Illegals Immigrants draining social services? A lie or a Lie.!!

There is no such as Illegal Immigrant either someone as undocumented Immigrant caugh draining or commited any fraud against any social services. Why continue blaming them for God sake. This is the main problem in America. Some have eyes but cannot see," "Some have tongues but cannot speak the truth. They have ears but can't hear. That's where the problem is".

According to their 2008 SEC filings, the largest hospital chain in the U.S., the Hospital Corporation of America (HCA) - founded by the family of former Senator and Majority Leader Bill Frist; After his Senate career, Frist became a partner with health-care investment firm, and chairman of a nonprofit (????) charitable (???) foundation focusing on Global health initiatives and Education issues- reports that in 2008 about 49% of their revenues and 59% of their hospital admissions were Medicare and Medicaid "related." In 2007, HCA reported revenues of $26.9 billion, approximately $16 billion of which was paid for by American taxpayers.

What most people may not know is that HCA plead guilty to 14 felonies and was hit with a $1.7 billion fine – far and away the largest such fine in history - for Medicare fraud. These fines, it seems, were a minor bump in the road for HCA, on their way to grabbing hundreds of billions of American taxpayer dollars in the years to come. Doctors and hospitals reap the financial benefit of surgeries, whether they are warranted or not. American taxpayers, both in terms of Medicare/Medicaid payouts and higher insurance premiums, pay the real price. Source



A former Oklahoma pharmacist faces up to five years in prison on a federal fraud charge for making a false claim to Medicaid.

Sentencing for Gary Wayne Nichols, 33, is expected in the next 60 days, said Bob Troester, spokesman for the U.S. attorney’s office in Oklahoma City.
Nichols was charged in September with one count of making a false claim, and pleaded guilty to the felony in November. As part of a plea deal, he’s agreed to pay $180,000 in restitution, said his attorney, Jean Paul Bradshaw.
Bradshaw said his client wants to take responsibility for his actions.
"He’s a very hard-working guy who got caught up in what he was doing and made some mistakes,” he said. "He’s sorry for what he did and is trying to make amends.”

Billed Medicaid $339,436 for prescriptions for nursing home patients that were not prescribed or filled.

Bought $100,000 in drugs for $25,000 in the parking lot of one of his pharmacies and tried to use the drugs to fraudulently get a refund from a drug company. They belonged to a tribal health clinic.

Man had six pharmaciesT

he case stems from a 2006 investigation by the state Board of Pharmacy and the state attorney general’s office that resulted in Nichols losing his pharmacist license.
He was licensed in 2001 and had been owner or part owner of six pharmacies in Moore, Oklahoma City, Altus, Guthrie, Allen and Lexington.
John Foust, executive director of the Board of Pharmacy, said Nichols’ case is one of the larger fraud cases investigated by his office.
Nichols lost his license and was fined $11,000 by the board.

Why blaming undocumented immigrants for draining social services?.

TWO AREA PHYSICIANS AMONG FOUR DEFENDANTS CHARGED IN THREE SEPARATE FEDERAL HEALTH CARE FRAUD SCHEMES.


CHICAGO – Two Chicago area physicians are among four defendants who have been charged recently in three separate, unrelated federal healthcare fraud cases, federal law enforcement officials announced today. Each of the physicians, who were charged in separate cases, allegedly defrauded either Medicare and/or private health care insurers – in one case for more than $13 million – by either billing for services they never provided or inflating the services they did provide to patients. In the third case, the operator and manager of two former suburban Chicago durable medical equipment providers allegedly defrauded Medicare and Medicaid by providing power wheelchair or orthotic devices that were not prescribed or medically necessary and the recipients were not qualified to receive.

“Health care fraud remains an important priority of federal law enforcement. We will use all of our resources to ensure that dishonest physicians and other medical providers do not profit from cheating Medicare and private insurers,” said Patrick J. Fitzgerald, United States Attorney for the Northern District of Illinois.

Mr. Fitzgerald announced the cases, all three of which were charged or unsealed this week in U.S. District Court, with Robert D. Grant, Special Agent-in-Charge of the Chicago Office of Federal Bureau of Investigation; Lamont Pugh, Special Agent-in-Charge of the U.S. Department of Health and Human Services Office of Inspector General in Chicago; and James Vanderberg, Special Agent-in-Charge of the U.S. Department of Labor Office of Inspector General in Chicago. The Office of Personnel Management Office of Inspector General also participated in the investigations.

The defendants in all three cases were charged with one or more counts each of health care fraud. If convicted, each count carries a maximum penalty of 10 years in prison and a $250,000 fine.

The Court, however, would determine the appropriate sentence to be imposed under the advisory United States Sentencing Guidelines.

In each case, the public is reminded that charges are not evidence of guilt. The defendants are presumed innocent and are entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt. The details of each case follow:

United States v. Sushil Sheth

Dr. Sushil Sheth, a cardiologist with privileges at three unnamed Chicago area hospitals, was charged with health care fraud in a criminal information filed Wednesday in U.S. District Court.

Between January 2002 and July 2007, he allegedly received approximately $13.4 million – $8.3 million from Medicare and $5.1 million from other health care insurers – in fraudulent reimbursement for the highest level of cardiac care when those services were not performed, and then used the proceeds for his own benefit.

Sheth, 47, of Burr Ridge and whose business office is in Flossmoor, will be arraigned at a later date in U.S. District Court.

According to the charges, Sheth used his hospital privileges to access and obtain information about patients without their knowledge or consent. He then hired individuals to bill Medicare and other insurance providers for medical services that he purportedly rendered to patients whom he knew he never treated. Typically waiting almost a year after the treatment was purportedly provided, Sheth submitted false claims for reimbursement for providing the highest level of cardiac care – requiring hands-on treatment in an intensive care unit – on multiple days during patients’ hospital stays.

The charges seek forfeiture of approximately $13.4 million and two parcels of real estate in Scottsdale , Ariz. The Government has seized or restrained approximately $11.3 million in various bank and investment accounts held by Sheth and his wife.

The government is being represented by Assistant U.S. Attorney Steven J. Dollear. The case was investigated by the FBI and the Inspector General’s offices of the Department of Health and Human Services and the Labor Department.

United States v. Otto Garcia Montenegro

Dr. Otto Garcia Montenegro, a general practice physician who owned and operated a private medical clinic, Montenegro Clinic, Inc., in Elmwood Park, where he treated dozens of patients each week, was charged with health care fraud in a criminal information filed yesterday in U.S. District Court. Between early 2003 and May 2007, he allegedly submitted false health insurance claims totaling approximately $500,000 to Blue Cross Blue Shield of Illinois and other private medical insurance providers. The insurers paid Montenegro approximately $373,000 based on the false claims, the charges allege.

Montenegro , 47, of Elmwood Park , will be arraigned at a later date in U.S. District Court.

According to the charges, Montenegro did not collect deductibles and co-payments from patients and, instead, submitted hundreds of fraudulent insurance claims to insurers for services and treatments that he knew he did not actually provide in order to exhaust patients’ deductibles and copays and obtain money for himself. As part of the scheme, he allegedly created hundreds of bogus bills falsely identifying visits and treatments that never occurred.

The government is being represented by Assistant U.S. Attorney Jacqueline Stern. The case was investigated by the FBI and the Labor Department’s Office of Inspector General.

United States v. Stephen Anthony Pam and Shavon Keyona Williams

Stephen Anthony Pam, who controlled and operated two former durable medical equipment companies in suburban Chicago that supplied motorized wheelchairs, scooters, reclining lift chairs and orthotic devices, and Shavon Keyona Williams, who at various times worked as office manager or salesperson for both business, were each indicted on 34 counts of health care fraud for allegedly fraudulently billing millions of dollars to Medicare and Medicaid and other health care benefit programs.

Pam, 47, of Sugarland , Tex. , was arrested on January 23 in Houston after returning from a foreign trip. He remains in federal custody while being transferred to Chicago to face prosecution.

Williams, 30, of Chicago , will be arraigned at a later date in U.S. District Court. They were indicted by a federal grand jury on December 11 and the indictment was unsealed following Pam’s arrest.

Pam controlled and operated the former Alliance Healthcare Services & Medical Equipment, Inc., in Glen Ellyn , and the former Medlinc Concepts, Inc., in Oak Brook.

Between 2004 and 2008, the defendants allegedly falsely claimed to Medicare and Medicaid that power wheelchairs or orthotic devices were medically necessary for beneficiaries when they knew that physicians had not ordered or prescribed such equipment and that beneficiaries did not qualify to receive them under Medicare and Medicaid rules. As part of the fraud scheme, Pam and Williams allegedly submitted hundreds of claims for reimbursement to Medicare and Medicaid totaling more than $5 million, falsely stating that Alliance and Medlinc had delivered equipment to beneficiaries when they knew that either no equipment was actually delivered; beneficiaries received less expensive scooters or reclining lift chairs instead of more expensive power wheelchairs; or beneficiaries received orthotic devices that were less in quantity or Medicare-approved quality than what was billed.

In one aspect of the fraud scheme, the indictment alleges that between February 2005 and May 2006, approximately 99 percent of the Alliance claims submitted to Medicare and Medicaid were for power wheelchairs and accessories that were never supplied. These claims totaled approximately $4.7 million. Pam, through Alliance , allegedly received reimbursements from these claims totaling more than $1.8 million, and the indictment seeks forfeiture of that amount.

The government is being represented by Assistant U.S. Attorneys Felicia Manno Alesia and Ryan Hedges. The case was investigated by the Department of Health and Human Service’s Office of Inspector General and the FBI.

Undocumented Immigrants draining Welfare system? A lie or a Lie.

Again is beyond belief the Anti Immigrants group are narrow minded towards facts and myths regarding draining social services like Welfare, Medicare, and Medicaid. Just a few facts for them; Are you there Lou Dobbs? Glenn Beck, Minuteman Groups? Read these facts:

A former Alabama Department of Human Resources employee from Prichard pleaded guilty this week to using her position to steal hundreds of dollars in food stamps, the attorney general's office announced Tuesday.

