Criminal Division of Justice Department in the state of California, pressed charges, owing to deceitful health care enactment, against 26 individuals including 14 certified health care professionals, for conspiring a total sum of $257 Million. Along with the 26 accused persons in the Central District of California, eight other inductees were named in Arizona and Oregon State for charges of counterfeit Medicaid billing more than a million dollars- announced Assistant Attorney General of Criminal Division, Brian A. Benczkowski.
While Medicaid Fraud Control Unit (MFCU) of each particular state supervises the legal enactments against the pressed charges, MFCU’s criminal division office teamed up with Medicare Fraud Strike Force (MFSF), US attorney office, DEA, FBI, HHS and various other state and federal units due to the vast and widespread nature of the fraud.
The organized schemes targeted mostly the medical bills, causing the health care insurance companies to cover unjust prescription bills in favor of the unethical individuals and Medical experts. According to the crime’s focal point, attorneys are performing extensive research on the genuineness of the covered medical bills for both Medicare and Medicaid facilities. The research data is gathered by testing sensitive information and prescription’s prerequisites, to determine whether prescribed to address a health alignment or for personal and unlawful advantages.
On behalf of the Criminal Division of the Justice Department, Deputy Assistant attorney General Brian A. Benczkowski, indicated the day-to-day enhancement of the technology and intelligence at the service of health care fraud control. He also added that the Division Department is committed to control and stop any fraud and protect the citizens from health endangerment and financial loss due to the voracity of a few.
U.S. Attorney, Nick Hanna at the Central district of California, expressed his concerns for the financial corruption aspects for public and insurance entities, including Medicare and Medicaid of the alleged cases. He also included the fact that several agencies and state and federal agents are in relentless search to determine any individuals involved in the scheme such as health care professionals, or as Attorney Hanna put it, anyone, who tries to “bilk our nation’s health care system.”
Timothy B. DeFrancesca, Special Agent of Health and Human Services, condemned the unlawful billing for prescriptions and financial health care coverage by insurance companies. He reminded that such undertakings would not be tolerated, and mentioned that the U. S Health and Human Service office has joined other state and federal authorized agencies, dedicated to refrain the medical health care system’s integrity and immaculate, with an unrelenting pursuit.
The FBI office in the Los Angeles Field office showed concerns regarding American taxpayer citizens and Health care insurance entities subject to fraudulent health care. Paul D. Delacourt, the Assistant Director of Los Angeles FBI, estimated the harms caused by the health care schemes to be over millions of dollars and announced the cooperative synchronicity of FBI and other federal agencies such as DEA in order to encounter the health and medical care related activities.
Whereas numerous government divisions are committed to the cause of medical care fraud prevention, there is an outlook of the entire exposed aspects to the counterfeit; Attorney General Xavier Becerra stated the concentration of California Department of Justice on vulnerable groups by a continuance to assist other federal agencies to stop and control the misconducts, and pinpoint deceivers and seek merited accountability for those in question.
Contemplating the adverse effects of such schemes on Employees from the U.S. Department of Labor’s Employee Benefits Security is highlighted by Crisanta Johnson, the Regional Director in Los Angeles, denoting the frailty of Health care plans with deceitful intentions through ploy and schemes. She also avowed that according to stand for the merit of affected individuals and victimized health care units by taking instant and assertive action against unprincipled and accountable individuals.
The following paragraphs discuss the alleged cases in Strike Force involving in Medical scare service fraud in the Central District of California:
Internal Medicine Specialist Ronald Weaver of Pacific Palisades California, Founder of Global Cardio Care in Santa Monica Sara Soulati, Internist Specialist of Alhambra John Weaver, Cardiologist in Pacific Palisades Dr. Ronald Carlish, a cardiovascular specialist in Whittier, Dr. Howard Elkin, cardiologist in L.A Dr. Wolfgang Scheele, Huntington Beach internal medicine Nagesh Shetty, unanimously conspired a scheme of 135 million dollars approximately. Most of the fraudulent medical services comprise a long list of redundant cardiac medications and treatment by Global Cardio Care in Inglewood. Counsels for the prosecutions are Attorneys Emily Z. Culbertson and Alexandra Michael under the authorization of the Fraud Section of the Criminal Division.
Other defendants are Antonio Olivera and Emelita Cephass in Downey, and Martin Canter in Rancho Palos Verdes were alleged for illegal participation in Anti-Kickback Statutes. Antonio Olivera is associated with Medicare Fraud and hence charges with further allegations due to his illicit grouping with Mhiramarc Management LLC Clinic in Downey. The clinic’s owner, John O’Brien, was accused of having the right direction with conspiring fraud and was charged with a separate lawsuit. Attorney Justin P. Givens oversees the pressed accusations with respect to the Fraud Section.
