MADISON - Attorney General J.B. Van Hollen announced today that seven people have been charged with Medicaid Fraud and Identity Theft related to payment of claims for durable medical equipment.
Showing posts with label medicaid fraud control units. Show all posts
Showing posts with label medicaid fraud control units. Show all posts
Friday, October 28, 2011
Seven People Charged with Medicaid Fraud and Identify Theft
Seven People Charged with Medicaid Fraud and Identify Theft
MADISON - Attorney General J.B. Van Hollen announced today that seven people have been charged with Medicaid Fraud and Identity Theft related to payment of claims for durable medical equipment.
MADISON - Attorney General J.B. Van Hollen announced today that seven people have been charged with Medicaid Fraud and Identity Theft related to payment of claims for durable medical equipment.
AG Reaches Additional $6.2 Million Settlements in AWP Cases
AG Reaches Additional $6.2 Million Settlements in AWP Cases
Jackson, MS--Attorney General Jim Hood today announced two more settlements in the ongoing Average Whole Price (AWP) litigation. The Attorney General's Office successfully negotiated these two settlements, involving three pharmaceutical manufacturers, which will put $6,032,000 into the State's coffers.
Jackson, MS--Attorney General Jim Hood today announced two more settlements in the ongoing Average Whole Price (AWP) litigation. The Attorney General's Office successfully negotiated these two settlements, involving three pharmaceutical manufacturers, which will put $6,032,000 into the State's coffers.
Attorney General Koster reaches settlement with St. Louis County in-home personal care company
Attorney General Koster reaches settlement with St. Louis County in-home personal care company
Jefferson City, Mo.- Attorney General Chris Koster today announced a settlement with Delmar Gardens Private Services (DGPS), a Chesterfield, Missouri, company that arranges for the provision of in-home personal care services for qualified individuals. The settlement resolves allegations that DGPS submitted claims to Medicaid for in-home health services that were not eligible for reimbursement under Medicaid rules and state regulations.
Jefferson City, Mo.- Attorney General Chris Koster today announced a settlement with Delmar Gardens Private Services (DGPS), a Chesterfield, Missouri, company that arranges for the provision of in-home personal care services for qualified individuals. The settlement resolves allegations that DGPS submitted claims to Medicaid for in-home health services that were not eligible for reimbursement under Medicaid rules and state regulations.
Hogsett Announces Indianapolis Man Charged With Medicaid Fraud
Hogsett Announces Indianapolis Man Charged With Medicaid Fraud
INDIANAPOLIS - Joseph H. Hogsett, United States Attorney, announced today that Ahmed Mohamed Abugroon, 56, of Indianapolis, Indiana, was charged with health care fraud\ following an investigation by the Federal Bureau of Investigation and the Indiana Attorney General's Medicaid Fraud Control Unit.
INDIANAPOLIS - Joseph H. Hogsett, United States Attorney, announced today that Ahmed Mohamed Abugroon, 56, of Indianapolis, Indiana, was charged with health care fraud\ following an investigation by the Federal Bureau of Investigation and the Indiana Attorney General's Medicaid Fraud Control Unit.
Friday, September 30, 2011
Mass. AG allege Medicaid fraud schemes cost $10M
Now imagine if the state actually went after Medicaid fraud in child welfare.
Mass. AG allege Medicaid fraud schemes cost $10M
BOSTON (AP) — Massachusetts Attorney General Martha Coakley announced indictments Friday against 10 people linked to a series of Medicaid fraud schemes that investigators say cheated taxpayers out of nearly $10 million.
The allegations included billing the state for care provided to dead patients, kickback schemes for unnecessary drug tests and claiming nursing home residents needed help walking and eating when they were able to do both on their own. In each case, investigators said the goal was to bilk MassHealth, the state's Medicaid program.
A total of 118 criminal indictments against 10 individuals have been handed down in the four cases.
Coakley said the indictments were returned Thursday by three grand juries including a special statewide grand jury and are the result of four major criminal investigations by the state Medicaid Fraud unit.