Three other Mobile County women also were convicted this week on charges of welfare fraud, according to a news release from Attorney General Troy King.

Elanda Stallworth, 57, admitted to charges of second-
degree theft of food stamp benefits or money from DHR and that she intentionally used her position for unlawful personal gain, the release states. She pleaded guilty in Mobile County Circuit Court on Monday. Stallworth apparently used her own computer to steal six checks worth $149, or a total of $894, King said. Source:


Attorney General Troy King today announced the convictions of three women in Mobile County Circuit Court for charges of welfare fraud.
“When people lie to receive welfare benefits to which they are not entitled, they are committing a crime against the State, the taxpaying public, and those who are truly deserving of welfare benefits,” said Attorney General King. “I take seriously my responsibility as Attorney General to protect public funds on behalf of the people of Alabama and pledge to prosecute those who break the law by abusing the welfare system.”

Chantell Robinson, 33, of Mobile, pleaded guilty today to third-degree theft of property in the amount of $1,401. She was sentenced to one year, which was suspended, and placed on probation for two years. The court ordered her to pay full restitution to the State of Alabama.

Tosha Lee, 32, of Chickasaw, pleaded guilty today to third-degree theft of property in the amount of $4,867. She was sentenced to one year, which was suspended, and placed on probation for two years. The court directed her to pay full restitution to the State of Alabama.

Shirley Ann Blackmon, 44, of Mobile, pleaded guilty yesterday to second-degree theft of property in the amount of $4,617. She was sentenced to three years, which was suspended, and placed on probation for three years. The court ordered her to pay full restitution to the State of Alabama.

The Attorney General commended Assistant Attorney General Noel Barnes and Senior Special Agent Assie Webb for their work in handling these cases. Attorney General King also thanked the Department of Human Resources in Mobile County for its assistance in preparing information and referring the matter to the Attorney General’s Office for review and appropriate action, noting in particular Rose Johnson, director of Mobile County Department of Human Resources; Avis Buford, caseworker, Mobile County DHR; Leon Kennedy, claims worker, Mobile County DHR; and Geraldine W. Turner, claims supervisor, Mobile County DHR.

Johnson stated, “We work to have our Food Stamp program deliver timely benefits to eligible individual’s and appreciate the Attorney General prosecuting those who illegally receive benefits. Every dollar given fraudulently takes away from those truly in need. We want the public to have confidence in the administering of these programs and appreciate prosecution when appropriate.”

The Mobile County cases are part of a continuing statewide effort by Attorney General King to aggressively investigate and prosecute welfare fraud. Prosecutions are pending in approximately 38 counties, including Baldwin, Clarke, Monroe, Escambia and Conecuh counties. Source:


Couple plead guilty to welfare fraud

A Shingletown couple have pleaded guilty to welfare fraud and are due to be sentenced March 24, a prosecutor said Tuesday.

William Wallner, 34, pleaded guilty Monday to welfare fraud and perjury in two separate cases, and is to be sentenced to three years in prison, Deputy District Attorney Michael Hemker said.

Teresa Wallner, 34, pleaded guilty to two counts of welfare fraud and is to be sentenced to 180 days in jail, he said.

Between 2004 and 2008, the couple were overpaid nearly $30,000 in welfare benefits for failing to report job and unemployment income, Hemker said. Source:

Polygamous Sect are the largest funded groups from Medicare and Medical.

If you are going to have three wives and 15 children, you need to figure out a way to support three wives and 15 children. Source:

Cardiologist Convicted of 51 counts of Healthcare Fraud. Ethic? Moral?

United States Attorney Donald W. Washington, along with Health & Human Services Office of Inspector General Special Agent in Charge, Mike Fields, and FBI, New Orleans Division, Special Agent in Charge, David Welker, announced the conviction of DR. MEHMOOD M. PATEL, 64, of Lafayette, by a federal jury of healthcare fraud After a three-month trial which began on October 1, 2008, and six days of deliberation, a jury returned a guilty verdict on 51 counts of healthcare fraud in United States District Court in Lafayette.

After the verdict Tuesday evening, Judge Tucker Melancon denied the government’s motion for detention before sentencing, but increased Patel’s release bond obligation to $500,000.00. The court also ordered the defendant to surrender all medical licenses, including those allowing him to practice medicine
in Louisiana, Canada, India and elsewhere by 9:00 a.m. on December 31, 2008. A date for sentencing is expected to be set soon.

PATEL was indicted in February 2006 stemming from a complaint made to the Department of Health & Human Services that the defendant was placing stents in people who did not need them. A search warrant was executed on Patel’s office in November 2003, at which time patient files were seized. Beginning on or about September 2003, Our Lady of Lourdes (OLOL) Hospital in Lafayette, LA conducted an internal investigation leading to the suspension of DR. PATEL’S privileges at OLOL. A similar process was undertaken by Lafayette General Medical Center (LGMC) in late 2003 and early 2004 which also led to DR. PATEL being suspended from practicing at LGMC. After the hospitals suspended the defendant’s privileges, the Louisiana State Medical Board restricted DR. PATEL’S license to practice interventional cardiology, leaving him the ability to practice internal medicine pending the results of the criminal trial.

Testimony at trial revealed that MEHMOOD M. PATEL, M.D., who has been practicing interventional cardiology in Lafayette, Louisiana and surrounding areas for more than 25 years, was falsifying patient symptoms in medical records, falsifying findings on medical tests, and performing unnecessary coronary procedures such as deploying angioplasty balloons and stents. Testimony from experts in cardiology specialties revealed that the defendant deployed stents, balloons and radiation in coronary arteries that had little or insignificant disease. Testifying medical experts included doctors from Emory University in Atlanta, GA, the University of Pennsylvania Medical School in Philadelphia, PA, Mt. Sinai Hospital in New York City, and the University of California at Los Angeles, CA, as well as cardiologists practicing in Louisiana. Each expert testified about only a small number of the thousands of procedures performed annually for many years by DR. PATEL. The indictment in the case contained 91 counts involving only 75 patients chosen by the government with the help of these experts.

Additionally, the jury heard testimony from dozens of other government witnesses including medical technicians, nurses, and patients who painted the defendant as one who lacked concern for patient care and safety. Many of the nurses and technicians indicated their concerns and made complaints to their supervisors after witnessing unnecessary angioplasty procedures performed by the defendant doctor. Testimony also revealed that DR. PATEL was performing unnecessary medical procedures and billing both Medicare and private insurance companies, which added up to millions of dollars paid to DR. PATEL and the hospitals where many of the procedures were performed. During the years 1999-2003, DR. PATEL was the number one biller in cardiology services for the State of Louisiana. During the approximately three-year period covered by the indictment, DR. PATEL billed Medicare and private insurance companies more than $3 million, of which he received $541,745.00 from this scheme. The indicted charges included less than $90,000.00 of the amount received by the defendant.

DR. PATEL performed procedures at both Our Lady of Lourdes Hospital and Lafayette General Medical Center, as well as a leased mobile catheterization lab located outside his practice, Acadiana Cardiology, before he opened his own catheterization lab in mid-2002 on the second floor of his office on St. Julien Street in Lafayette, Louisiana.

United States Attorney Donald W. Washington stated: “Patient care and safety are the primary duty of all healthcare providers. Doctors are never privileged to perform medically unnecessary procedures on any person for any reasons whatsoever. I hope that this matter sends a strong message to those good and honorable medical professionals to police their ranks and be faithful to their credo of doing no harm to any patient. Healthcare providers like Dr. Patel are not entitled to payment by federal and/or private health plans for medically unnecessary procedures. Physicians must be held accountable when they fail in their primary mission to care for their patients appropriately, ethically and respectfully. Healthcare fraud will continue to remain a priority for this office, and we will aggressively investigate and devote our full attention and resources to matters of this magnitude.”


Special Agent in Charge for Health & Human Services Office of Inspector General, Mike Fields, stated: “Yesterday, Dr. Patel heard from this jury what healthcare providers who defraud Medicare are hearing from juries all over America - you will be held accountable for your greed. HHS-OIG agents will
continue to work closely with our state and federal law enforcement partners to protect the Medicare Trust Fund.”

Special Agent in Charge of the FBI’s New Orleans Division, David Welker, stated: “It is reprehensible to think that a medial professional would put patients at significant risk and conduct medically unnecessary procedures simply to fill their personal coffers. Hopefully, as U.S. Attorney Donald Washington notes, this conviction should send a powerful message to healthcare providers of the perils of deviating from their oath. It should also send a message to patients to be personally involved in their own care. We will continue to aggressively investigate healthcare fraud to ensure the safety of the public.”
PATEL faces a maximum of ten years imprisonment, a fine not more than $250,000.00, and a term of not more than three years of supervised release following confinement.

Sentencing in federal court is determined by the discretion of federal judges and the governing statutes. Parole has been abolished in the federal system. This case was investigated by Special Agent Barbara Alleman of Health & Human Services and Special Agents Troy Chenevert and Greg Harbourt of the Federal Bureau of Investigation. The case was prosecuted by United States Attorney Donald W. Washington and Assistant United States Attorney Kelly
Uebinger

Undocumented Immigrants draining social services?

How many times did you heard that Undocumented Immigrants are responsible for draining Hospitals and social services like Medicare, Medicaid, Social Security Benefits. My point is when someone as a Citizen has been caught and supposedly committed fraud against those Social services has being protected by the Media, and by law under Presumed innocent unless and until proven guilty.

