Monday, September 19, 2011

NEW ORLEANS PHYSICIAN CHARGED WITH CONSPIRACY TO COMMIT HEALTH CARE FRAUD

FOR IMMEDIATE RELEASE

September 15, 2011

DR. ANTHONY STEPHEN JASE, age 41 and a resident of New Orleans, Louisiana, was charged in a one-count Bill of Information for conspiracy to commit health care fraud, announced U. S. Attorney Jim Letten.

DR. JASE is a physician with offices in New Orleans, Louisiana. The Bill of Information charges that DR. JASE certified that certain Medicare patients qualified for power wheelchairs and orthotic equipment for patients he never saw. As a result of fraudulent claims Medicare paid $280,323 to a durable medical equipment supplier.

On July 7, 2010, DR. JASE was indicted in the Middle District of Louisiana on several counts of health care fraud, conspiracy to solicit and pay health care kickbacks, and substantive counts of paying and receiving illegal kickbacks, in connection with a $1 million scheme to defraud the Medicare program by submitting fraudulent claims for durable medical equipment.

If convicted, DR. JASE faces a maximum term of imprisonment of ten (10) years, a fine of $250,000.00 and three (3) years of supervised release following any term of imprisonment.

U. S. Attorney Letten reiterated that the bill of information is merely a charge and that the guilt of the defendant must be proven beyond a reasonable doubt.

The case was investigated by the United States Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation.

The case is being prosecuted by Assistant U. S. Attorney Patrice Harris Sullivan.

Louisiana Bill of Information Health Care Fraud Felony

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What is Single Payer?

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs. In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.) In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

What is Single Audit?

Each year, the Federal Government provides over $400 billion in grants to State, local and tribal governments, colleges, universities and other non-profit organizations (non-Federal entities). The Single Audit Act of 1984 (with amendment in 1996) and OMB Circular A-133 ("Audits of State, Local Governments, and Non-Profit Organizations") provide audit requirements for ensuring that these funds are expended properly. All non-Federal entities that expend $500,000 or more of Federal awards in a year ($300,000 for fiscal year ending on or before December 30, 2003) are required to obtain an annual audit in accordance with the Single Audit Act Amendments of 1996 (pdf), OMB Circular A-133, the OMB Circular Compliance Supplement and Government Auditing Standards. A single audit is intended to provide a cost-effective audit for non-Federal entities in that one audit is conducted in lieu of multiple audits of individual programs. The Single Audit provides the Federal government with assurance that these recipients comply with such directives by having anindependent external source (the CPA) report on such compliance.

OMB Circular A-133 Compliance Supplement 2009

Health Care Fraud Enforcement

Monday, September 19, 2011

NEW ORLEANS PHYSICIAN CHARGED WITH CONSPIRACY TO COMMIT HEALTH CARE FRAUD

NEW ORLEANS PHYSICIAN CHARGED WITH CONSPIRACY TO COMMIT HEALTH CARE FRAUD

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