and submitted false claims in order to steal millions of dollars from the state’s Medi-Cal system,” Lockyer said. “It also illustrates the aggressive stance my office takes in prosecuting those who try to cheat a system that more than six million Californians rely on for vital health care.”

Prison for New York Hospital Employee - Serostim Worth $1.7 Million

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“Attorney General Eliot Spitzer today announced that former Montefiore Medical Center employee Enrique Rojas has been sentenced to one and two-third years to five years in state prison for stealing more than $1.7 million from taxpayers during a nine-month period by faxing hundreds of forged prescriptions for the AIDS medication Serostim to out-of-state pharmacies. The pharmacies, in turn, filled the prescriptions, shipped the medications to various New York City addresses being used by Rojas, including his own residence, and billed the New York State Medicaid program for having dispensed the expensive medication.
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