Since August 2006, more than 450 hospitals across the country were subject to fraud investigations and the Goverment has been recovered Millions.
Audits should be “particularly challenging from a provider perspective. The conditions for billing Medicare can be incredibly technical and a number of health care systems don’t always use the exact, correct language in their medical records and don’t have systems in place to ensure documentation is being done correctly” — which can lead to disallowed payments and payment recovery by the government against the provider.
Prosecuting health systems, hospitals and physicians for Medicare and Medicaid fraud was a priority during the Bush era, and should continue as a focus under the new administration.
With the Barack Obama administration taking office, Lucinda Jesson, director of Hamline University’s Health Law Institute, expects to see some shift in priorities from the Bush era. The Obama plan for more cost-effective health care is expected to include more emphasis on primary and preventive care but also should focus on effective regulations.

ANDERSON MAN CHARGED WITH DEFRAUDING THE INDIANA MEDICAID PROGRAM OF OVER $900,000

Timothy M. Morrison, United States Attorney for the Southern District of Indiana, announced that DENNIS LENNARTZ, 55, Anderson, Indiana, was charged with defrauding the Indiana Medicaid program, following an investigation by the U.S. Department of Health and Human Services, Office of Inspector General, the Federal Bureau of Investigation, and The Indiana Attorney General’s Medicaid Fraud Control Unit.

The information alleges that beginning in April 2006, DENNIS LENNARTZ, knowingly defrauded the Indiana Medicaid program of $964,852.59, by billing for services not actually rendered. In furtherance of his scheme, LENNARTZ concealed his involvement from Indiana Medicaid by billing under the provider number of another company.

"This case demonstrates the commitment of the Office of Inspector General working with our Federal and State law enforcement partners to protect our Nation's vulnerable Medicaid recipients," said Lamont Pugh III, Special Agent in Charge for the Chicago region of the U.S. Department of Health and Human Services Office of Inspector General which covers the State of Indiana. "Defrauding the Medicaid program isn't fair to the taxpayers who deserve accountability," said Attorney General Steve Carter. "Even more tragically, though, it wastes money that would otherwise provide healthcare for those who can't afford to pay."

According to Assistant U.S. Attorney Bradley P. Shepard, who is prosecuting the case for the government, LENNARTZ faces a maximum possible prison sentence of 20 years and a maximum possible fine of $250,000. An initial hearing has been scheduled for January 20, 2009 before a U.S. Magistrate Judge in Indianapolis, Indiana.

The information is an allegation only, and the defendant is presumed innocent unless and until proven guilty at trial or by guilty plea.

State Gets $67,000 in Medicaid Settlement

North Dakota Human Services officials say the state has received more than $67,000 as its share of a settlement with drug maker Cephalon, Inc.

Officials say the state`s share of $67,723 is part of a $425 million settlement involving the National Association of Medicaid Fraud Control Units and the federal government. The company was accused of illegally arketing three of its drugs.

Federal prosecutors, in announcing the settlement last fall, said Cephalon also agreed to plead guilty to one misdemeanor count of distribution of misbranded drugs.

Officials say the settlement reimburses the federal government and states for amounts paid by the Medicaid program as a result of the company`s improper marketing campaign. The program covers medical services for the needy.

The settlement includes a $375 million civil settlement and $50 million in criminal fines and penalties.

Undocumented Immigrants draining social services. Ignorance or Lie?.

It is important to note that an Indictment should not be considered as evidence of guilt and that all persons charged with a crime are presumed innocent until proven guilty beyond a reasonable doubt. So why Nativist, Protectionists, Anti Immigrants considered Undocumented Immigrants Criminals without an evidence of a crime? Ignorance is not a Family value either a development skills.

Obama's recent statement that " This isn't about big government or small government. It's about building a smarter government that focuses on what works" and predicted that "...we'll hear a lot about the defense department and homeland security. I suspect that we will hear nothing about the education department, health and human services, housing and urban development and all the other oriented special interests out there."

I hope that Obama administration really goes through the department of Health and Human Services entitlement programs, Social Security, Department of Homeland security and Pentagon to find the waste, fraud and abuse in these programs. There are literally tens of billions of dollars from these programs that could be better invested in public transportation, education and job training rather than scapegoating and blaming the undocumented Immigrants for all of their crisis.

United States Attorney Rebecca A. Gregory announced today that a Port Arthur medical billing business and three employees have been indicted and charged with multiple counts of Health Care Fraud related violations in the Eastern District of Texas.

ASHLEY COLLIN WALKES, 36, of Houston, ISAM NAZMI ANABTAWI, 77, of Groves, KRISTI ROSE, 30, of Bridge City, and 4500 GULFWAY MEDIC MANAGEMENT, PA, a Port Arthur business, have each been charged with 150 counts of Health Care Fraud in an indictment returned by a federal grand jury late today.

According to the indictment, from September 2004 until March 2008, Medic Management PA, a "pain management facility", under the direction of Walkes, Anabtawi, and office manager Kristi Rose, fraudulently billed Medicaid, Medicare, and private insurance for physical therapy and office visits.

Medic Management billed Medicaid, Medicare and private insurance for thousands of physical therapy sessions, despite the fact that the clinic never employed a licensed physical therapist, and treatment was provided by unsupervised personnel who had no physical therapy training, but all the physical therapy sessions were billed as if they were performed by Dr. Anabtawi. In total, Medic Management billed Medicaid, Medicare, and private insurance nearly $7.5 million for physical therapy and was paid nearly $4.2 million. Also, Medic Management billed Medicaid, Medicare, and private insurance for thousands of office visits claiming each patient was seen by Dr. Anabtawi for approximately 25 minutes, when each patient was only actually seen for five minutes or less. From September 2004 until March 2008 Medic Management billed the government approximately $2.5 million for office visits and was paid $633,749.51.

Walkes was also indicted for six counts of money laundering and one count of making a false statement during a health care investigation. The money laundering counts stem from Walkes' use of the fraudulently obtained money to make large purchases for himself, including things such as cars, houses, and nearly $37,000 in landscaping costs. Rose was indicted with Walkes on one of the money laundering counts for accepting a check for $20,000.

Anabtawi was indicted for 149 counts of health care fraud and one count of conspiracy to commit health care fraud. Rose was indicted for 149 counts of health care fraud, one count of conspiracy, and one count of money laundering. Walkes was indicted for 149 counts of health care fraud, one count of conspiracy, one count of making a false statement related to a health care investigation, and six counts of money laundering. The clinic itself was indicted for 149 counts of health care fraud and one count of conspiracy.

The case was jointly investigated by the Texas Attorney General's Office and the Federal Bureau of Investigation and is being prosecuted by Special Assistant United States Attorney Christopher Tortorice

Undocumented Immigrants draining social services? A lie or a Lie.

I really question the Notion or lie that Undocumented Immigrants draining social services or brankrupt Hospitals.

If they were too old to work chances are they would not be here. And if they can not work due to some physical problem chances are they would not be here either. The vast majorities of Undocumented Workers entering U.S. are between 18-30 years old and are fit for work. I think the stats on this so-called social services drain is more fiction than fact. And again if a few they are not paying their fair share of the taxes you can not blame them, they do not sending the tax money, the employer does.

I will continue exposing the fact that Hospitals, CEO's, Managers, vendors, Suppliers, even some Doctors are the burden and the major factor of draining U.S. social services and not the Undocumented Immigrants.

Condell Medical Center in Libertyville, Ill., is to pay $36 million to settle allegations it accepted improper payments, federal prosecutors said Monday. The settlement resolves allegations the center accepted improper payments from Medicare and Medicaid programs for more than five years. Continue reading here:

A federal judge in Houston on Monday also ordered 55-year-old Edem James Etuk to repay nearly $1.6 million to Medicare and Medicaid. Continue reading here:

An Alabama court has ordered two major drug companies to pay the state more than $114 million after finding them guilty of Medicaid price fraud. Continue reading here:

Walgreen Co., owner of Walgreens Pharmacy, has agreed to pay $35 million to settle a federal lawsuit accusing it of defrauding Medicaid by switching patients onto more expensive drugs, Continue reading here:

A doctor who claimed he provided Medicare and Medicaid-covered services in Martinsburg - more than 250 miles away from his office near Parkersburg, W.Va. - has been named in a 157-count indictment by a federal grand jury in Martinsburg. committed mail fraud by devising a scheme to defraud in an attempt to obtain about $2.25 million from Department of Health and Human Services programs. Continue reading here:

Are you follow me; Continue reading because this is not the ending.

The former president of the Nevada State Medical Association, the state’s largest physician advocacy group, is one of six Las Vegas doctors who have repaid a total of $625,000 to the federal government to resolve allegations of Medicare fraud stemming from an apparent kickback scheme. who allegedly performed unnecessary services and then submitted claims to Medicare, the federal government’s insurance program for people who are disabled or over age 65. Continue reading here:

An investigation into what the authorities say was a scheme that used homeless people to bilk tens of millions of dollars from federal and state health insurance programs began four years ago with a tip from a rescue mission employee. federal agents raided three private for-profit hospitals — Los Angeles Metropolitan Medical Center, City of Angels Medical Center, and Tustin Hospital and Medical Center in Orange County — in connection with an alleged fraud scheme involving federal Medicaid and state Medi-Cal health insurance programs. Agents arrested Dr. Rudra Sabaratnam, owner and chief executive of City of Angels Medical Center, and Estill Mitts, who is accused of recruiting patients from his Skid Row storefront church, the 7th Street Christian Day Center. Mr. Mitts posted $25,000 bond and is confined to his home. Dr. Sabaratnam posted $700,000 bail. Continue reading here:

Bayer HealthCare will pay $97.5 million plus interest to settle allegations that it paid kickbacks to 11 diabetic supply companies in a "cash-for-patient" scheme, and caused those suppliers to submit false claims to Medicare. Continue reading here:

Health care continues to top the government's list of federal fraud investigation priorities, yielding the lion's share of recoveries in false claims cases in 2008.

