July 7, 2008

Miami Pharmacy Owner of Convicted of Medicare Fraud, Co-defendant Acquitted

After a six day trial in Miami, a federal jury in Miami convicted Gustavo Smith, 43, the owner of a Miami pharmacy for his role in a $3 million Medicare fraud scheme and for money laundering of all 17 counts charged against him in the September 2007 Indictment.

The charges included: conspiracy to defraud the U.S. government, to commit health care fraud, and to submit false claims to the Medicare program; seven counts of health care fraud; seven counts of submitting false claims to the Medicare program; conspiracy to commit money laundering; and one count of money laundering.

Schock%20verdict-1.jpgSmith’s co-defendant, Friedhelm Schock, the nominee owner of Medstar, was acquitted by the jury on all charged counts.

According to Schock's defense attorney, Michael Band of Adorno & Yoss, the government argued that Schock was the "nominee" owner of the pharmacy, signed all the Medicare documents, opened all the bank accounts, formed the corporation, received monies far in excess of what reflected the work he performed at the pharmacy and lied to the government to cover up the fraud.

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April 17, 2008

Psychiatrist Sentenced to 30 Months for Medicare Fraud

ist1_5514174_dictionary_series_psychology_psychiatry.jpgCheck this out. Usually you would think of a psychiatrist as being someone who treats patients who suffer from auditory or visual hallucinations. However, an Illinois psychiatrist is headed to federal prison for two and a half years for defrauding Medicare of $1.75 million for submitting bills to Medicare for patients he never saw.

According to the indictment, Dr. Ajit Trikha (ah-JEET' TREEK'-ah) a 55-year-old psychiatrist pleaded guilty last June in U.S. District Court in East St. Louis to two counts of health care fraud. Trikha submitted bills to Medicare for reimbursement claiming that he had therapy sessions with patients, when in truth he never met the patient and in some instances was out of the country on vacation. He also billed for group-therapy sessions that far exceeded the 12-person limit set by Medicare and Medicaid.

Additionally, the indictment specifically alleged that the doctor and his medical practice "regularly submitted claims with [erroneous] . . . codes when spending little or no time with the patient rather than approximately 20 to 30 minutes face-to-face with the patient as required by 08 17, or approximately 45 to 50 minutes face-to-face with the patient as required by 9081. TRIKHA and TRX also submitted claims with these codes for visits with patients who were not able to communicate verbally at all."

A federal judge has ordered Trikha to reimburse the government for the money he bilked.

April 11, 2008

Miami Woman Sentenced to 10-years for Role in $170M Healthcare Fraud Consiracy

540236_secret_garden.jpgOn April 2, the same day that seven co-defendants were indicted (click here) for their roles in an $11 million Medicare fraud scheme involving HIV infusion clinics, Rita Campos Ramirez who had pleaded guilty in August 2007 to a $170 million conspiracy to commit health care fraud was sentenced to 10 years in prison. According to the U.S. Department of Justice and local federal prosecutors, the scheme represents the largest known individual case of Medicare fraud in the history of the program.

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April 8, 2008

Feds Charge Seven in $11 Million Medicare Fraud Scheme

253396_iv_drip_-_intravenous_treatmen.jpgSeven Miami-area residents were indicted on April 2, 2008, in connection with an $11 million Medicare fraud scheme involving HIV infusion clinics. The defendants were all charged with: conspiracy to defraud the United States, to cause the submission of false claims, to pay health care kickbacks, and conspiracy to commit health care fraud.

According to a report filed early last fall, by the Inspector General for the U.S. Department of Health and Human Services, health care providers in Broward, Miami-Dade and Palm Beach submitted $2.5 billion in claims to Medicare on behalf of HIV/AIDS patients in 2005.

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April 4, 2008

Two Florida Men Sentenced for Healthcare Fraud & Money Laundering

moneylaundering.jpg.gif On April 2, 2008, U.S. District Court Judge Adalberto Jordan of the Southern District of Florida sentenced defendant Michael Labrada, 27, of Miami to a 97 month prison term and Miguel Castillo, 42, of Miami, to a 57 month prison term for their participation in a multi-million dollar health care fraud and money laundering scheme.

Labrada was convicted of conspiring with Angel Castillo, Jr. to commit health care fraud by serving as a straw owner of a medical equipment company known as JJ & D Medical Equipment, Inc. The company submitted more than $6.8 million dollars in bogus claims and received approximately $1.6 million in payments. In the second case, Labrada was convicted of money laundering charges in connection with a $2.3 million laundering scheme orchestrated by his co-defendant, Angel Castillo, Jr.

Miguel Castillo was also convicted of related health care fraud and money laundering conspiracy charges. In addition to serving as a straw owner of a medical equipment company, Miguel Castillo collected hundreds of thousands of dollars in fraud proceeds from check cashers at the direction of his cousin and co-conspirator, Angel Castillo, Jr.

