Articles Posted in Medicare Fraud

BATON ROUGE, La. (AP – Karen Rayburn, a 47-year-old Baton Rouge woman, who worked as a patient recruiter for several Louisiana durable medical equipment (DME) companies has been sentenced to 18 months in prison for her role in a Medicare fraud scheme. Rayburn pleaded guilty to one count of conspiracy to commit health care fraud In January.

The companies linked to the scheme allegedly submitted more than $21 million in bogus Medicare claims. Prosecutors say bogus prescriptions for leg braces, wheel chairs and other equipment that Rayburn obtained were used to submit fraudulent claims to the Medicare program.

The United States Probation office conducted a Pre-Sentence Investigation and determined that Rayburn’s advisory guidelines offense level was 23 with a criminal history category of I. Her advisory guideline imprisonment range is 46 to 57 months.

From the Miami Herald Blog:
Medicare fraud bill reintroduced U.S. Rep. Ileana Ros-Lehtinen, R-Miami, has reintroduced legislation that would double the fines and jail time for people convicted of Medicare fraud. It also creates a new criminal offense punishable with a 10 year minimum sentence for those who knowingly sell or distribute the ID numbers of Medicare beneficiaries. The legislation also bars those who have been part of Medicare fraud in the past from billing Medicare if they switch companies. It also facilitates real-time information sharing among law enforcement agencies to aid in uncovering and dismantling Medicare scams. “South Florida has been known as the epicenter of Medicare fraud for years,” she said. “It is time we took the fight to those who seek to defraud Medicare and prey on our most vulnerable citizens. This bill not only increases the penalties for those who engage in Medicare fraud, but also sets up a pro-active paradigm that will help stem the tide of abuse in South Florida and across the nation.” The bill takes particular aim at Medicare theft in Miami-Dade County, widely regarded as the nation’s capital of healthcare fraud. Medicare fraud in South Florida costs taxpayers between $3 billion and $4 billion every year, according to law enforcement and healthcare officials. Nationwide, Medicare and other healthcare fraud is estimated to cost $68 billion annually.

Read more here: http://miamiherald.typepad.com/nakedpolitics/2011/12/medicare-fraud-bill-reintroduced.html#storylink=cpy

BY JOSEPH MARKS 12/20/2011

Medicare officials should better evaluate whether a new system designed to spot fraudulent claims and roll back the program’s roughly $50 billion in annual improper payments is living up to its potential, a bipartisan group of senators said Tuesday.

The Centers for Medicare and Medicaid Service responded that it had been measuring results from the $100 million system since soon after its July launch and would update Congress on the results soon.

Diakon agrees to pay federal government $10.5 million

Diakon Hospice Saint John, which operates hospice care at facilities in Hazleton, Allentown, and Wyomissing, has agreed to resolve its liability for violations of the False Claims Act by paying the United States $10.56 million.

The announcement was made today by the United States Attorney’s Office for the Middle District of Pennsylvania and the U.S. Department of Health and Human Services‘ Office of the Inspector General.

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Operators of South Florida assisted-living facilities and halfway houses charged in one of the nation’s biggest Medicare fraud cases are rushing to plead guilty rather than face risky trials and long prison sentences.

Six defendants are now looking at shorter federal sentences because of their plea agreements.

And a seventh defendant, Joseph B. Williams, 41, who ran an assisted-living facility in Pompano Beach, plans to plead guilty next week to defrauding the taxpayer-funded Medicare program, court records show.

BATON ROUGE, La. — Four Louisiana physicians wrote hundreds of bogus prescriptions that powered multimillion-dollar health-care frauds in the Baton Rouge area, according to evidence amassed by the nearly two-year-old local Medicare Fraud Strike Force.

Yet all four physicians remain licensed to practice medicine, including two who pleaded guilty and a third convicted at a jury trial in August. The fourth doctor, who had previous probations of his license, is fighting the charges in his indictment.

In a similar case that dates from before creation of the Strike Force, the Advocate reports (http://bit.ly/uTiKlA ) a Louisiana physician in 2009 retained his medical license even though he was convicted of health care fraud.

The article below illustrates why having excellent legal defense for Medicare and Healthcare Fraud is so important. If you have been accused of Medicare, Medicaid, or Healthcare Fraud, contact Robert Malove for a free consultation.

954-861-0384

From the Miami Herald, Nov 13, 2011