The latest figures from the Dept. of Justice show enforcement officials recouped $1.34 billion in settlements and judgments under the False Claims Act in the fiscal year ending Sept. 30. Of that total, $1.12 billion, or 84%, came from health care entities. The act gives federal officials authority to prosecute fraudulent billing of any government program.
That number represents a drop from the $1.54 billion in recoveries reported in 2007 and a record $2.2 billion in 2006. But that doesn't mean federal prosecutors have let up efforts to combat health care fraud, said Russell Hayman, a partner and health care fraud expert with McDermott Will & Emery LLP in Los Angeles.
The government tallied its biggest returns in 2008 from settlements with pharmaceutical firms Merck & Co. Inc. and Cephalon Inc., and managed care company Amerigroup, with recoveries ranging from $225 million to $361 million.

But what was the outcome and consecuence of the Narrow minded, and Anti Immigrant sentiment? coming soon...

Your hard earned Tax Money at Illegals Hands.

R. Alexander Acosta, United States Attorney for the Southern District of Florida, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, and Bill McCollum, Attorney General of the State of Florida, announced today that Miguel Almanza, formerly of Hialeah, FL, pled guilty in connection with a $56.7 million Medicare fraud scheme.

According to the government’s factual proffer, defendant Miguel Almanza operated and controlled thirteen durable medical equipment ("DME") companies, and three medical clinics located in Miami-Dade and Hillsborough Counties. Using these thirteen companies, Almanza and his co-conspirators submitted nearly $57 million of false claims to Medicare for medical equipment, prescription medications, and outpatient medical services.

Almanza and his partners concealed their control of these DME companies and medical clinics by recruiting "nominee" or "straw owners," who were typically paid a percentage of the fraud proceeds to sign the necessary corporate records and Medicare applications. Notably, Almanza often recruited family members from his hometown of Moron, Cuba, to serve as the nominee owners of his DME companies.

To execute the scheme, Almanza purchased the identities of various Medicare beneficiaries in Miami-Dade County, including their driver's licenses, Medicare cards, and other identification documents. Almanza would then use the patients' Medicare numbers to submit fraudulent claims to Medicare for a wide variety of high-priced medical equipment, including nebulizers, oxygen concentrators, powered air mattresses, and wheelchairs. During the early years of the conspiracy, Almanza and his partners paid monthly cash kickbacks to these "professional patients." The kickbacks were paid so that the patients would not report the false claims to Medicare. Over time, the scheme changed because Almanza and his partners found it cumbersome to pay kickbacks to dozens of patients. Consequently, Almanza and his partners began to purchase stolen patient identities from patient recruiters and billing companies.

Once Medicare paid the false claims, Almanza and his partners implemented complex schemes to launder the fraud proceeds and conceal their ultimate destination. In one version of the scheme, Almanza and his partners would distribute pre-signed corporate checks, often for amounts just under $10,000, to a broad network of so-called "check cashers." The "check cashers" would cash the checks at local banks throughout Miami-Dade County, often visiting numerous bank branches within one day so as to avoid raising red flags. The "check cashers" would keep a commission, typically about 10%, and give the remaining proceeds to Almanza and his co-conspirators.

Under a second laundering method, Almanza and his partners recruited nominee owners to open various sham corporations, including construction companies and investment firms. The Medicare fraud proceeds were deposited into the bank accounts of the sham corporations, and then later distributed to Almanza and his partners. Almanza used the fraud proceeds to purchase a home, luxury cars, and to finance other lavish personal expenditures. Almanza also used the funds for gambling at various South Florida casinos, where he often spent more than $10,000 per night.

Almanza faces a maximum term of ten years’ imprisonment for the Medicare conspiracy, and five years’ imprisonment for making false claims upon the United States .

Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation, the U.S. Department of Health and Human Services, Office of Inspector General, and the Office of the Attorney General of Florida, Medicaid Fraud Control Unit. This case is being prosecuted by Assistant United States Attorneys Ryan Stumphauzer

your hard earned tax dollars at Illegals hands.

Can you believe this? Well, of course you can. After all, it's the strange and sour marriage between Medicare and phony equipment suppliers.

Medicare shut down more than 200 medical equipment companies last year. Why? Because they either were operating out of their hats, with no actual business addresses, or because they had been implicated in fraud or even indicted for fraud.

Now, get this: Advance your clock to 2008. Medicare allowed 90 percent of these fake companies to go back into business because of "flawed appeals processes." Great balls of fire! If a private enterprise operated that way, it would be out of business within two days. And the merry-go-round continues, because after allowing these scam artists to go back to their scams, Medicare decided to shut them down again. And meanwhile, a number of them had the opportunity to send out spurious bills again.

The sad but undeniable evidence is that federal agents visited, unannounced, some 1,581 Medicare suppliers in South Florida. Of that number, a solid one-third — 491 to be exact — had no business operation or just weren't open because they had no employees. Nice deal, isn't it? So Medicare revoked their billing privileges again, but so what since about half of them appealed, and based on nothing but an invalidated appeal, Medicare reinstated just about all the ones who appealed. An Inspector General's report is unsurprising: Medicare's hearing officers applied "no criteria" for accepting anything offered as evidence. An electric bill or a simple statement would do it.

One lawyer — Miami-Dade not Broward, thank goodness — represented fifteen so-called Medicare providers. Seem familiar? The whole charade has been a comedy of errors.

Comedy, all right, but when these counterfeit claims hit us taxpayers in the pocketbook it isn't funny.

Every now and then, the law actually clamps down on a couple of flimflams. One of them was ordered to pay $11 million in restitution. That's a hefty amount and it gives us an inkling of the number of dollars Medicare fraud represents.

Here we are, about to enter 2009. Medicare costs are about to increase again, and anyone who deludes himself or herself that fraudulent claims (yes, by people on Medicare, too) aren't partly responsible has been living on Mars.

We should be outraged that our public servants are so casual in accepting non-evidence as evidence. But every one of us is so used to "business as usual," we've long since substituted acceptance for outrage.

The phrase, "your tax dollars at work," never has been as derogatory and uncomplimentary as it is today. Will a new administration actually do something about these suppliers who treat Medicare officials as suckers? Will exposure such as this make any difference?

Don't count on it because corruption are at the tip of the Iceberg and of course the people without Voice and Political support are always being blame for it.

These are the comments from the Nativist and Anti Immigrants Jim Gilchrist and Jerome Corsi:

The large numbers of illegal immigrants already living in the country have put an enormous fiscal strain on government-funded social service programs because many of the illegal immigrants who arrive here are impoverished and undereducated. They are then forced to supplement their low-paying incomes with social welfare benefits, including those fraudulently obtained, to make ends meet. Moreover, the willingness of these illegal immigrants to commit fraud—both tax fraud and social service fraud—compounds the problem, as they work the system to get the maximum benefit from government-funded social services….

Why we as American citizens do not speak out loudly enough against these generous Social fraudulently beneficiaries(Hospital CEO's, CFO's, Doctors, and the list goes on and on) on behalf of U.S. Taxpayers?.

Undocumented Immigrants Draining social services?

A Clinic owner has been sentenced to 2.5 years (30 months) for defrauding Medicare 10.9 Millions which this sentence is far too light. Not only do we need to clean up this medicare fraud cesspool but we need to be sending a very strong signal to each of these criminals that the game is over, find something ethical or positive to do for your fellow taxpayers Citizens or pay real penalties. I am sure these people look at 2.5 years in federal camp as a great way to make 100x what they would have made in an honest job. With this sentencing, we continue to send the signal that white collar crime does pay. Very wrong signal. At the same time we need to expose that the real criminals which draining social services are not Undocumented Immigrants are the Owners, Hospital CEO's, CFO's,and the list goes on and on.

Nayda Freire, 61, was sentenced Wednesday to 30 months in prison and ordered to pay nearly $8 million in restitution for defrauding Medicare in connection with a $10.9 million HIV infusion fraud scheme.

Freire pleaded guilty to one count of conspiracy to commit health care fraud in connection with her role as the owner of Global Med-Care Corp., a Miami-area HIV clinic that claimed to provide HIV infusion services to Medicare beneficiaries.

Freire admitted that, between April and November 2003, she and others conspired to file $10.9 million in false claims to the Medicare program for HIV infusion services that were not provided and were not medically necessary.

Patients were given kickbacks in return for agreeing to allow Global Med-Care to bill Medicare for the unneeded services.

Freire admitted that she and co-conspirators transferred $6 million to sham management, marketing and investment companies owned and operated by Carlos, Luis and Jose Benitez.

Carlos and Luis Benitez and Thomas McKenzie were charged separately with health care fraud and money laundering crimes in an indictment unsealed on June 11.

On Sept. 18, McKenzie pleaded guilty to one count of conspiracy to commit health care fraud and one count of submitting false claims to the Medicare program, and also admitted his role in a $119 million HIV infusion fraud scheme. The Benitez brothers remain fugitives.

Undocumented Immigrants draining Social Services?. A Myth or a Lie?

HEALTH CARE COMPANY OWNER PLEADS GUILTY TO MEDICAL IDENTITY THEFT AND MEDICARE FRAUD.


WASHINGTON – A La Crescenta man pleaded guilty today to federal criminal charges of defrauding Medicare by using patients’ Medicare identification numbers without their knowledge, Acting Assistant Attorney General of the Criminal Division Matthew Friedrich and U.S. Attorney for the Central District of California Thomas P. O’Brien announced. Between August 2003 and April 2008, Melkon Gabriyelyan, 51, billed the Medicare program for more than $1,640,000.

Gabriyelyan pleaded guilty to one count of aggravated identity theft and one count of health care fraud before U.S. District Judge Manuel L. Real in U.S. District Court for the Central District of California. Judge Real scheduled Gabriyelyan’s sentencing for Jan. 12, 2009. At sentencing, Gabriyelyan faces a maximum term of 12 years in prison for his crimes.

According to the plea agreement, Gabriyelyan admitted owning and operating TA Medical Supply, a durable medical equipment (DME) company located in the Tujunga area of Los Angeles. In his plea agreement, Gabriyelyan acknowledged that beginning in January 2004 he fraudulently billed Medicare for DME purportedly supplied to Medicare beneficiaries. Gabriyelyan submitted false claims to Medicare for orthotic braces, power wheelchairs and other DME that were not delivered to Medicare beneficiaries, were not prescribed by the physicians listed on the claims that he made or were not medically necessary.

