Alleged Armenian Crime Ring Arrested For Defrauding Medicare For $35.7 MillionThe Los Angeles Times: More than two dozen Los Angeles-area residents were arrested Wednesday "for their alleged roles in a nationwide scheme to bilk Medicare out of more than $160 million." "The investigation, dubbed Diagnosis Dollars, resulted in the arrests of 52 people across the U.S. in what authorities described as 'the largest Medicare fraud scheme ever perpetrated by a single criminal enterprise.'" Most of the defendants are purportedly part of the organized crime group Mirzoyan-Terdjanian, and allegedly "stole doctors' identities," "used the information to enroll the phantom physicians as providers in Medicare," and "set up bogus offices and, using stolen beneficiary information, began billing for procedures that never occurred" (Glover, 10/14).
The Wall Street Journal http://online.wsj.com/article/SB10001424052748703673604575550002841068546.html?KEYWORDS=insurance: "Members of the group, based in New York and Los Angeles, were taken into custody as part of a nationwide Medicare fraud sweep that resulted in charges in California, Ohio, New Mexico and Georgia." Authorities say participants submitted to Medicare "more than $100 million in concocted bills" beginning at least as early as 2006, though they obtained only $35.7 million in improper payments." Many of the 118 nonexistent clinics they are charged with setting up were nothing more than a post office box (Rothfeld, 10/14).
The New York Times http://www.nytimes.com/2010/10/14/nyregion/14fraud.html?_r=1: "Most of the fake claims were traditional. The hard-to-believe exams like the dermatologist's heart test were the exception, and raised flags at Medicare. But often, the claim had already been paid." "Charges included racketeering, health care fraud, identity theft, money laundering and bank fraud." The defendants took advantage of a system that is inherently vulnerable due to its emphasis on timely payments, said Preet Bharara, the U.S. attorney in Manhattan (Wilson and Rashbaum, 10/13).
The New York Post http://www.nypost.com/p/news/local/mediscam_9QQ5NRf3pvykHFF0fecg2I: "Those charged in New York include reputed crime boss Armen Kazarian, who holds the title of "vor," which authorities said is similar to a Mafia godfather" (Golding, 10/14).
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.