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March 18, 2008

Symposium on Healthcare Fraud Investigations

884L08-WAS.gif Healthcare Fraud Blog publisher, Robert David Malove, has been invited to attend the American Conference Institute's Symposium on Healthcare Fraud Investigations. This is a one-of-a-kind event you won’t want to miss. The Symposium will be held Monday, March 31, 2008 to Tuesday, April 1, 2008 at The Latham Hotel Georgetown, Washington, DC. Reserve your space today by calling 888-224-2480 or by faxing your registration to 877-927-1563, or online. Be sure to register before spaces are filled for this unique event.

The challenge of obtaining full comprehension of the complex and constantly changing, laws and regulations governing Medicare and Medicaid is well documented. Nonetheless, in the current environment of ever increasing government scrutiny of the healthcare industry, there is no room for error. With staggering settlements extracted to date and the increased potential for criminal penalties, it is imperative that you fully understand the implications of every statement and action you, your client, and employees of your institution make when you are the target of an investigation into Medicare and Medicaid practices.

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March 11, 2008

Defendant Acquitted of Healthcare Fraud

Guerrero%20verdict.jpg Yeleiny Guerrero was the co-owner of Denis Medical Services, Inc. She was charged in a 6 count indictment with conspiracy to defraud the United States by causing the filing of false Medicare claims, conspiracy to commit health care fraud and 4 counts of health care fraud. Her codefendants were Ramon Oscar Soto, Araelia Nieto and Rafael Moreno. Soto was the leader of the charged conspiracy which involved three separate DME companies: P & A Medical, ROS Medical and Denis Medical Services. Nieto and Moreno were co-owners of the other two DME companies. All three of them pleaded guilty and were sentenced to time in the federal pokey: Moreno 18 months, Nieto 24 months and Soto 37 months.

The evidence at trial demonstrated that Guerrero established the corporation in her name, opened a bank account as the sole signatory, applied for all state and federal licenses and signed the Medicare Supplier Application so as to obtain a provider number. She worked at the office in a warehouse district daily from 8 am to 12 noon.

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March 1, 2008

ACFE Healthcare Fraud Seminar Orlando March 24-25, 2008

HCF-Orlando-thumb%20%282%29.jpgHealthcare Fraud Blog publisher, Robert David Malove, will attend the ACFE Healthcare Fraud Seminar Orlando March 24-25, 2008.

CEO Magazine reports that healthcare costs are within the top three business concerns, and for good reason: U.S. healthcare spending has increased from a mere $27 billion in 1960 to $2 trillion in 2005. That is a 7,100 percent increase in spending! Employers today face many unique regulations, systems, procedures and records, with the potential for fraudulent activity at a heightened level. Fraud fighters need an improved understanding of these staggering numbers and the types of healthcare fraud that may occur. This two-day, instructor-led course is designed for anti-fraud and audit professionals who work in the payer, provider, vendor and employer benefit areas or advise clients who operate within the healthcare continuum. Get the targeted training you need to keep up with the latest fraud schemes and related laws affecting this highly complex profession.

For more info, please visit http://www.ACFE.com

February 14, 2008

Ben Kuehne Had No Motive Or Financial Incentive To Launder Money For Ochoa’s Attorney’s And Exclusive Beneficiaries, Especially Roy Black

By Benson Weintraub, Esquire, Fort Lauderdale February 14, 2008

Headshot.jpgBen Kuehne was my law partner for 5+ years during the 1980'-1990's (Sonnett…Kuehne) and he mentored me since 1983 when I served as his 'associate' at the predecessor firm, Bierman, Sonnett, Shohat et. al.

I served as a full-time Visiting Professor of Law in 2005, after which I resumed private practice, now largely in the corporate compliance field (invariably circuitous to white collar criminal defense representation, particularly in the health care industry.).

Ben Kuehne is clearly a 'lawyer's lawyer' who instilled in me the highest appreciation of academic excellence in the practice of federal law. More critically, Ben sensitized me to the distinct ethical dilemmas presented institutionally to criminal defense counsel and ALWAYS taught me (AND CONTINUOUSLY REINFORCES THE NEED) to uphold and exceed our profession's highest ethical/legal standards.

Practicing criminal law in the federal courts places these dedicated, tenacious professionals in legal jeopardy merely by discharging their duties oaths, and obligations to the Sixth Amendment of the US Constitution, coextensively with duties to the courts and clients.

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January 28, 2008

Prof. Benson Weintraub to Present "Defense of a Criminal Healthcare Fraud Case" at Health Care Compliance Association's 12th Annual Compliance Institute

Professor Benson Weintraub, Esquire, a Ft. Lauderdale-based global health care attorney and counselor with an international practice and clientele, and a distinguished academic authority on the Federal sentencing of corporations and individuals, has been invited to present "Defense of a Criminal Healthcare Fraud Case" at Health Care Compliance Association's (HCCA) 12th Annual Compliance Institute to be held in New Orleans April 13-16, 2008.

