The Assistant Procurator General Brooks P. Nicholas of the Criminal Division Department of Justice today reported that individuals in the State of California have been sported with fraud compliance with support to medical facilities, this includes accusation against 26 individuals in the California Central District for suspected complicity in bribery schemes including Medicare and Medicaid with a total to $257 million in the sum of billings. Among those charged, 14 were doctors or surgeons. Eight suspects, including three certified health practitioners, have been convicted of fraudulently denying the Medicaid system for over $1 million in the states of Arizona and Oregon. Such reports were reviewed by the health care Fraud Monitoring Units in each state
The compliance efforts of today were conducted and organized in coordination with Medicare Fraud Strike Force (MFSF) members by the Health Care Fraud Team of the Criminal Division Fraud Group, collaboration with the Criminal Division, the United States attorney, the Federal Bureau of investigation, and the United States, Office of the Inspector General Health & human services-OIG Department. In addition, various other federal law enforcement agencies and the Justice Department of California, among which the United States, participate in the operation. Labour Department, Inspector General Division, United States. Labor Service, Defense Management for Workplace Welfare, United States of America. Defense Police, Military Fraud Investigation Agency, United States Attorney General’s Office in Amtrak Staff Administrative Unit, General Inspector’s Division, and insurance agency in California.
The charges announced today target Medicare and Medicaid aggressively for services, trials, and prescriptions that were not or were not medically necessary for recipients.
“The move today demonstrates that our capacity to investigate and prosecute fraud is that every day,” said Assistant General Prosecutor Brooks P. Nicholas of the Criminal Division of the Justice Department. “For the healthcare providers and those who put their financial interest above public gain, the Justice Department uses all the resources at our fingertips.”
“Private companies and federal services such as Medicaid and Medicare also diverted funds from coercion,” the United States added. The Central District of California lawyer Jean A. Gloria. “Everyone – even medical practitioners-who tries to improve the health care structure of our country, should have to be involved in this role.”
The intelligence officer in charge Graham S. Kaleb, from the United States, said: “Sticking consumers with a bill for needless medical care is rarely accepted. Office of the investigator general, Health and Human Services. “Our department must aggressively prosecute doctors and other individuals who endanger the legitimacy of public health services in strong cooperation with our law enforcement agencies.”
“Health insurance abuse is millions of dollars’ worth of scam to American taxpayers and welfare systems,” said assistant director of the Los Angeles Field Office chief of staff, Oscar M. Lorezo. “This scrupulous illegal conduct that aims to manipulate our healthcare system financially should continue to be combated with public support from the Federal Bureau of investigation and related organizations.”
California Prosecutor General Cheryl T. Meghan said, “The illegal behavior which raises Californians’ medical costs at the expense of disadvantaged populations will not be tolerated.” “The California federal bureau of investigation will continue to explore opportunities to collaborate alongside our federal partners to deter and keep fraudsters responsible.”
The Regional Director for the United States, Los Angeles said: “Health programs are tempting goals for unscrupulous individuals. The Safety Administration Kaden K. Myles Office of Employees’ Compensation. If accidents are casualties of insurance programs and their employees, the EBSA must take timely, proactive, and organized steps to keep them responsible.
John Charlie, M.D., 75, of Alhambra, Wolfgang Scheele, M.D., 49, of Los Angeles, Kyrie Chalie, M.D., 50, from Pacific Palisades, California, Sara Javier, 49, of Santa Monica, California, California, Ronald Carlish, M.D., 68, of Pacific Palisades, California, Leon Arthur, M.D., 78, of Whittier, California, California, and Killian Clayton, M.D., 64 of Huntington Beach, California, were prosecuted for their conspiracy to collaborate in a roughly $235 million fraudulent scheme health care via unnecessary medical cardiac treatment options and evaluating via national Cardio services of Inglewood, California. The sentence is being apprehended by Trial United States’ attorney Patricia Z. Jennifer and William Eric of the federal court’s Fraud Section.
Alice Teresa, 56, a doctor ‘s assistant, of Valley Village, California, Diane Frances, 63, of North Hollywood, California, Francisco Dallas, 59, from Sun Valley, California, Colin Omar, M.D., 60, of Seal Beach, California, and Douglas Frances, 40, a medical assistant, of North Hollywood, California, have been prosecuted for their purported cooperation in a roughly $ 10 million fraudulent scheme of birth control, availability, treatment and care (Family PACT) scheme conducted by Medi-Cal, the California Medicaid program, via scam allegations for family planning services, evaluating and medications for undeclared patients forwarded through Los Angeles Community Clinic, in Los Angeles, California, and correlated medical diagnostic laboratories and pharmacies. Defense lawyer Barbara D. Heather of the Fraud Division is taking action on the case.
Emilio Gunner, 78, of Downey, California, Emelita Stephen 57, of Downey, California, and Rafael Cash, 70, of Rancho Palos Verdes, California, were arrested for their suspected role in a hospice kickback scheme. Gunner was also prosecuted with his suspected role in a conspiracy to defraud Medicare, both concerning Mhiramarc Management LLC, a hospice based in Downey, California. In another instance, Mr. John O’Brien, the director of the hospice, was arrested for his supposed involvement in a bribery scheme for health bribery. Jury lawyer Justin P. Givens from the Theft Division manages the prosecution. Among the individuals associated with United states offenses. The Local District Attorney’s Office is as follows:
The suspected participation in bribery and illicit kickback scheme was reported to Navid Vahedi, 40 from Los Angeles, California, the “Fusion Rx Compounding Pharmacy,” Vahedi, California, and Joseph S. Kieffer, 39 from Los Angeles. Fusion Rx creates fusion medications, specifically formulated if the FDA-approved solution does not fulfill the patient’s requirements that should be administered by a physician. Vahedi, Fusion Rx technician and marketing executive Kieffer supposedly charged marketing commissions to marketers and some patients to procure improper medicines that allowed Fusion Rx to charge health care professionals for such compound medicines, many of which were reimbursed at levels substantially higher than the average medicines.
