News and Commentary

Flu Shot Fraud Indictment in Texas

News and Commentary | Fraud Cases | Links to Press Releases | Prescription Drug Fraud

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

News and Commentary | Fraud Cases | Kickbacks | Links to Press Releases | Prescription Drug Fraud

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.

TennCare Fraud Covered by Nashville City Paper

News and Commentary | Breaking News | Fraud Cases | Medicaid Fraud Cases

According to the article by Judith R. Tackett, TennCare is increasing their focus on beneficiary fraud through their new Office of Inspector General:

“Faulkner, who was appointed by Gov. Phil Bredesen in July 2004 to establish the state’s Office of Inspector General, said Tennessee is ahead of the game when it comes to fighting TennCare fraud. Her office targets TennCare recipients committing fraud while the TBI concentrates on provider fraud.

Short of Evidence: Growth Hormones and Shortness

News and Commentary | Quality

I’ve written a lot about growth hormone fraud, but this article is not about fraud. It is about waste. It is legal to use growth hormones to treat shortness in children, but that doesn’t mean that insurance and Medicaid should pay for it. One month ago, the New York Times Magazine covered this subject in an article by Stephen S. Hall. The long and short of it is while growth hormones can add an inch and a half to a child’s final height, it is not clear that this is of any value. There are far better uses for the $20,000 or more per year (treatment is typically 4-5 years) per child spent on growth hormones.

Kansas Couple Convicted on Involuntary Servitude Charges

News and Commentary | Fraud Cases

U.S. Newswire : Releases : “Kansas Couple Convicted on Involuntary Servitude Charges…”

WASHINGTON, Nov. 7 /U.S. Newswire/ — The Justice Department announced today that Arlan Kaufman, 69, and his wife, Linda Kaufman, 62, were convicted on federal charges for forcing mentally ill patients to perform sexually explicit acts on videotape and to perform physical labor in the nude. The jury found Arlan Kaufman guilty on 31 federal counts and Linda Kaufman guilty on 30 federal counts, including involuntary servitude, forced labor, conspiracy, healthcare fraud, mail fraud, and Medicare fraud.

U.S. prosecutor vs. health industry (Pioneer Press)

News and Commentary | Breaking News | Fraud Cases | Medical Equipment Fraud Cases

After string of successful fraud prosecutions, Sullivan takes on medical device makers

BY JEREMY OLSON

Pioneer Press

A watchdog of the pharmaceutical industry is turning his attention to the marketing practices of the medical device industry.

Michael Sullivan, the U.S. attorney for the Massachusetts district, has earned more than $3.3 billion for the federal government through health care fraud lawsuits. His biggest cases challenged whether drug makers used kickbacks or other improper methods to sell their products.

Medical Transporter Admits Medicaid Fraud (North Country Gazette)

News and Commentary | Breaking News | Fraud Cases | Medicaid Fraud Cases

From the North Country Gazette:

“The owner of a Westchester County transportation company has admitted to stealing more than $400,000 from the state Medicaid program by fraudulently billing for hundreds of rides that never took place and for rides that were not authorized by medical practitioners.

Meir Sassoon, president of Saswitz Corporation, appeared before Westchester County Court Judge Rory J. Bellantoni, on Sept.1 and pleaded guilty to every count of an indictment which charged him with one count of grand larceny in the second degree and 25 counts of offering a false instrument for filing in the first degree. The defendant agreed to make full restitution to the New York State Medicaid program, in the sum of $437,845.51, before sentencing on Sept. 28.. Saswitz Corporation previously pled guilty to grand larceny in the second degree.

Massachusetts Medicaid Audit Reveals Poor Oversight (Boston.com)

News and Commentary

Audit: State losing hundreds of millions to Medicaid fraud
By Steve LeBlanc, Associated Press Writer | October 13, 2005

BOSTON —The state may be losing hundreds of millions of dollars to Medicaid fraud, according to a new report from the state auditor which criticizes state officials for not doing more to detect and discourage such abuses.

From 2001 to 2003, investigators recovered just $17.2 million lost to theft, abuse and fraud. That’s a tiny fraction of the $15 billion spent on the state’s Medicaid program, known as MassHealth, Auditor Joseph DeNucci said.

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

News and Commentary | Links to Press Releases | Prescription Drug Fraud
  • 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.

Janet Reno and I Discuss Health Policy

News and Commentary | In the News

Janet Reno spoke today at the National Conference of the Gay and Lesbian Medical Association. As a GLMA Board Member, I had the opportunity to chat with her briefly after her presentation.

Janet Reno and Robin Mathias Discuss Fraud Ms. Reno spoke about how important it is for all people to have access to healthcare. If minorities are protected from discrimination in healthcare but do not have the financial ability to access care, then the rights are only paper and not real. She gave many examples of how lack of health coverage harms our population. And she talked about the costs that could be avoided by having universal coverage. Ms. Reno also stressed the importance of helping the elderly stay in their homes and avoid nursing home care.

XML feed