Weintraub has served as a full-time Professor of Law. During his legal career, Porf. Weintraub has successfully represented complex white collar targets, corporations, business entities, executives, defendants, and witnesses as a tenacious, exclusively federal white collar criminal defense lawyer for more than 25 years.

Among his credits has defended more than 60 Physicians, Health Care Delivery Corporations & Organizations, DME Distributors, Internet Pharmacies, Pharmacists, Pharmaceutical Manufacturers, and public officials on hospital regulatory boards throughout the nation.

He also represented David Paul in the failed CenTrust Bank case as well as reputed drug lords, Willie Falcon and Salvador Magluta.

Weintraub recently represented Arne Soreide, a high profile telecom executive convicted after trial (by other counsel) in Fort Lauderdale of a $22m fraud, successfully convincing the U.S. Court of Appeals for the Eleventh Circuit in Atlanta that his 25 year sentence of imprisonment must be reversed, which the appellate court conceded was improper.

Weintraub was appointed by the first Chairman of the US Sentencing Commission to assist the fledgling agency in drafting its initial sentencing guidelines for organizations and individuals.

His extensive academic writing has been widely published or cited in Yale L.J., Harvard Law Review, Federal Sentencing Reporter, Stanford Journal of Law & Policy, Notre Dame Law Review, Federal Probation (US Courts), etc., and health care blogs.

Florida Board Certified Criminal Trial Lawyer Robert David Malove is Of Counsel to Benson Weintraub, LLC, upon whom a Masters Degree in Forensic Science, was conferred on Malove by the distinguished George Washington University in Washington DC. Malove received his JD from Pepperdine University School of Law. He has completed the Graduate Certificate Program in Healthcare Corporate Compliance at George Washington University and is Certified in Healthcare Compliance (CHC) by the Compliance Certification Board of HCCA. For more information visit www.healthcarefraudblog.com.

January 23, 2008

Medicare Fraud Defendant Sentenced in Florida

548707_barbed_wire__2.jpgOn January 10, Cesar Romero was sentenced by U.S. District Court Judge Patricia A. Seitz to forty-six months in jail and remanded into immediate custody for his role in a multi-million dollar Medicare billing fraud scheme on which Romero previously had pled guilty. Romero faced a potential sentence range of 46 to 57 months in prison, but was sentenced to the low-end of the advisory guidelines' sentencing range called for under an Adjusted Offense Level of 23. Romero's counsel disputed the 2-level upward departure from the base offense level of 21 with a lower advisory sentencing range of 37 to 46 months incarceration.

253463_iv_drip_-_intravenous_therapy.jpgRomero took part in a scheme in which a phantom health clinic, named “The Real Group & Associates, Inc.,” was incorporated in South Florida and subsequently billed Medicare for reimbursement for non-existent drug infusion and injection therapies typically prescribed to AIDS and chemotherapy patients. Nearly $17 million of false claims were submitted to Medicare for reimbursement, resulting in payments of more than $2.5 million on the false claims. To date, law enforcement has recovered more than $1.6 million of the fraud proceeds. At sentencing, Romero was held responsible, in part, for recruiting and managing the straw owner of the clinic, and for the creation and control of the clinic’s corporate bank accounts that were used to transfer and disburse the Medicare fraud proceeds through a series of fraudulent financial transactions.

If you or someone you know has been charged with healthcare fraud or is under investigation, call attorney Robert Malove.

January 14, 2008

Former St. Elizabeths Hospital Chief Pharmacist Pleads Guilty

On January 9, 2008, U.S. Attorney for the District of Columbia Jeffrey A. Taylor announced that Raymond Jackson, former Chief Pharmacist at St. Elizabeths Hospital, pleaded guilty to stealing $95,000 of medication from the hospital. Taylor waived his right to be be indicted by a federal grand jury and instead entered a plea agreement a one count information charging him with theft or embezzlement in connection with health care in violation of Title 18, U.S. Code, Section 669.606632_pills_pills_pills_3.jpg

Jackson, 48, of Ashford Drive, Waldorf, Maryland, will face up to ten years of incarceration when he is sentenced by the Honorable Emmet G. Sullivan on May 2, 2008. Under the federal sentencing guidelines, the advisory sentence Jackson faces is between 24 and 30 months in prison. The guidelines' recommended sentence sentence takes into consideration specific offense characteristics including a loss in excess of $200,000 and abuse of position of trust. Jackson will be ordered to pay restitution of $95,000 to St. Elizabeths and $140,882 to Kaiser Foundation Health Care Plan.

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