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.
Smith’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.
]]> Schock's defense held together. Schock presented a case that raised a reasonable doubt about the government's case. While Schock admitted that he was the owner, although held a minority share and performed services to the pharmacy, he delegated work to his co-defendant, and he did not have the requisite intent to defraud the United States.The government through the introduction of 404 evidence established that Smith had engaged in healthcare fraud in other cases. The jury heard evidence that Smith owned and operated another company, Orthotics Fitters, through which he was billing the Medicare program for the same equipment being billed through Medstar. During 2006, Smith caused Orthotics Fitters to bill approximately $2.9 million in fraudulent claims for negative pressure wound pumps and wound care supplies that were never actually provided to Medicare beneficiaries.
The jury heard testimony from patients whose names were used by Smith’s Medstar pharmacy to bill the Medicare program for durable medical equipment. The patients testified that they never received any equipment from Medstar and did not have a medical need for the equipment. The jury also heard testimony from several doctors who allegedly wrote prescriptions for the equipment being billed by Medstar. These doctors testified that they never wrote the prescriptions in question and never prescribed the types of equipment being billed by Medstar.
Schock argued that he was unaware of Smith's prior dealings and knew nothing of the false submissions. Schock also argued that although he signed the Medicare forms he was unaware of the consequences and was betrayed by trusted his friend, Smith.
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Check 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.
On 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.]]>
In addition to the prison sentence, Campos will be placed on three years of supervised release following her release from prison; forfeit $207,000, her three homes and an automobile; and pay $105 million in restitution to the U.S. Department of Health and Human Services. According to court records, Campos' attorney argued for leniency claiming that Campos cooperated with federal agents and placed herself in personal danger in helping further the investigation . However, U.S. District Court Judge Alan S. Gold was apparently unpersuaded. It is unknown whether Campos will receive any future reduction in sentence pursuant to Section 5K1.1 of the United States Sentencing Guidelines. Section 5K1.1 authorizes the government to file a motion asking the court to reduce a prisoner's sentence based upon the nature and extent of their cooperation.
Seven 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.
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.
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.
Upon her arrest on August 31, 2007, Yeleiny Guerrero told the FBI that she met Ramon Soto when she was taking care of his child at a child care center where she worked. She and her husband became friendly with Soto and his wife, and they offered to set her up in a business. Soto would finance the company, and they would split the profits 70/30 in his favor. However, nothing could be in his name because he already owned other companies, and he would not be able to obtain a license or provider number. During the course of her employment from March 2006 to March 2007, she was paid $200 per week, until they began receiving checks from Medicare. From March 2007 until June 2007, Yeleiny Guerrero signed blank checks for Soto, which represented the bulk of the $181,000 which were made payable to her.
Healthcare Fraud Blog publisher, Robert David Malove, will attend the ACFE Healthcare Fraud Seminar Orlando March 24-25, 2008.
Ben 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.
On 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.
Romero 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.
has successfully completed the Certified in Healthcare Compliance Examination, thus earning the "CHC" designation.