Coakley said the kind of fraud alleged in the indictments ultimately forces up health care costs for everyone in Massachusetts.
"It's like when people are shoplifting in a store, it's passed onto consumers," Coakley said Friday. "They might as well be walking over to MassHealth and taking money out of the state treasury."
The cases involved four private health care providers: Adlife Healthcare; Preventative Medicine Associates; Mitchell Counseling Services; and Wetterberg Nursing Homes, which ran the Pond View Nursing Facility in Boston.
In the case of Adlife, investigators allege that owner Sharon Richardson, 55, of Framingham and two employees billed MassHealth for approximately $5.5 million in services that were not provided.
Adlife is a group adult foster care provider for MassHealth with locations in Framingham, West Springfield, Boston and Hyannis.
Investigators' allege Adlife billed MassHealth for treating deceased individuals and individuals who never received services. Richardson is also accused of falsifying records submitted to MassHealth and working with two employees to destroy internal records to cover up the fraud.
Richardson was arrested Thursday. Her lawyer, Michael Stromsnes, declined comment.
The second set of indictments focus on a Brookline doctor, Punyamurtula Kishore, 61, and his company Preventative Medicine Associates, Inc., with 29 locations statewide.
Investigators said Kishore and three others orchestrated an elaborate drug screening kickback scheme and fraudulently billed MassHealth for nearly $3.8 million.
Coakley's office said Kishore used bribes to induce various so-called "sober homes" to send patients to his laboratories to perform unnecessary urine drug screens — as many as three a week — that were later billed to Medicaid. Investigators said drug screens are generally billed at between $100 and $200 each and Kishore billed MassHealth for tens of thousands of the tests.
Three managers or owners of the "sober homes" — New Horizon House in Boston, Marshall House in Malden and Gianna's House, which operates homes in Wareham, New Bedford and Sandwich — were also indicted.
Kishore was arraigned Wednesday in Malden District Court and later released after surrendering his passport.
Kishore's attorney said Kishore is "an extremely well-regarded member of the community" who denies the allegations.
The third alleged scheme defrauded MassHealth of $160,000 and involved David Benson, 48 of New Bedford and his company Mitchell Counseling Services.
Investigators said Benson, an independent clinical social worker, routinely billed for treatment that exceeded services provided to six patients. Coakley's office said Benson billed as if his patients were in need of acute care multiple times a week when they were being provided minimal care or no care at all.
A call to Mitchell Counseling Services wasn't answered Friday.
The final investigation resulted in an indictment against Carolyn Wetterberg, 70, of Weymouth for allegedly billing MassHealth more than $600,000 for services not provided.
Wetterberg was part owner and sole manager of Wetterberg Nursing Homes, Inc., which ran the Pond View Nursing Facility in the Jamaica Plain neighborhood of Boston. The 43-bed long term care facility was shut down by the Massachusetts Department of Public Health in June for poor quality of care.
Coakley's office said Wetterberg defrauded MassHealth by deliberately overstating the level of disabilities of those who lived in the facility, allowing her to bill for more than their care required.
Investigators said in some cases patients she claimed needed help walking were walking independently and those she claimed needed help eating were eating on their own.
A man who answered the phone at Wetterberg's home said she wasn't available for comment.
Mass. AG allege Medicaid fraud schemes cost $10M
BOSTON (AP) — Massachusetts Attorney General Martha Coakley announced indictments Friday against 10 people linked to a series of Medicaid fraud schemes that investigators say cheated taxpayers out of nearly $10 million.
The allegations included billing the state for care provided to dead patients, kickback schemes for unnecessary drug tests and claiming nursing home residents needed help walking and eating when they were able to do both on their own. In each case, investigators said the goal was to bilk MassHealth, the state's Medicaid program.
A total of 118 criminal indictments against 10 individuals have been handed down in the four cases.
Coakley said the indictments were returned Thursday by three grand juries including a special statewide grand jury and are the result of four major criminal investigations by the state Medicaid Fraud unit.
Coakley said the kind of fraud alleged in the indictments ultimately forces up health care costs for everyone in Massachusetts.