Gabriyelyan also acknowledged in the plea agreement that to accomplish the fraud he knowingly and willfully stole the identity of a Medicare beneficiary for the purpose of submitting false claims. He admitted billing a back brace and two knee braces that the beneficiary did not need or receive, and that the patient had no knowledge of. In addition, Gabriyelyan admitted that he created a patient file for this beneficiary that contained a delivery slip with the beneficiary’s forged signature.

“Medical identity theft is a growing problem that poses significant harm to both the Medicare program and the patients whose personal information is stolen,” said Acting Assistant Attorney General Matthew Friedrich. “The Department will continue fighting to protect the rights of Medicare patients as well as prosecuting individuals who defraud the Medicare program.”

“Medical identity theft is a striking example of the kind of fraud we are combating in the Los Angeles area. One new weapon in our arsenal is our Strike Force operations, which seek not only to protect American taxpayers from Medicare fraud, but protect the private and personal information of all patients,” said U.S. Attorney Thomas P. O’Brien.

Gabriyelyan was arrested in May 2008 following an investigation by the Medicare Fraud Strike Force (MFSF). The MFSF is a multi-agency team of federal, state and local prosecutors and agents designed to combat Medicare fraud. Strike force operations began in the Los Angeles area on March 1, 2008. The MFSF is led by the Criminal Division’s Fraud Section in Washington, D.C., and the office of U.S. Attorney Thomas P. O’Brien of the Central District of California. Since the inception of MFSF operations in 2007, federal prosecutors have indicted 104 cases with 184 defendants in both Los Angeles and Miami. Collectively, these defendants fraudulently billed the Medicare program for more than half a billion dollars.

This case is being prosecuted by Assistant U.S. Attorney Margaret L. Carter, and is being investigated by the FBI; the Department of Health and Human Services, Office of the Inspector General; the California Department of Justice; the Bureau of Medical Fraud and Elder Abuse; and the Los Angeles County Health Authority Law Enforcement Task Force.

Undocumented Immigrants draining the Medicare.!!!!!!!

For Nativists and protectionists this is a must to see and read. Keep blaming your own ignorance.

MIAMI PHYSICIAN AND HIV CLINIC ADMINISTRATOR PLEAD GUILTY FOR THEIR ROLES IN A $37 MILLION MEDICARE FRAUD SCHEME

Doctor Wrote Prescriptions for Unnecessary HIV Infusion Treatments at Clinic;
Administrator Ran Related HIV Infusion Clinic

WASHINGTON - Miami physician Ronald Harris, M.D., and Miami resident Mariela Rodriguez each pleaded guilty today to defrauding the Medicare program in connection with a $37 million HIV infusion fraud scheme, Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced.

Harris pleaded guilty to conspiracy to commit healthcare fraud and three counts of submitting false claims to the Medicare program before U.S. District Judge Cecilia M. Altonaga. In his plea, Harris admitted that he wrote false prescriptions for HIV infusion treatments while serving as the medical director for two medical clinics, Physicians Med-Care and Physicians Health. Both clinics purported to provide HIV infusion services to Medicare beneficiaries. Harris admitted that beginning in August 2002 and continuing through March 2004, he conspired with others to defraud the United States, to cause the submission of false claims to the Medicare program, to pay health care kickbacks and to commit health care fraud. Harris also admitted to submitting false claims.

According to information contained in plea documents, Harris admitted that between August 2002 and March 2004 he served as the medical director of Physicians Med-Care and Physicians Health, two Miami HIV infusion clinics that were owned and controlled by Carlos and Luis Benitez, and that were operated for the purpose of committing Medicare fraud. Prior to August 2002, Harris had no prior experience with infusion therapy for HIV patients. During his employment with Physicians Med-Care and Physicians Health, Harris admitted he approved approximately $26.2 million worth of fraudulent medical bills, signed documents containing false information about treatments purportedly provided to HIV patients and approved medically unnecessary treatments. According to information in the plea documents, the Medicare program paid approximately $17.5 million in fraudulent bills as a result of Harris' conduct.

Rodriguez pleaded guilty before U.S. District Judge Federico Moreno to conspiracy to commit health care fraud and one count of making false declarations to a federal grand jury. In her plea, Rodriguez admitted that she administered an HIV infusion clinic named Saint Jude Rehab Center, a Miami HIV infusion clinic that was owned and controlled by Carlos and Luis Benitez, and that was operated for the purpose of committing Medicare fraud. Similar to Physicians Med-Care and Physicians Health, Saint Jude purported to provide HIV infusion services to Medicare beneficiaries.

Rodriguez admitted that she served as an administrator of Saint Jude between June 2003 and November 2003, during which time she submitted false claims to the Medicare program for HIV infusion treatments. Rodriguez further admitted that beginning in June 2003 and continuing through November 2003, she conspired with others to defraud the United States, to cause the submission of false claims to the Medicare program, to pay health care kickbacks and to commit health care fraud. Rodriguez also admitted to making false statements in her testimony before a federal grand jury. Between June 2003 and November 2003, Saint Jude submitted approximately $11.3 million worth of fraudulent bills to the Medicare program for HIV infusion services that were never provided and services that were medically unnecessary. As a result of this conduct, the Medicare program paid approximately $8.2 million in fraudulent bills. Sentencing for both Rodriguez and Harris has been scheduled for Nov. 4, 2008.

In a related case, Carlos and Luis Benitez, as well as their brother Jose Benitez, were indicted on June 11, 2008, for their role in a $110 million HIV infusion fraud and money laundering scheme. The indictment alleges that Carlos, Luis and Jose Benitez were the masterminds of a massive HIV infusion fraud operation throughout south Florida involving at least 11 clinics and that they laundered the proceeds of their crimes. Also according the indictment, Carlos and Luis Benitez were the true owners of Physicians Med-Care, Physicians Health and Saint Jude. All three Benitez brothers remain fugitives.

The cases were prosecuted by Hank Bond Walther, John K. Neal and Nathan Dimock of the Criminal Division's Fraud Section, and investigated by the FBI and the Department of Health and Human Services, Office of Inspector General. The cases were brought as part of the Medicare Fraud Strike Force, supervised by Deputy Chief Kirk Ogrosky of the Criminal Division's Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. Strike Force prosecutors have indicted 82 cases involving 142 defendants since Strike Force operations began in March 2007. Collectively, these defendants committed more than $492 million in Medicare fraud.

Undocumented Immigrants draining the Social Services? A lie or a lie.

I had seen more often the tip of the Iceberg when Hospitals, Corporations, Vendors and Suppliers has been the most abusives of the Medicare and Medicaid System were money is flying out the pocket of taxpayers as well as Legal and Undocumented Immigrants.

DME DEFENDANTS SENTENCED IN MULTI-MILLION DOLLAR MEDICARE FRAUD SCHEME

R. Alexander Acosta, United States Attorney for the Southern District of Florida, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, Miami Regional Office, and Bill McCollum, Attorney General, State of Florida, announced that defendants Mabel and Abner Diaz , of Miami Lakes, FL were each sentenced today to fourteen years’ incarceration for conspiracy to commit health care fraud and health care fraud. Defendant Suleidy Cano , of Hialeah, FL was sentenced to eleven years’ incarceration for conspiracy to commit health care fraud and aggravated identity theft.

According to the parties' joint factual statement in support of the plea, the fraud involved durable medical equipment (DME), which is equipment that can be used in the home on a repeated basis for a medical purpose. Where DME is prescribed or ordered by a physician, an authorized Medicare provider who supplies the equipment to a Medicare beneficiary may be eligible for reimbursement by Medicare.

Abner Diaz and Mabel Diaz co-owned and operated All-Med Billing Corp., a Miami medical billing company, where Cano worked as a biller. All-Med submitted claims to Medicare on behalf of suppliers who purportedly provided DME to Medicare beneficiaries. All-Med submitted $419,935,692.74 in fraudulent claims for DME purportedly provided to Medicare beneficiaries by 85 DME suppliers. These claims were for equipment that not been ordered by physicians or delivered to the beneficiaries as claimed. As a result of these claims, Medicare paid the suppliers approximately $148,586,919.99.

Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation, the U.S. Department of Health and Human Services, Office of Inspector General, and the Office of the Attorney General, Medicaid Fraud Control Unit. This case is being prosecuted by Assistant United States Attorneys Marc Osborne and Joseph Shumofsky

Deceased physicians still receiving Medicare benefits.!!!!!!!

Outrageous Illegal and Unethical conduct were Dead Docs Stiff Taxpayers money and Nativists, Protectionists keep blaming the Other, The Undocumented, The Citizen without voice either vote. Money blowing out of your pocket.