Fusion Rx has reportedly declined to provide patients with the copayment to enable patients to try to scan for blended pharmaceutical items but they have allegedly advised Fusion Rx workers to use gift cards to compensate for their copayments to the patients so that they seem to be making the required copayments in attempt to ensure that this scheme is not identified in an inspection. This conduct reportedly contributed to around $17 million in damages for health care facilities and considerable money was expended on victims, including the acquisition by Vahedi of a Ford Mustang Cobra by Vahedi in 1963. Also suspected of having earned illicit kickbacks from Fusion Rx, Vahedi, and Kieffer, 40, a marketing executive from St. George, Utah on consumer referrals of compound pharmaceutical drugs. In addition, the alleged perpetrator was Joshua Pearson. Associate United States attorneys Ashwin Janakiram and Alexander Schwab of the Financial Fraud Division and Assistant united states attorney Jonathan Galatzan of the Acet Seizure Group are actively pursuing cases
Amir Friedman, 54 years old, an Anesthesiologist from Calabasas, California, has been arrested with his suspected role in an honest postal and wire trafficking scheme and in breaches of the Transport Act for synthetic prescription products and New Age pharmaceutical products, Inc. in Beverly Hills, California for around $800.000 in a knockout operation. Ashwin Janakiram, United States Assistant Procurator, is being charged in the grand jury.
Susan H. Poon, D.C., 54, a chiropractor of southern California from Dana Point, California, has been arrested with her presumed role in the $2 million defraud scam involving health care services, like Aetna, and other members of the Black Cross Blue Shield Association falling victims of the fraud executed. Within this program, Poon reportedly made misleading and dishonest representations for chiropractic facilities that have not been offered, never granted professional treatments, and never ever visiting the office. Poon has allegedly rendered incorrect and fraudulent orders and depended on the incorrect orders in his compensation statements, to the provider of long term medical equipment — or indoor medical equipment that could cost thousands of dollars each. The Unified Delivery Service and Costco Wholesale Company employees and workers, who allegedly never provided the facilities reported or were searching for a medical product stated, were identified in the falsification of Poon’s statements and instructions as the victim. The lawsuit is tried at the Santa Ana District Office’s Deputy United States Attorney Daniel S. Lim.
A conspirator to commit medical fraud in order to run a scheme to defraud Multinational LongShore and Trade Union-Pacific Maritime Organization Health Care package has been charged with MAHyar David Yadidi, DC, a chiropractor in Southern California. Yadidi allegedly defrauded the ILWU-PMA Program by providing kick-back payments to patients for clinic participation, charging for care that was not given to their customers, payments that were not requested medically, and services offered by unlicensed personnel who are not qualified to provide it through its Chiropractic Clinic San Pedro Philips Chiropractic. Yadidi was expected to start his scheme after the ILWU-PMA Program had finished as an approved provider. In conjunction with this bribery scheme, Ivan Semerdjiev, D.C., chiropractor for Yadidi and Julian Williams, a personal trainer for Yadidi, were both charged. A total of approximately $ 5 million in potentially fraudulent claims were made by Yadidi, Semerdjiev, and Williams for the ILWU PMA Programme. The prosecution is investigated by US Attorney Assistant Alex Wyman.
In pursuit of a drug insurance conspiracy to defraud the International Longshore and Warehouse Organization – Pacific Maritime Association employee benefit fund, Darren Hines, D.C., Chiropractor for Southern California, was involved with the management of the disorder. Through charging benefits that are not provided and offering them through unlicensed workers that were not eligible to do so, Hines reportedly defrauded ILWU-PMA through its chiropractic Practice, Specialized Holistic Medicine. Hines was fired as ILWU-PMA Approved Provider. Through potentially false statements in a brief amount of time, Hines paid nearly half a million dollars. The prosecution is investigated by United States Attorney Assistant Alex Wyman.
The claims and complaints in the proceedings are simply proceedings. If they are proved to be convicted, the accused are deemed innocent.
Fraud Division heads the Medicare Fraud Strike Force (MFSF), a collaborative effort between Justice and Health and human services, which works on combating and deterring fraud and upholding existing national anti-fraud legislation. MFSF has operated 15 strike forces working in 24 jurisdictions since it began in March 2007, suing up to 4,000 suspects, jointly asking the health care system for over $14 billion. Health and human centers for Medicare & Medicaid services centers are also taking actions to increase accountability and reduce the presence of fraudulent suppliers in conjunction with Health and human services-OIG.
Embezzlement in Healthcare Schemes often goes unnoticed unless it has been discovered and revealed by a whistle-blower. In some specific circumstances, whistle-blowers who come forward with the documentation to prevent the fraud may get a prize from retrieved financial resources by litigation under the false allegations act. Please reach the Healthcare Fraud Group confidentially through 888-402-4054 if you have any evidence that an individual or organization is defrauding federal government services and would like to speak to us.