The following paragraphs discuss the several allegations by U.S Attorney Office involving in fraudulent health service in the central District of California:
Doctor and owner of Fusion Rx Compounding Pharmacy, Navid Vahedi, and pharmaceutical marketer Joseph S. Kieffer in Los Angeles, California, were accused of illegitimate activities and participation in Anti-Kickback Conspiracies. As indicated by the name, Fusion Rx Compounding Pharmacy, manufactured compounded medicines and prescriptions that required pharmaceutical preparation before use. This accordance usually takes place only if the Doctor decides that the FDA approved equivalent medications are not suitable or helpful to the patient’s condition. Vahedi and Kieffer, as operator and marketer respectively, scammed the health care insurance companies by conspiring unnecessary prescriptions by bribing pharmaceutical marketers and some patients. Alongside unnecessary medication compounding, most of the prescriptions were priced much higher than the actual rates. While thriving to run their con business to further extents, Fusion Rx illicitly avoided to propose copay to the pharmacy’s customers. However, to distract the customers from their right to have a copayment, Rx Pharmacy’s employees were instructed to create confusion by using gift cards. This way, the patients would assume the necessary company is created. Through the period of the illegal conduct of this particular pharmacy, a proximate of $17 million financial losses to medical care providers resulted in extravagant expenses made by the accountable professionals. The alleged network of Vahedi included Joshua Pearson, based in St. George, Utah. He assisted the accused staff of Fusion Rx pharmacy by directing patients for their high-cost compound medications. Due to the complicity of the case, Assistant U.S attorneys of Major fraud section, Ashwin Janakiram and Alexander Schwab, and Assistant attorneys of Asset Forfeiture Section, Jonathan Galatzan.
A certified anesthesiologist in Calabasas, Amir Friedman, is another faulted of fraud in mail services. He was accused on the accounts of dishonest conduct in mail service ethics, wire fraud, and Travel Act defilements that resulted in a financial cost with approximate $800,000 in anti-kickback conspiracies, in particular with New Age pharmaceutical Inc. compound medications, in Beverly Hills. Attorney Ashwin Janakiram, in favor of fraud sections, handles these indictments.
A specialized spine chiropractor in Dana Point, Dr. Susan H. Poon, was traced with illegal participation with Blue Cross Blue Shield Association in various locations, resulting in nearly $2 Million fraudulent scheme. Federal agents discovered that Dr. Poon provided false reports on services, visits, and medical advice that, in reality, had not taken place. Dr. Poon was also charged with fraud in the field of costly medical equipment in a series of fabricated claims. Other entities, which participated in the alleged activities of this case were United Parcel Service and Costco Wholesale Corporation and numerous employees and involved individuals. Assistant attorney Daniel S. Lim of Santa Ana oversees the allegations of Dr. Poon’s case.
Dr. Mahyar David Yadidi, another practiced chiropractor in southern California, was found in direct link with conspiracy of fraudulent schemes against medical coverage plans of Pacific Maritime Association. Dr. Yadidi operated a chiropractic clinic, known as San Pedro Chiropractic, through which he was able to perform his scheme to take advantage of the mentioned health plans. He proposed alleged participation to the patients for both appearing at the clinic and getting billed for untruthful billings. The alleged medical bills covered unnecessary medications, unauthorized services, or non-existent assistance. Dr. Yadidi misused his authority as a formal representative of the Pacific Maritime Association. Ivan Semerdjiev and Julian Williams were together employers of Dr. Yadidi and involved with conspiring alleged claims with over $5 million financial loss. Alex Wyman, the US Assistant Attorney, superintends the schemes associated with this legal dispute.
Darren Hines, another noted chiropractor, used a fraudulent scheme against ILWU-PMA Plan or International Longshore and Warehouse Union – Pacific Maritime Association in south California. While defiling the ethical aspect of his status as a certified health care professional, Dr. Hines drafted several false claims in means of personal advantage in the Advance Alternative Health Clinic. Untruthful service listings, the unauthorized employee provided services and unnecessary services charged, were the claims Dr. Hines made to scam the health care benefits of ILWU-PMA. Through a short span of time, the doctor in question claimed for over $500,000 from the respective health care providers. Attorney Alex Wyman is indicting the case of the Advanced Alternative Health Clinic scheme.
According to the law, all the accused individuals are considered blameless until the opposite is proven through adequate evidence.
The authorized agencies of federal and state units are conjugated to take an aggressive stand against fraud and protect the citizen’s merit. MFSF or Medicare Fraud Strike Force, HHS, department of justice office, FBI, and DEA all are committed to the cause of lawful enforcement of anti-fraud undertakings. MFSF, on its own routes, has a network of 15 potent strike forces. More than 4000 individuals with a legal dispute of $14 billion have been held accountable for their fraudulent acts in 24 districts of administration. HHS offices for Medicare and Medicaid health plans are leading the way to filter the corrupted individuals in the system and hence improve the authenticity of the health care systems.
Fraudulent billing and falsified claims focus on advantage seeking from Medicaid and Medicare Programs, along with private insurance companies and other government medical support groups. These undertakings are illegal and must be reported immediately. If you know anyone who has suffered fraudulent Medicare billings, or is allegedly accused of involvement, you are duty bound to share this info with your local law enactment agencies. In case of failing to meet these requirements, you may be charged with Qui Tam Lawsuit, as an associate to the crime.
The Healthcare Fraud Group advises and represents our clients concerning any Violation of medical care systems, whether as a patient or a deceptively alleged medical professional. Our experienced defense attorneys, with decades of field practice in Medical Audits and Fraudulent health care investigations, have successfully defended the right and honor of our clients. By calling our hotlines at 888-402-4054, you can speak to our reputable defense lawyers and seek immediate advice.