A report from the Senate Permanent Subcommittee on Investigations found that from 2000 to 2007, Medicare paid 478,500 claims containing identification numbers that were assigned to deceased physicians. The total amount lost: between $60 million and $92 million.
Congressional investigators said Tuesday that Medicare had paid tens of millions of dollars to suppliers improperly using identification numbers of doctors who died years ago.
The government has no reliable way to spot claims linked to dead doctors, many of whom are still listed as active Medicare providers though they died 10 or 15 years ago, the Senate Permanent Subcommittee on Investigations said.
Medicare covers wheelchairs, walkers, home oxygen equipment and many other types of medical equipment. When suppliers file claims for equipment provided to a Medicare beneficiary, they normally must list an identification number for the doctor who prescribed or ordered it.
“From 2000 to 2007, Medicare paid 478,500 claims containing identification numbers that were assigned to deceased physicians,” the subcommittee said in a new report. “The total amount paid for these claims is estimated to be between $60 million and $92 million. These claims contained identification numbers for an estimated 16,548 to 18,240 deceased physicians.”
In 16 percent of these cases, the report said, suppliers used identification numbers of doctors who had been dead for more than 10 years. In one case, Medicare paid more than 2,000 claims totaling $479,000 for services provided from 2002 to 2007, even though the doctor had died in 1999.
Another doctor died in 2001, but his identification number was used in more than 3,800 claims from 2002 to 2007, with payments totaling more than $354,000.
“Scam artists have treated Medicare like an automated teller machine, drawing money out of the government’s account with little fear of getting caught,” said Senator Norm Coleman of Minnesota, the senior Republican on the subcommittee. “When Medicare is paying claims and the doctor has been dead for 10 or 15 years, you know there is a serious problem.”
The subcommittee, headed by Senator Carl Levin, Democrat of Michigan, plans to hold a hearing on the issue on Wednesday.
Herb B. Kuhn, deputy administrator of the Centers for Medicare and Medicaid Services, said he shared the concern that “Medicare is continuing to pay claims to providers who are using invalid or inactive physician numbers.”
Mr. Kuhn said his agency was taking steps intended to stop such payments. For example, it will get monthly death reports from Social Security and compare that information with its list of doctors in Medicare.
Robert A. Vito, regional inspector general of the Department of Health and Human Services in Philadelphia, said that in some cases doctors did not know that their billing numbers were being used by suppliers of medical equipment. But in other cases, he said, doctors collude with suppliers. He cited the case of a Florida doctor who received kickbacks from suppliers in return for prescribing medical equipment covered by Medicare.
The identification number for this doctor was used on nearly $8 million worth of claims for medical equipment in one year — the equivalent of more than $20,000 a day, Mr. Vito said in testimony prepared for the hearing.
Medicare has issued new identification numbers to doctors in the last two years. But, Mr. Vito said, these numbers are “readily available to the public,” so “fraudulent suppliers can easily obtain a valid number” and use it on their Medicare claims.
Mr. Levin said Medicare and its contractors shared responsibility for “this taxpayer rip-off.”
About 2,500 doctors who died before 2003 “still had active identification numbers” in May of this year, Mr. Levin said.

Undocumented Immigrants draining Medicare and Medicaid?. A myth or a Lie?

At this point I have not seen an accurate report from a balance and fair group of the amount used by Undocumented Immigrants but I see more often the tip of Iceberg from Companies, Hospital, Vendors and suppliers committed fraud against Medicare and Medicaid affecting taxpayers Citizens, Legal and Undocumented Immigrants.

WellCare to pay $35.2M as part of Medicaid inquiry.

WellCare Health Plans Inc. said it will pay $35.2-million as part of an agreement with U.S. prosecutors in a Medicaid fraud investigation, the company said in a regulatory filing Monday.

The payment doesn't settle the case or limit the U.S. government and state of Florida from making further claims in their continuing investigation, WellCare said.

WellCare, whose top executives quit in January, said the agreement includes an estimated $24.5-million owed the government for Medicaid "behavioral health" claims from 2002 to 2006 by two of its Florida HMO subsidiaries: WellCare of Florida Inc. and HealthEase of Florida Inc. The additional $10.7-million will be held in escrow during the government probe.

"We do not know whether other areas of the investigations might lead to fines, penalties, operating restrictions or disqualifications or other material adverse impaction on the company or the company's previously issued financial statements,'' WellCare said in the filing with the Securities and Exchange Commission.

WellCare manages benefits for more than 1.23-million members of state Medicaid programs for the poor and an additional 200,000 elderly and disabled customers who are part of the government's Medicare program.

In October, agents from the Federal Bureau of Investigation and other federal and state agencies raided the Tampa headquarters of WellCare

Undocumented Workers do no paid taxes.!!!!!! That Sounds familiar to you. A myth or a lie?
Tax evasion is in progress BUT not from Undocumented workers from Citizens!!!!!!.




A U.S. Citizen preventing the IRS from assessing and attempting to collect more than $34 million of unpaid payroll tax liabilities from Trebert, Ewing and May, and creating the appearance that these sham staffing/payroll entities employed more than 4500 nursing facility employees, when they did not. Where Nativists, Minuteman groups, Lou Dobbs, Tommy Tancredo stand on this issue? Hypocrisy is not a Family Value?


FORMER NURSING HOME EXECUTIVE SENTENCED TO 10 YEARS IN FEDERAL PRISON AND ORDERED TO PAY $11 MILLION RESTITUTION

Tarrant County Resident Convicted of Various Offenses Related to Operation of Nursing Homes


FORT WORTH, Texas — Stephen Michael Ewing, 60, of Bedford, Texas, who was convicted of various offenses related to his operation of nursing homes in Texas and elsewhere, was sentenced today by U.S. District Judge Terry R. Means to 120 months in prison, announced U.S. Attorney Richard B. Roper of the Northern District of Texas. In addition, Judge Means ordered that Ewing pay approximately $11 million in restitution. Ewing was ordered to surrender to the Bureau of Prisons on August 25, 2008.

A jury convicted Stephen Michael Ewing in March on one count of conspiracy, seven counts of tax evasion, five counts of mail fraud, seven counts of making false statements to government agencies and seven counts of making false statements regarding health care.

From August 1999 to mid-May 2004, Ewing, along with co-defendants, Gary Trebert and Larry May, conspired together, and with others, to defraud the U.S. by impeding, impairing, obstructing, and defeating the lawful government functions of the Internal Revenue Service (IRS) in the ascertainment, computation, assessment, and collection of the revenue, that is, nursing facility employees’ withheld income taxes, social security taxes and Medicare taxes, and the Department of Health and Human Services (HHS) in the administration of the Social Security Act and the Medicare and Medicaid programs.

Gary Trebert, 51, of Frisco, Texas, a licensed attorney, pled guilty in February 2008 to conspiracy to defraud the government by obstructing and impeding lawful government functions of the IRS and HHS and tax evasion and aiding and abetting. Trebert admitted that in April 2004, he attempted to evade and defeat the assessment and payment of more than $4,113,000 in withholding taxes taken out of employees’ pay at 42 nursing homes he and his coconspirators controlled. While Trebert faces a maximum statutory sentence of 10 years in prison, the government, as part of its his plea agreement, will make a non-binding recommendation that the Court sentence Trebert to an eight-year prison sentence. Trebert also may be ordered to pay restitution which will be based on all his criminal conduct relating to the offenses charged in the indictment, including, but not limited to, unpaid taxes and unlawfully obtained healthcare payments. He is scheduled to be sentenced on August 11, 2008.

Co-defendant Larry Gordon May, 49, of Hurst, Texas, pled guilty to his role in the conspiracy in October 2007. He was sentenced in April to 48 months in prison and is currently serving that sentence.

Ewing and his coconspirators, using the names of sham corporate entities, obtained control of 70 licensed nursing facilities with thousands of patient beds and thousands of employees. In order to acquire control of these facilities, Trebert, Ewing and May used false statements and false and fraudulent documents, including Applications for Nursing Facility License and Medicaid Contracts, Medicare Federal Provider Enrollment applications, ownership documents, IRS Employer Identification Number applications, Health Insurance Benefit Agreements, and Electronic Fund Transfer forms. Their falsifications included falsely identifying relatives as owners, operators, and managers of the nursing homes on the applications; failing to disclose staffing/payroll companies on nursing home applications; failing to disclose Ewing and May as the true owner/operators of nursing homes; and forging names of individuals on filed documents to divert responsibility away from the three defendants. They used the false statements and documents to hide from HHS, state licensing and Medicaid agencies, and the IRS, the true control and management of the nursing facilities, their responsibility for more than $200 million in money derived from the nursing homes, and their responsibility for the nursing facilities’ residents.

Both Trebert and May testified against Ewing at trial. Trebert testified that he and Ewing repeatedly discussed the creation and the overseas payroll companies to interfere with IRS efforts to collect the payroll taxes. Trebert also testified that Ewing once boasted about having previously operated nursing homes without having to pay the payroll taxes. Larry May testified that Trebert and Ewing made him president of the company, even though he told them he was not qualified.

May further testified that, during some of the periods covered by the Indictment, he was making $10,000 to $25,000 per month for doing little more than signing documents, including tax returns, and taking tax returns to England to mail back to the IRS in the U.S. More than 150 sham staffing/payroll entities, many with foreign business addresses at drop boxes in England and Austria, were created to file Form 941 employer withholding tax returns with the IRS, preventing the IRS from assessing and attempting to collect more than $34 million of unpaid payroll tax liabilities from Trebert, Ewing and May, and creating the appearance that these sham staffing/payroll entities employed more than 4500 nursing facility employees, when they did not.

The defendants diverted to themselves and their personal activities substantial sums of money derived from their nursing home operations and from the non-payment of employees’ withheld payroll taxes. At trial, the government presented evidence that, during the period covered by the Indictment, Ewing spent more than $2.5 million in money derived from the nursing home operations on his personal expenses. The total expenditures included more than $200,000 at department stores such as Saks Fifth Avenue, and more than $250,000 on automobiles

Undocumented Immigrants draining the social services. Sounds familiar to you. Then Someone Lie to you.








MISSOURI HEALTH CARE SYSTEM TO PAY U.S. $60 MILLION TO SETTLE FALSE CLAIMS ACT ALLEGATIONS.

WASHINGTON – Lester E. Cox Medical Centers, a health care system headquartered in Springfield, Mo., has agreed to pay the United States to settle claims that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute between 1996 and 2005, by entering into certain financial relationships with referring doctors at a local physician group and engaging in improper billing practices with respect to Medicare. Cox, a not-for-profit healthcare organization, will pay the United States $60 million to resolve these claims.

Under the Stark Statute, Medicare providers like Cox are prohibited from billing the federal health care program for referrals from doctors with whom the providers have a financial relationship, unless that relationship falls within certain exceptions. The United States contended that certain relationships between Cox and physicians ran afoul of the Anti-Kickback Statute, which prohibits offering inducements to providers in return for patient referrals, and the Stark statute. Additional claims being resolved concern Cox’s inclusion of non-reimbursable costs on its Medicare cost reports and improper billings for services provided to dialysis patients.