"It's like when people are shoplifting in a store, it's passed onto consumers," Coakley said Friday. "They might as well be walking over to MassHealth and taking money out of the state treasury."
The cases involved four private health care providers: Adlife Healthcare; Preventative Medicine Associates; Mitchell Counseling Services; and Wetterberg Nursing Homes, which ran the Pond View Nursing Facility in Boston.
In the case of Adlife, investigators allege that owner Sharon Richardson, 55, of Framingham and two employees billed MassHealth for approximately $5.5 million in services that were not provided.
Adlife is a group adult foster care provider for MassHealth with locations in Framingham, West Springfield, Boston and Hyannis.
Investigators' allege Adlife billed MassHealth for treating deceased individuals and individuals who never received services. Richardson is also accused of falsifying records submitted to MassHealth and working with two employees to destroy internal records to cover up the fraud.
Richardson was arrested Thursday. Her lawyer, Michael Stromsnes, declined comment.
The second set of indictments focus on a Brookline doctor, Punyamurtula Kishore, 61, and his company Preventative Medicine Associates, Inc., with 29 locations statewide.
Investigators said Kishore and three others orchestrated an elaborate drug screening kickback scheme and fraudulently billed MassHealth for nearly $3.8 million.
Coakley's office said Kishore used bribes to induce various so-called "sober homes" to send patients to his laboratories to perform unnecessary urine drug screens — as many as three a week — that were later billed to Medicaid. Investigators said drug screens are generally billed at between $100 and $200 each and Kishore billed MassHealth for tens of thousands of the tests.
Three managers or owners of the "sober homes" — New Horizon House in Boston, Marshall House in Malden and Gianna's House, which operates homes in Wareham, New Bedford and Sandwich — were also indicted.
Kishore was arraigned Wednesday in Malden District Court and later released after surrendering his passport.
Kishore's attorney said Kishore is "an extremely well-regarded member of the community" who denies the allegations.
The third alleged scheme defrauded MassHealth of $160,000 and involved David Benson, 48 of New Bedford and his company Mitchell Counseling Services.
Investigators said Benson, an independent clinical social worker, routinely billed for treatment that exceeded services provided to six patients. Coakley's office said Benson billed as if his patients were in need of acute care multiple times a week when they were being provided minimal care or no care at all.
A call to Mitchell Counseling Services wasn't answered Friday.
The final investigation resulted in an indictment against Carolyn Wetterberg, 70, of Weymouth for allegedly billing MassHealth more than $600,000 for services not provided.
Wetterberg was part owner and sole manager of Wetterberg Nursing Homes, Inc., which ran the Pond View Nursing Facility in the Jamaica Plain neighborhood of Boston. The 43-bed long term care facility was shut down by the Massachusetts Department of Public Health in June for poor quality of care.
Coakley's office said Wetterberg defrauded MassHealth by deliberately overstating the level of disabilities of those who lived in the facility, allowing her to bill for more than their care required.
Investigators said in some cases patients she claimed needed help walking were walking independently and those she claimed needed help eating were eating on their own.
A man who answered the phone at Wetterberg's home said she wasn't available for comment.
Monday, September 26, 2011
HHS False Claims Reports Nothing On Child Welfare Fraud
Below, is a few examples of Medicaid fraud schemes where individuals are employed who were not eligible because they had been previously busted for Medicaid fraud.
Of all the years in existence, the U.S. Department of Health and Human Services Office of Inspector General has never, ever, ever brought forth violations of the Civil Monetary Penalties Law against any child welfare entity.
Never.
Not only that, no one from the child welfare industry has been placed on the OIG Exclusionary Database.
The reason it is never enforced is because it would shut down the entire child welfare system.
08-09-2011
After it self-disclosed conduct to the OIG, Kmart Corporation (Kmart), Indiana, agreed to pay $945,021.19 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Kmart employed four individuals that it knew or should have known were excluded from participation in Federal health care programs
07-22-2011
After it self-disclosed conduct to the OIG, Health Management Services, Inc. (HMS), Louisiana, agreed to pay $6,545.61 for allegedly violating the Civil Monetary Penalties Law. Specifically, HMS disclosed the alteration of continuous positive airway pressure downloads for patients by two individuals at HMS in order to obtain Federal health care program reimbursement.
