Health Care Fraud Blog

According to an article in the South Florida Sun-Sentinel, at least 45 pain clinics opened in Broward and Palm Beach counties in the past year, while state law makers and state and local law enforcement agencies stepped-up their efforts to put an end to the operation suspected “pill mills.”

In August 2008, 66 pain clinics were open for business in Broward and Palm Beach counties combined. The Sun-Sentinel article reports that according to data available from the Florida Department of Health, the number centers issuing narcotic pain medications currently is more than the times what it was in August 2008 - with 122 in Broward to 122 and in Palm Beach County to 108.

Pain clinics “are proliferating despite our efforts," Broward Sheriff Al Lamberti said last week, after state and federal agents executed search warrants at three pain clinics owned or controlled by Christopher and Jeffrey George in Palm Beach County. The Georges' homes were also searched.

No arrests have been made yet, however, a federal law law suit has been filed in U.S. District Court in West Palm Beach. According to the law suit, three of the Georges’ clinics collected $14 million last year and dispensed more than 2.1 million pills. [To read the law suit, click: here.] Additionally, five doctors who worked at the clinics have had their DEA numbers to prescribe pain medications suspended. The doctors can either voluntarily agree to the suspension or can challenge the suspension before a DEA Administrative Law Judge at a hearing scheduled for May.

Independent sources close to the investigation indicate that patient files were properly documented, regular MRI's were required and prescriptions that issued were 100% medically necessary. From time to time, patients who were suspected of phony symptom ology were discovered, refused treatment and escorted off the premises. If you or someone you know has ever suffered from debilitating pain, then no one has to tell you that life can be pure hell without taking pain medication just to get through the day and attempting to perform even the simplest of tasks. The real tragedy in the "gung-ho, rah, rah" attitude of law enforcement targeting pain clinics, is that the overwhelming majority of patients have well-documented injuries requiring pain medication for treatment. These legitimate pain sufferers are the forgotten "victims" who unfortunately wind up as unintended by-product caught in the overreaching net of law enforcement, much like innocent dolphins caught in the nets of profit-driven commercial fisherman.

Palm Beach County and several cities in both counties have temporarily banned new pain clincs, reported by the HCFB here and here. "Palm Beach County is ahead of us [in law enforcement efforts aimed at detecting criminal activities at pain clinics]. We're [Broward County is] trying to play catch up now," Lamberti said. "On the street, [there are] too many targets, not enough deputies. We're really trying to be hard on it because it causes crime in the community. We think they know we are serious."

To read the Sun-Sentinel article, click here.

Federal officials in charge of preventing fraud in the billion-dollar Medicare program ignored dozens of warnings of criminal activity during the Bush administration, according to investigations by the Associated Press and U.S. Senator Charles Grassley’s (R-IA) office.

CMS received about 30 tips over more than three-years reporting scams, but less than half of them got any attention. Organized crime groups have realized it is much easier and less dangerous to steal millions from the Medicare without as opposed to traditional criminal enterprises like prostitution, gambling or dope dealing.

Southern California is one that has been particularly hard hit area for Medicare fraud, where Russian, Armenian and Nigerian mafias are under investigation by federal agents. Konstantin Grigoryan, a former Soviet army colonel turned crime boss, recently pled guilty to taking $20 million from Medicare. Click here to watch a CNN report including undercover surveillance video.

MIAMI, FL (September 29, 2009) Defendant Daniel Martinez, of Davie, Florida, was sentenced for his participation in a $20 million health care fraud and money laundering scheme. U.S. District Judge Paul C. Huck sentenced Martinez to a total of a 150 months' imprisonment followed by an additional 18 months of home confinement. For more: Click here.

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.

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.

Continue reading "Miami Pharmacy Owner of Convicted of Medicare Fraud, Co-defendant Acquitted" »

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.

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

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.

Continue reading "Two Florida Men Sentenced for Healthcare Fraud & Money Laundering" »

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

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.

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