“The Justice Department is committed to ensuring that the best interests of federal health care program patients are not compromised by unlawful payments to physicians,” said Gregory G. Katsas, Assistant Attorney General for the Justice Department’s Civil Division. “The resolution of this matter resulted in a significant recovery for taxpayers, and it exemplifies our dedication to vigorous enforcement of the Stark and Anti-Kickback Statutes.”

As part of the $60 million settlement, Cox has entered into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services (HHS) Office of Inspector General. The Corporate Integrity Agreement contains measures to ensure compliance with Medicare regulations and policies in the future.

“Today’s settlement furthers both our commitment to protecting patients from improper billing practices and the continued ability of Cox to provide quality medical care in Springfield and the Ozarks,” said John F. Wood, U.S. Attorney in Kansas City, Mo. “I am pleased that we were able to resolve this matter without litigation.”

The settlement with Cox was the result of a coordinated effort by the Commercial Litigation Branch of the Justice Department’s Civil Division; the U.S. Attorney’s Office for the Western District of Missouri; HHS’ Office of Inspector General, Office of Counsel to the Inspector General, and Office of Audit Services; and the FBI

Another Charged in $110 Million Health Care Fraud Scheme. Isn't Just the Tip of the Iceberg and List going on and on.




WASHINGTON – Three Miami area brothers who allegedly financed 11 corrupt HIV infusion clinics and a physician’s assistant who worked at those clinics have been charged in a $110 million HIV infusion fraud scheme, the Department of Justice’s Criminal Division and the U.S. Attorney’s Office for the Southern District of Florida announced today.

The indictment alleges that between January 2001 and November 2004, Carlos and Luis Benitez conspired to submit approximately $110 million in false and fraudulent claims to the Medicare program for HIV infusion services allegedly provided at 11 corrupt HIV infusion clinics that they owned and controlled. As part of the scheme, Carlos and Luis Benitez referred Medicare beneficiaries to the clinics and directed the beneficiaries be paid kickbacks to induce them to claim they received legitimate services at the clinics when in fact the HIV infusion services were either not provided or were not medically necessary. The HIV infusion clinics that they owned and controlled were: AH Medical Office Inc.; Advanced Medical Rehabilitation Center Inc.; Best Medi Corp.; Physician’s Health Med-Care; Physician’s Med-Care Inc.; Saint Jude Rehab Center Inc.; Global Med-Care Corp.; CNC Medical Corp.; G&S Medical Centers Inc.; Karla Medical Services Inc.; and Best Medicare Inc.

The indictment alleges that Jose Benitez owned and operated one of the eleven clinics, Advanced Medical, and assisted in submitting approximately $10 million of the false and fraudulent claims to the Medicare program for HIV infusion services that were not provided and for services that were not medically necessary. Thomas McKenzie was a physician’s assistant at the HIV infusion clinics owned and operated by Carlos, Luis and Jose Benitez. The indictment alleges that, at the direction of Carlos, Luis and Jose Benitez, McKenzie was responsible for training physicians and providers in how to make it appear that legitimate and appropriate medical services were being provided as well as overseeing the preparation of documents to make it appear that the services were actually rendered and medically necessary.

After obtaining the proceeds from their crimes, the indictment alleges that Carlos, Luis, and Jose Benitez engaged in a scheme to launder those proceeds by, among other things, transferring millions of dollars in proceeds to sham "marketing" and "management" companies that they owned and controlled and by transferring proceeds among the corrupt HIV infusion clinics.

Carlos Benitez, Luis Benitez, Jose Benitez, and Thomas McKenzie were charged with conspiracy to defraud the United States, to cause the submission of false claims to the Medicare program, and to pay health care kickbacks; conspiracy to commit health care fraud; and submitting false claims to the Medicare program. Carlos, Luis and Jose Benitez were charged with conspiracy to launder the proceeds of their crimes, and Carlos and Luis Benitez were each charged with money laundering. The indictment also seeks forfeiture of assets held by all defendants. Carlos and Luis Benitez each face a maximum sentence of 155 years in prison, Jose Benitez faces a maximum of 40 years, and Thomas McKenzie faces a maximum of 50 years.

This case is being prosecuted by Trial Attorneys Hank Bond Walther and John K. Neal of the Criminal Division’s Fraud Section, as well as Laurel Loomis Rimon and Constantine Lizas of the Criminal Division’s Asset Forfeiture and Money Laundering Section, with the investigative assistance of the FBI and the Department of Health and Human Services Office of the Inspector General. The case was brought as part of the Medicare Fraud Strike Force that has been operating in Miami since March 2007. The Strike Force is led by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section in Washington, D.C., and the office of U.S. Attorney R. Alexander Acosta of the Southern District of Florida.

Nativists, and Anti Immigrants. What part of Ilegal you do not Understand.!!!!!!!!!!!!



Most of Nativists, Anti Immigrants found that Undocumented(Ilegal) Immigrants were mostly a drain. Well Just Ilegal Billing, Ilegal fraud, ilegal benefits entitled to, ilegal claim, ilegal Kickbacks, Ilegal charges for services do not rendered to patient,

But they found greater ambiguity on whether Undocumented immigrants are good or bad for American society because they do not see the real facts. They rather create waves of flames of Anti Immigrant sentiment to our Society to see Undocumented people as a bad people.

Undocumented Immigrants has been persecuted, scapegoated, dimished, criminalized and labeled as a problem on Social Services specially Healthcare Services like Medicare and Medicaid. Well lets see the real facts.!!!!!!!!!!!!!!!!!!.

False Claims Act Returns $2 Billion in FY 2007.

The Justice Department has announced that $2 billion has been recovered under the federal False Claims Act in Fiscal Year 2007, of which $1.45 billion came from whistleblower-filed cases. The total amount returned to the U.S. Government under the False Claims Act since 1986 is well over $20 billion. Department of Justice data is actually very conservative, as it does not include billions of dollars in civil recoveries returned to the states or criminal fines imposed as a direct consequence of False Claims Act filings and prosecutions.

The cases below represent a "running tally" of False Claims Act cases compiled by the Taxpayers Against Fraud Education Fund for Fiscal Year 2007.

Amount in Millions $ Date Nature of the fraud Medicare Medicaid.

Bristol-Myers Squibb 328 9/28/2007 A total $515 million settlement, with $328 million to be paid under the Federal False Claims Act, and the state's getting $187 million. Fraud charges included off-label marketing, kickbacks, AWP drug pricing violations and several other frauds involving 50 drugs and a total of seven qui tam cases.

Amerigroup 172 3//14/2007 Judgment for $334 million including penalties. Amerigroup cherry-picked patients in violation of its HMO Medicaid contract, purposely avoided women in their third trimester of pregnancy because they cost more to insure. Note that this judgment is on appeal and reflects a $190 million penalty on top of a $144 million jury verdict.

Combined settlement with four orthotics companies: Smith & Nephew, Biomet, Zimmer, DePuy (Johnson & Johnson) 310 9/27/2007 $310 million total settlement of broad practice of kickback in the orthotics industry. Zimmer to pay 169.5 million, DePuy to pay $84.7 million, Smith and Nephew to pay $28.9 million, Biomet to pay $26.9 million. Stryker agreed to be monitored, but has entered no civil settlement.

Aventis (sanofi-aventis) 180 9/17/2007 Medicaid Average Wholesale Price case involving the anti-nausea drug Anzemet. Total settlement was for $190 million

Medco 155 10/24/2006 Shorting prescriptions, canceling prescriptions to avoid paying non-performance penalties, soliciting and accepting kickbacks from pharmaceutical manufacturers to favor their drugs, and paying kickbacks to health plans to obtain business. X X

Purdue Pharma 140.5 5/10/2007 Company "mislabeled" the drug saying it was less addictive than it was. This is a $634.5 million settlement, with $276 million to be forfeited to the United States, $160 million allocated to federal and state government agencies to resolve false claims for government healthcare programs and $130 million will go to resolving private civil claims. Of the 160 million to go to State and Federal FCA claims, $19.5 million is to go to the states.

Bill L. Harbert-owned construction companies 102 5/15/2007 Bid rigging for US AID paid for water and sewer systems installed in Egypt in the 1980s as part of the Camp David peace accords.

Oracle / PeopleSoft 98.5 10/10/2006 Provided false pricing information to GSA to obtain a federal contract.

ConocoPhillips 97.5 8/15/2007 Underpaid royalties owed on natural gas produced from federal and Indian leases

Omnicare / Specialized Pharmacy Services (Michigan) 52.5 10/5/2006 Improper billing, failure to credit Medicare for returned drugs, billing drugs for dead patients. X
Omnicare 49.5 11/14/2006 Illegal switching of generic pill to capsule forms of Zantac (ranitidine) in nursing homes and other facilities.

InterMune, Inc. 36.8 10/27/2006 Illegal off-label promotion of Actimmune. X X

Lourdes Perez, Provident Home Health Care Services Inc. and Tri-Regional Home Health
Care Inc. 33.8 10/11/2006 Medicare "bill mill" in which Medicare was billed for patients who were not homebound and for services her companies did not perform, creating false medical records to support the claims. X

Maximus Inc. 30.5 7/24/2007 Maximus billed DC Medicaid for targeted case management services that it either did not provide or had no records for.

Kerr-McGee Oil 30 1/25/2007 Jury verdict on case involving Kerr-McGee cheating the government out of millions of dollars in royalties on oil it produced in publicly owned coastal waters.

Robert I. Bourseau, Dr. Rudra Sabaratnam, and their two single-employee corporations, RIB Medical Management Services, Inc., and Navatkuda, Inc., 23.8 10/2/2006 Used false cost reports to bill Medicare for unreimbursable services at the Chula Vista psychiatric hospital formerly known as Bayview Hospital & Mental Health Systems. X

Akal Security Inc 18 7/13/2007 Akal violated terms of its contract to provide trained civilian guards at eight U.S. Army bases.

