News and Commentary

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

News and Commentary | Fraud Cases | Links to Press Releases | Medicare Fraud Cases

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.

Attorney General Lockyer Offers Reward for Reporting Medi-Cal Fraud

News and Commentary

Attorney General Bill Lockyer today launched a crackdown on rip offs of the taxpayer-funded Medi-Cal program, announcing he will offer up to a $1,000 reward for information leading to the conviction of providers of health care services and goods who defraud the system.

“This is a triple crime,” said Lockyer. “The money could be used for people who are truly ill and count on Medi-Cal as their only source of health care. Second, people are getting medical procedures they don’t need and putting themselves at risk. And taxpayers’ money is being wasted at a time when the need is great and dollars are precious.”

MMIS Call for Submissions

News and Commentary | Healthcare Policy and Technology

I’m helping PS-TG put together presentations for the MMIS Conference in August.

You are invited to submit an abstract of a proposed topic to be considered for presentation at the upcoming MMIS conference. Don’t miss this unique opportunity! The MMIS Conference attendees include IT and health care professionals from Medicaid agencies as well as CMS and the government services sector of the health care vendor community. There are numerous benefits to being a speaker, including:

  • Your name and State or company name included in conference promotional materials related to speaker session(s)

Huge Billing Fraud Is Cited by Health Plans at California Clinics

News and Commentary | Fraud Cases
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.

Abuses Endangered Veterans in Cancer Drug Experiments

News and Commentary
Abuses Endangered Veterans in Cancer Drug Experiments - Scores of patients at the V.A. hospital in Albany were put at risk, and employees say bigger concerns were dismissed by officials. [New York Times Healthcare News]

5 Cases Settled in West Virginia

News and Commentary | Fraud Cases
U.S. attorney says he’s serious about health care fraud, LancasterOnline.com

U.S. Attorney E. Thomas Johnston announced plea agreements of five healthcare fraud cases.

The article describes the settlements with five providers:

  • Dr. William C. Dressler of Martinsburg, WV was charged with upcoding.
  • Dr. Sadtha Surattanont of Romney, WV agreed to settle charges of upcoding by paying $195,000 and agreeing to five years of monitoring of his participation in Medicaid and Medicare.
  • Dr. Harry D. Price of Martinsburg, WV allegedly filed false claims from 1997 to 2002.

Computers blamed for billing woes (Republican American)

News and Commentary | Prescription Drug Fraud
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?

Modesto chiropractor arrested - $10M scam

News and Commentary | Fraud Cases

“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.

Documents Said to Show Prozac Risks

News and Commentary
Documents Said to Show Prozac Risks - The British Medical Journal said it had sent documents to health regulators in the U.S. that it said appear to suggest a link between the antidepressant drug Prozac and suicidal behavior. [New York Times Healthcare News]

Are pharmaceutical companies hiding important information that the FDA should see? In addition to this article about missing documents, there has been a lot of attention given lately to possible links between Prozac and suicide. The New York Times Magazine recently featured a cover-story about anti-depressants and links to teenage suicide. There are going to be lawsuits over this for years to come.

Gambro to pay $355 million in fraud case

News and Commentary | Fraud Cases | Kickbacks | Medicaid Fraud Cases | Medical Equipment Fraud Cases
Gambro US to pay $355 mln in fraud case - Gambro Healthcare US, Lakewood, Colo., said it will pay $355 mln to settle civil and criminal charges stemming from illegal relationships with doctors and pharmaceutical companies in an alleged decade-long fraud scheme that began in 1991. [Healthcare Fraud News]

The settlement resolves civil liabilities from alleged kickbacks paid to physicians, false statements made to obtain payment for unnecessary services, and payments made to Gambro Supply, a sham DME company.

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