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Health Care Fraud Blog

Covers fraud in Medicare, Medicaid and insurance benefits.
By Robert David, Esq.

Post Frequency: 0.6/day

Last Entry: March 02, 2011 at 00:22:24

PALM BEACH STATE ATTORNEY FILES CHARGES AGAINST 11 IN OPERATION ?PILL NATION? WITH RACKETEERING (RICO) AND OTHER RELATED CRIMINAL ACTIVITY

Posted on March 02, 2011
PALM BEACH, FL ? Palm Beach County State Attorney Michael McAuliffe announced the arrest and filing of criminal charges against 11 individuals, including five physicians, for a total of 172 counts which include Racketeering (RICO), Conspiracy to Commit Racketeering, Trafficking...

OPERATION SNAKE OIL - SOUTH FLORIDA ROGUE PAIN CLINICS (PILL MILLS) TARGETED - FIVE DOCTORS AMONG THOSE ARRESTED

Posted on February 24, 2011
Defendants Owned and Worked at Seven Area Clinics that Prescribed over 660,000 Pills, Profited More than $22 Million FORT LAUDERDALE, FL - The United States Attorney for the Southern District, Drug Enforcement Administration (DEA), Internal Revenue Service (IRS) Criminal Investigation,...

More Than 30 Medicare-fraud Suspects Rounded Up in Miami as Part of Nationwide Operation

Posted on February 17, 2011
Miami, FL - Federal agents took to the streets early this morning arrested and more than 30 suspects charged with Medicare fraud as part of a nationwide operation authorities are describing as the largest healthcare fraud take-down to date. This...

U.S. authorities charge 111 in Medicare fraud worth $225-million

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Miami Clinic Owner Pleads Guilty in $5 Million Health Care Fraud Scheme

Posted on February 15, 2011
MIAMI, FL - Defendant Ramon Moreira, 82, of Miami, pled guilty today to one count of health care fraud, in violation of Title 18, USC, � 1347. Sentencing has been scheduled for May 17, 2011. According to court records, the...

FLORIDA ATTORNEY GENERAL BONDI ANNOUNCES STRATEGIES TO COMBAT PILL MILL EPIDEMIC

Posted on February 03, 2011
TALLAHASSEE, FL- Attorney General Pam Bondi announced comprehensive strategies to combat the epidemic of pill mills in Florida. The Attorney General?s initiative includes a series of legislative recommendations for the upcoming legislative session. Because of the proliferation of pill mills,...

Miami-area Clinic Owner Sentenced to 5 Years Prison for Home Health Agency Medicare Fraud Scheme; Four Nurses Sentenced

Posted on December 17, 2010
MIAMI, FL ? Yudel Cayro, the owner and operator of Courtesy Medical Group, was sentenced to 5 years behind bars for his role in a wide-ranging Medicare fraud scheme. U.S. District Judge Adalberto Jordan also ordered Cayro to serve two...

Two More DME Owners in Miami Arrested for Health Care Fraud

Posted on August 16, 2010
An investigation coordinated by the U.S. Department of Justice Medicare Fraud Strike Force, supervised by the Criminal Division?s Fraud Section and the U.S. Attorney?s Office for the Southern District of Miami has resulted in the arrest of Emilio Felipe Lopez,...

Illinois Cardiologist Sentenced for $13M Health Care Fraud

Posted on August 12, 2010
The Associated Press reports that on August 12, Sushil Sheth, a suburban Chicago cardiologist was sentenced to five years in prison for bilking Medicare and insurance companies out of more than $13 million for care never provided. The 5-year sentence...

Congress Set to Approve $1.7B to Fight Health Care Fraud

Posted on August 08, 2010
Congress is moving forward toward granting the Obama administration's request for a record $1.7 billion to fight health-care fraud, in part to almost triple investigations into crime rings that steal from Medicare. The money, included in both House and Senate...

MIAMI CLINIC OWNER CONVICTED IN $24 MILLION HIV-INFUSION FRAUD

Posted on July 22, 2010
On July 21, 2010, Raul S. Ramirez, 55, of Miami Gardens, FL, was convicted of one count of conspiracy to commit health care fraud, twelve counts of health care fraud, and three counts of money laundering. According to the evidence...

Feds Announce Largest Healthcare Fraud Takedown Underway

Posted on July 17, 2010
MIAMI (July 16) - U.S. Agents have arrested 94 doctors, health care owners, and executives in a nation-wide crack down on fraudulent medicare billing, U.S. Attorney General and Health and Human Services Secretary Kathleen Sebilius announced today in Miami,...

HHS Secretary Sebelius, U.S. Attorney General Holder Kick-Off First Regional Health Care Fraud Prevention Summit in Miami, Florida

Posted on July 16, 2010
MIAMI (July 16, 2010) ? U.S. Health and Human Services Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder today kicked-off the first in a series of Regional Health Care Fraud Prevention Summits in Miami, Florida. The summit brought...