Harris County Hospital District 15.5 3/28/2007 Medicare Secondary Payer violations plus billing Medicaid for patients under custody of law enforcement.

Larkin Community Hospital in Miami and its current and former owners, Dr. Jack Michel, Dr. James Desnick, Morris Esformes and Philip Esformes 15.4 11/30/2006 Kickbacks X X

Aggregate Industries 15 7/27/2007 Total settlement of $50 million, of which $27 million will go into a special fund to be used to pay for future maintenance and repair of the Big Dig highway project, and an additional $8 million will be paid in criminal fines.

Jackson Memorial Health System 14.25 12/20/2006 Jackson Memorial was deliberately making use of unallowable or reopened cost reports, getting wrongful overpayments as a result. X

Ajax Paving Industries Inc. and Dan's Excavating Inc. 11.75 3/16/2007 Knowingly violated Disadvantaged Business

Enterprise (DBE) contracting requirements for federally funded construction
projects at Detroit Wayne County Metropolitan Airport

Cell Therapeutics 10.5 4/18/2007 Off-label marketing of Trisenox billed to Medicare.

Intergris Baptist Medical Center 10 11/28/2006 Inflated costs for organ transplants

Emory Worldwide 10 11/14/2006 Inflated bills for handling priority mail for USPS

Medicis Pharmaceutical 9.8 5/8/2007 Off-label marketing: Company promoted the use of a topical anti-fungal, Loprox, for diaper rash on children under the age of 10, without approval by the Food & Drug Administration.

American Medical Response Inc. 9 10/5/2006 Ambulance services fraud. X

KBR Inc. 8 11/29/2006 Overcharged the U.S. Army for logistical support in the Balkans during 1999 and 2000
Crane Co.
7.6 8/14/2007 Substandard valves sold to the U.S.

SCCI Health Services Corporation, and its subsidiary, SCCI Hospital Ventures Inc 7.5 1/7/2007 Kickback and self-referral (Stark violations) X

Raritan Bay Medical Center 7.5 3/16/2007 Purposefully inflated outlier charges for inpatient and outpatient care to make these cases appear more costly than they actually were.

PBSJ 6.4 1/25/2007 PBSJ submitted claims to the overstated overhead rates in its Government contracts.

Atlanta's Northside Hospital 5.75 10/20/2006 Kickbacks

Oakland City University 5.3 7/31/2007 University paid incentives to admissions recruiters contrary to federal regulations.

IBM & PriceWaterhouseCoopers 5.2 8/16/2007 Companies solicited and provided improper payments and other things of value on technology contracts with government agencies

Keystone Mercy Health Plan 5 10/27/2006 Medicaid HMO Kept Medicaid overpayments X
Cook County, Illinois 5 12/20/2006 County mismanaged a federally funded study involving pregnant drug addicts.

AIT Worldwide Logistics of Itasca, Ill. 4.2 10/20/2006 Kickbacks and bill padding.

St. Elizabeth Regional Medical Center (NE) 4 10/31/2006 Used false cost reports to overbill l Medicare for neonatal and burn units.

Scooter Stores 4 5/14/2007 Settlement includes $4 million in cash and $13 million in foregone Medicare payments to settle charges the company billed Medicare medically unnecessary power wheelchairs.

HealthSouth Corporation 4 11/3/2006 HealthSouth submitted fraudulent Medicare claims for prosthetic and orthotic devices - such as artificial limbs and braces - used to treat HealthSouth hospital inpatients X

Our Lady of Lourdes Regional Medical Center 3.8 5/9/2007 Billing Medicare, Medicaid and private insurance providers $2.5 million for unnecessary cardiac procedures, such as angiograms and angioplasties, on more than 70 patients.

Orphan Medical/ Jazz Pharmaceuticals Inc 3.75 7/13/2007 Aggressive marketing of Xyrem (GBH, the "date rape" drug) for unapproved use. Part of a total settlement of $20 million, including criminal.

Cabrini Medical Center 3.4 3/29/2007 Kickbacks billed as administrative services for referral of patients.

Korrect Optical 3.25 1/25/2007 Korrect Optical submitted false claims to the

Department of Veteran Affairs ( VA )through ophthalmic prescriptions for eyewear for veterans.

Dr. Daniel Nixon and other board members of the Institute for Cancer Prevention, Tatum, LLC and Weiser, LLP 3.2 1/17/2007 Unlawful receipt and use of federal grant money.

Electronic Data Systems Inc. and Travelers Casualty 2.85 1/23/2007 EDS was processing National Flood Insurance Program claims based on backdated policies written by Travelers.
Dey 2.8 4/26/2007 Settle charges of price inflation and defrauding Mass. Medicaid program (AWP).

Rural/Metro Corporation 2.5 6/11/2007 Kickback for referrals

David Rommel 2.48 11/13/2006 Dental practice fraud. Won by summary judgment.

Danbury Hospital (CN) 2.4 10/27/2006 Self-reported upcoding for septicemia, respiratory failure, respiratory infections and inflammations. X

Affiliated Computer Services, Inc 2.3 7/2/2007 ACS allegedly Submitted inflated claims for programs run by and through the U.S. Department of Agriculture (USDA), the U.S. Department of Labor (DOL), and the Administration for Children and Families of the U.S. Department of Health and Human Services. Self reported.

APAC Atlantic 2.25 10/3/2006 False asphalt testing

University of Miami Medical School 2.2 12/27/2006 UM sometimes billed for critical care services when patients were not critically ill or where critical services were not rendered. X X

Loma Linda Behavioral Medicine Center (Loma Linda BMC) in Redlands 2 4/26/2007 Fraudulently overbilled federal health insurance programs by manipulating cost reports.

O'Hara Regional Center for Rehabilitation, Health Care Management Partners, ORCR Inc., Solomon Health Management, Solomon Health Services 1.9 10/5/2006 Abuse and neglect and substandard nursing home services. X

Emeritus Corp 1.86 8/30/2007 False and inaccurate billing to the Texas Medicaid program.

COSMOS Corp 1.5 1/23/2007 COSMOS improperly charged government contracts for costs that dealt with the company's operations, and also shifted labor costs from private contracts to government contracts.

Crawford and Company 1.36 10/11/2006 Billing the government for health care services to federal employees at rates set by Crawford managers, rather than billing the actual time spent performing that service.

Ciena Healthcare Management 1.25 8/20/2007 Improperly billed Medicaid and Medicare for inadequate care of and services to residents at four metro Detroit nursing homes.

Bli Farms, Richard Bli and the estate of James E. Bli 1.229 11/29/2006 False crop insurance claims.

Lancaster Community Hospital 1.2 6/8/2007 Knowingly overbilled Medicare for physical therapy costs.

Lakewood Cheder School 1.2 10/31/2006 False information to obtain funds for preschool lunch program.

Robert E. Eberhart and Jonathan Holzaepfel, orthopedic surgeons and partners in
Seacoast Trust, and Thomas King 1 3/8/2007 HealthSouth paid higher than normal rent equivalent to income from referrals made by the doctors

Parkway Hospital, Inc 1 8/14/2007 Inflated hospital costs reports.

Environmental Management Inc. 1 4/2/2007 Overbilling and illegal disposal of chemicals in methamphetamine lab cleanups for DEA.

Dey 1 4/4/2007 Settlement of Hawaii FCA marketing the spread cases

Julio C. Melo, M.D., 0.984 7/23/2007 Billed Medicare for Evaluation and Management services that exceeded the number of hours there were in a day.

RightCHOICE Managed Care Inc. 0.975 1/31/2007 RightCHOICE paid higher fees to physicians serving government0insured patients than for other plans.

Comprehensive Cancer Centers 0.9 11/8/2006 Upcoding led to overbilling of Medicare for CCC services at Desert Regional Medical Center (owned by Tenet) X

Iftakhar Khan and Amjad Khan 0.825 1/9/2007 Owners of Livonia-based Michigan

Rehabilitation and Pain Management fraudulently billed Medicare. X

Green Valley Pavilion, LLC 0.55 5/14/2007 Forging and altering patient charts to maximize reimbursement from Delaware's Medicaid Program

Oregon Imaging Center 0.51 12/12/2006 Tests not ordered by doctor.

Moritz Embroidery Works 0.5 7/10/2007 False "Buy American Act" certification to the United States government for military and police emblems and patches.

John Dempsey Hospital 0.475 6/27/2007 Overbilled Medicare for chemotherapy treatment.

Colquitt Regional Medical Center 0.475 3/5/2007 Overcharged the government for services through CRMC's Home Health Office in Sylvester, GA X X

Hillsboro Area Hospital, in Hillsboro, Ill. 0.3 2/7/2007 Over billing for the treatment of Medicare beneficiaries who were diagnosed with pneumonia, sepsis, and renal failure. X

Beacon Ambulance Company. 0.219 3/29/2007 Use of one basic technician and a single Paramedic on ambulance run, and billing for two Paramedics.

Promark, Inc. 0.2 11/14/2006 Overstating warranty on epoxy paint to DoT

Riverview Cancer Center 0.165 10/5/2006 Upcoding and services not provided

LS Technologies 0.145 3/16/07 Submitted duplicate claims for two different subcontracts and was paid $50,000 based on these false claims.

Madison County, Alabama 0.11 2/19/2007 Diversion of money from "Working Connection," a welfare-to-work program.

Kansas City, Missouri School District 0.066 5/18/200 66,000 paid in money and over $13.6 in claims relinquished in E-Rate fraud case.

Armstrong Williams 0.035 10/22/2006 Failing to do contracted work for Dept. of Education

Dr. Roberto Ramirez 0.03 12/21/2007 False dental billing X X

Clark's Trading Company (Clark's 0.012 10/18/2006 Product substitution (meat) at Federal Bureau of Prisons.
Link: http://www.taf.org/total2007.htm