06-06-2011
After it self-disclosed conduct to the OIG, University of North Texas Health Science Center at Fort Worth (UNTHSC), Texas, agreed to pay $859,500 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that UNTHSC submitted claims for physicians' services provided to beneficiaries of Federal health care programs using the provider identification numbers of 103 physicians who neither furnished the service nor personally supervised the services rendered.
08-30-2010
After it self-disclosed conduct to the OIG, Catholic Healthcare West, Bakersfield Memorial Hospital, and Community Hospital of San Bernardino (collectively CHW), CA, agreed to pay $243,819.28 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CHW employed five individuals that it knew or should have known were excluded from participation in Federal health care programs.
Stop Child Medicaid Fraud
Of all the years in existence, the U.S. Department of Health and Human Services Office of Inspector General has never, ever, ever brought forth violations of the Civil Monetary Penalties Law against any child welfare entity.
Never.
Not only that, no one from the child welfare industry has been placed on the OIG Exclusionary Database.
The reason it is never enforced is because it would shut down the entire child welfare system.
Stop Child Medicaid Fraud
Thursday, September 8, 2011
Nebraska Joe Bruning Advocates Medicaid Fraud In Child Welfare
I posted this almost 4 years ago. In honor of Nebraska's Auditor General Report on posthumous payments, I have dedicated this piece on privatization to them.
Privatization can be fiscally responsible.
The Detroit News
This was published 10/31/07 06:09 PM
The Governor should embrace with joy the championing of privatization of foster care and adoption services by Senator Hardiman. This is what we all have been awaiting.
Privatizing foster care and adoption services releases the constraints of enforcement within the executive branch. The Attorney General is now able to flick the switch of the oversight machine and provide accountability for the state and its families. This is what is to happen:
The responsibility of contract monitoring and compliance is transferred from DHS back into the hands of the Attorney General. For example, families whose children have been removed where privatized agencies do not believe in family reunification, can now file complaints with the Attorney General regarding protection of consumer rights. The Bureau of Children and Family Services Fraud Division may now protect, not just vulnerable adults, but vulnerable children and families.
When the Attorney General conducts investigations and finds material violations of law and policy by the privatized child placing agencies, he is now allowed to follow through with full prosecution of the agencies and their workers.
In turn, families are provided proactive services, there are no longer phantom programs funded by DHS, tens of millions of dollars in improper payments of improper, unneccessary services and placements of children in foster care are ameliorated.
The number of children entering foster care are reduced because privatized child placing agencies must promote and advocate for placement of children within the family which is more cost effective than having a child prescribed psychiatric medication to "calm" from the trauma of being ripped from his/her home and placed in a strangers home, further reducing medicaid waste and fraud.
Privatized child placing agencies, under the theory of punishment by deterrence, will produce accurate and transparent audit reports, simply from the fear of prosecution.
Practices of targeting minority and impoverished children, due to the fact that child abuse and neglect is an entitlement program, will cease in the face of civil rights penalties.
Michigan will become a model state for accountability and transparency by reducing dependency of federal funding streams in Social Security. The money saved by privatized child placing agencies can be invested in education, thus, replacing the state's number one industry (Human Services) with higher education.
Michigan is no longer liable for litigation. The Executive Office is no longer a demagogue to privatized child placing agencies who also lobby (many without proper IRS status), but becomes the fiscal savior of our families.
Everyone wins...except the privatized child placing agencies that violate federal and state laws and policies, under color of state law.
Beverly Tran
Where the hell is the Attorney General?
Hey Joe, get off your lazy punk ass and get that Medicaid Fraud Control Unit up and do something. Damn. Just sad. Maybe you might want to keep screaming about too much regulation particularly the antifraud provisions in the Obamacare. Moron.
Seriously, listen to him. Here he is referring to welfare recipients as "raccoons". He has to know that when the families are cut off, the children go to foster care... wait, he does know what he is talking about. The privatized child placing agencies are making a killing on Medicaid fraud.
