KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Feds Crack Down On Health Care Fraud In California, Florida

The Sacramento Bee reports: "Three Sacramento-area residents are among 11 people, including five doctors, accused of participating in a Medicare fraud ring. ... From February 2006 through August 2008, the defendants are alleged to have operated three health-care clinics -- in Sacramento, Carmichael and Richmond -- that submitted more than $5 million in allegedly fraudulent claims to Medicare" (Locke, 5/25).

Modern Healthcare on the same case: "Clinic employees allegedly hired recruiters, or 'cappers,' to deliver patients, who were paid $100 for their trouble and their Medicare numbers. The phony billings, according to the indictment, included physical therapy and sleep studies never performed, as well as blood draws and ultrasound exams that employees performed on themselves and one another. The only licensed physician to see any of the patients was [Dr. Sol] Teitelbaum, who was not enrolled as a Medicare provider, the indictment alleges. The leader of the alleged conspiracy was Vardges Egiazarian, who pleaded guilty last year and was sentenced to spend 6½ years in prison and pay $1.5 million restitution" (Blesch, 5/25).

Fresno Business Journal: "A Fresno woman convicted in a scam to sell unnecessary power wheelchairs to unwitting victims was sentenced to 12 months in prison for her participation in the nearly $1-million scheme. ... The evidence at trial showed that [Maria Nelo] Moreno recruited Medicare beneficiaries for power wheelchairs they did not need at a cost to Medicare of $6,000 per power wheelchair. ... Beneficiaries testified that Moreno tricked them into giving her their Medicare numbers by telling them they should take a power wheelchair because Medicare would soon run out of money and they would not be able to get a chair if they needed one in the future" (5/25).

South Florida Sun Sentinel: "Federal agents arrested the owner and supervising doctor of an Oakland Park pain clinic on Monday, saying he had illegally prescribed tens of thousands of narcotic pills to patients in Kentucky. Lauderhill Medical Clinic, owned and operated by Boca Raton internist Dr. Michael Shook, was so well-known in Kentucky that members of the 'Marsillett II' drug dealing ring told federal drug agents it was their main source of pills."

"In an unrelated case, Fort Lauderdale police said they and Florida Department of Health officials raided their third pain clinic this month" (LaMendola, 5/25).

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