Attorney General & HHS Secretary Send Letter to States on New Outreach and Education Efforts to Combat Medicare Fraud

Posted on June 08, 2010
WASHINGTON (June 8, 2010) ? Attorney General Eric Holder and Secretary of Health and Human Services (HHS) Kathleen Sebelius have sent a letter to state attorneys general urging them to work with HHS and federal, state and local law...

Health Care Reform Legislation Seeks Funding for 13 New Health Care Fraud Stike Forces

Posted on March 24, 2010
As reported previously here, a central feature of the Obama administration?s health care reform has been the HEAT (Health Care Fraud Prevention and Enforcement Action Team) initiative is the use of Strike Force teams. Strike Forces are multi-agency units of...

The Illusion of Cheaper Drugs From Canada

Posted on March 15, 2010
The Governor of Montana, following a line of other politicians over the years, is promoting the idea of that state purchasing drugs for publicly run health care programs from Canada . However, for a number of reasons, such ideas have...

Sometimes Being The Low Man On The Totem Pole Doesn?t Help Much At Sentencing

Posted on March 11, 2010
Alex Carrazana was a Medical Assistant. He is currently serving 72 months in prison for Medicare Fraud. He was for a time employed by a clinic called Midway Medical. At that clinic his job was to help with the infusion...

The War On Pain, Law Enforcement versus Medicine?

Posted on March 10, 2010
When it comes to chronic pain, the current DEA war on pain management leads to a question: How much authority should the DEA have over the treatment of patients? According to the Association of American Physicians and Surgeons, ?If you?re...

Law Enforcement Focuses on Pain Clinics, Ignoring Patients Who Suffer

Posted on March 09, 2010
According to an article in the South Florida Sun-Sentinel, at least 45 pain clinics opened in Broward and Palm Beach counties in the past year, while state law makers and state and local law enforcement agencies stepped-up their efforts to...

The Value of Patient Information

Posted on March 08, 2010
Florida and a number of states attempting to outlaw so called ambulance chasing in personal injury cases have employed several methods to limit access to records of patients. First, statutes prohibit access to police accident reports for 60-days. Second, statutes...

The Return Of The Medicare Bounty Hunters

Posted on March 04, 2010
In the 1990?s there was a system in place that seemed reasonable at the time. The government hired private companies to audit hospital cost reports on the government?s behalf and to add additional incentive, those companies, generally large insurance companies,...

Shut Up! Don't Call Attention to Yourself

Posted on March 03, 2010
Whatever you do, don't harass the Medicare fraud investigators. A kind of simple rule, if you are committing a crime (no one I represent does that), don?t go out of your way to send harassing emails and phone calls to...

Delray Beach Pain Management Regulation: Great Idea, No Way To Carry It Out

Posted on February 28, 2010
The City of Delray Beach, Florida, is considering requiring pain management patients to give their fingerprints so those fingerprints can be used to immediately electronically check against a database to make sure the patient is not doctor shopping. That sounds...

Undercover Patients for Medicare Fraud Investigations?

Posted on February 25, 2010
U.S. Senator Tom Coburn of Oklahoma, who is also a medical doctor, is proposing that the United States root out Medicare Fraud through the use of undercover patients. Actually this is not new a new idea, government agents have in...

Create A Problem to Solve A Problem; An Internet Canadian Pharmacy Originator Loses His License

Posted on February 25, 2010
In case where it appears the governments of the Untied States and Canada to stop a practice they disfavored, created a worse problem, the originator of the Canadian internet pharmacy business model gave up his license to practice pharmacy in...

Man Sentenced To 70 Months In Drug Diversion Scheme

Posted on February 19, 2010
Arnesto Segredo, of Miami was sentenced to 70 months in prison for of conspiring to divert the prescription drugs Serostim and Nutropin AQ. Both drugs are human growth hormones (HGH). The scheme involved Segredo using first and unlicensed company and...

Google Gets Around To Policing Internet Pharmacy Sites

Posted on February 15, 2010
Google has for many years profited somewhat well from advertising by websites dedicated to gambling and internet pharmacy. Website owners who want to advertise on Google and other search engine companies bid on words in an ongoing auction. So, when...

The Self Reporting Quandary

Posted on February 10, 2010
If a provider discovers that it may have submitted false claims to Medicare or Medicaid, either through errors or through the malfeasance of an employee, the provider is obligated to pay the program back the funds wrongfully obtained. Medicare has...

Florida County Places Moratorium On Pain Clinics

Posted on February 09, 2010
In an intriguing development in the war on pain, Palm Beach County, Florida, passed an ordinance designed to prevent new pain clinics from opening up and are intending to pass ordinances to curb the practices of existing pain clinics. This...

Detroit Clinic Manager Sentenced in Miami to 63 Months in Prison for Role in $2.3 Million Medicare Infusion Fraud Scheme

Posted on February 05, 2010
According to a Department of Justice press release, Miami-Dade County resident Dulce Brice�o was sentenced on February 4th to 63 months in prison for her role in a $2.3 million Medicare fraud scheme. Miami based U.S. District Judge Ursula Ungaro...