This is why his Medicaid Fraud Control Unit allows fraud to flourish in child welfare.
Thursday, March 24, 2011
Michigan Did Not Get Its False Claims Act Together, Again
Pay attention to the whom the review was addressed. Mike Cox is no longer Attorney General. It is now Bill Schuette.
HHS OIG Review of Michigan False Claims Act 2011
HHS OIG Review of Michigan False Claims Act 2011
Wednesday, March 9, 2011
Tuesday, January 25, 2011
AstraZeneca, The Policy Pimps Of Medicaid Fraud
A precious gem I have discovered!
This is an excellent specimen of pathological propaganda. In 2004, AstraZeneca, LP, a pharmaceutical corporation, sponsors a symposium with a university to reshape Medicaid. The main focus was on mental health and children, not on quality of life but to increase funding to expand eligibility for drugs.
That's right, boys and girls, a drug company pays off a university to get Congress to pay more money for their drugs. This is tangent to the practice of ghostwriting in medical literature.
These cats were so good at manipulating public policy to make more money that they even got former Michigan Governor John Engler, the king of privatization, to come and support their agenda. For those of you who may not know, Governor Engler was the individual who established the nation's first privatized child welfare system. As a result, Medicaid fraud has been astronomical. Here is a sample of his work.
Without further adieu, I present to you, a hallmark in the history of Medicaid fraud child welfare! The Future of Medicaid: What Will Medicaid Look Like in 2010?
What makes this so-called "Medicaid vision" so entertaining is that it is now 2010 and look at what the Department of Health and Human Services Office of Inspector General caught AstraZeneca, LP doing... "wrongfully and illegally marketing" their drugs
I am not sure as I have yet to investigate, but I believe the U.S. Food and Drug Administration was allowing Medicaid to pay for the experimental drug trials on foster kids for AstraZeneca, LP. Even so, Medicaid pays for using foster kids as lab rats.
In the end, the only lesson I am trying to teach is that it is time for transparency and accountability. No more secrets. CORPORATE INTEGRITY AGREEMENT BETWEEN THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN...
AstraZeneca's policy pimping only gets funnier. Utah's Attorney General Shurtleff wants his money back. I wish the other States would follow suit. Utah Seroquel Risperdal Complaint
This is an excellent specimen of pathological propaganda. In 2004, AstraZeneca, LP, a pharmaceutical corporation, sponsors a symposium with a university to reshape Medicaid. The main focus was on mental health and children, not on quality of life but to increase funding to expand eligibility for drugs.
That's right, boys and girls, a drug company pays off a university to get Congress to pay more money for their drugs. This is tangent to the practice of ghostwriting in medical literature.
These cats were so good at manipulating public policy to make more money that they even got former Michigan Governor John Engler, the king of privatization, to come and support their agenda. For those of you who may not know, Governor Engler was the individual who established the nation's first privatized child welfare system. As a result, Medicaid fraud has been astronomical. Here is a sample of his work.
Without further adieu, I present to you, a hallmark in the history of Medicaid fraud child welfare! The Future of Medicaid: What Will Medicaid Look Like in 2010?
What makes this so-called "Medicaid vision" so entertaining is that it is now 2010 and look at what the Department of Health and Human Services Office of Inspector General caught AstraZeneca, LP doing... "wrongfully and illegally marketing" their drugs
I am not sure as I have yet to investigate, but I believe the U.S. Food and Drug Administration was allowing Medicaid to pay for the experimental drug trials on foster kids for AstraZeneca, LP. Even so, Medicaid pays for using foster kids as lab rats.
In the end, the only lesson I am trying to teach is that it is time for transparency and accountability. No more secrets. CORPORATE INTEGRITY AGREEMENT BETWEEN THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN...
AstraZeneca's policy pimping only gets funnier. Utah's Attorney General Shurtleff wants his money back. I wish the other States would follow suit. Utah Seroquel Risperdal Complaint
Monday, January 24, 2011
Subscribe to:
Posts (Atom)