Friday, May 30, 2008

YOu are kidding.......what is this DOJ of DHHS going to do to prevent CORRUPTION???


The U.S. Department of Justice (DoJ) continues its efforts to combat health care fraud and other criminal acts against the health care system by strengthening its overall enforcement.

THIS MIGHT BE ONE OF THE PROBLEMS>>>>>>>LEAVITT LETS LOOK AT THE LEAVITT GROUP IN UTAH!!!! IDIOTS!!!Working closely with the Department of Health and Human Services, the DOJ has guided the enforcement efforts of the national Health Care Fraud and Abuse Control Program (HCFAC) since its inception in 1997. This program was designed to coordinate federal, state and local law enforcement on cases of health care fraud and abuse as part of the Health Insurance Portability and Accountability Act (HIPAA).

According to a fact sheet released by the Department on May 28, last fiscal year claimed the following accomplishments:

U.S. Attorneys' Offices opened 878 new criminal health care fraud investigations involving 1,548 potential defendants.
Federal prosecutors had 1,612 health care fraud criminal investigations pending, involving 2,603 potential defendants, and filed criminal charges in 434 cases involving 786 defendants.
A total of 560 defendants were convicted for health care fraud-related crimes during the year.

The department also highlighted its efforts to combat fraud involving a wide spectrum of health care providers and suppliers including doctors, dentists, hospitals, pharmacies, durable medical equipment providers, home health providers, and pharmaceutical and device manufacturers under the False Claims Acts. This included claims settlements against businesses such as Merck & Company, CVS, and Medtronic.

Don Jackson, director of threat intelligence at SecureWorks, told on Thursday that he thinks that the DoJ is doing a good job overall at catching those who commit fraud against the health care system, but he is concerned that the department's focus was and will likely remain on large, high-profile cases.

“A lot of smaller cases will never see the light of day, even though that's where the biggest problem lies,” Jackson said. “These are the cases that are dealing with individual access and are siphoning off one record.”

Health care breaches and the related crimes are increasing faster than any other type of identity theft crimes, Jackson added.

“Health care is a huge complicated network to begin with,” he said, “and technology enables the opportunities for more access and more opportunities for fraud.”


Who is watching over this enterprise? More one arm bandits controlling the HOME HEATL CARE in this country! OMG!!!
How much frayud will take place or these enterprises be allowed to STEAL RIGHT FROM UNDER OUR NOSES!!

Fully automated electronic fax system jointly developed by Thornberry Limited and SecureCare Technologies.
(Lancaster, PA and Austin, TX – May 20, 2008) Thornberry Limited, developer of home care clinical management software, and SecureCare Technologies (OTCBB: SCUC), a health care information technology company based in Austin, Texas, have partnered to provide what they believe is the home care industry's first, fully-automated electronic fax system.

SecureCare's Sfax™ system will be available to Thornberry customers on June 1, 2008. It eliminates the entire manual physician order fax operation and replaces it with an automated fax system that is integrated within Thornberry's NDoc® clinical management application.

Twin Tier Home Health in Vestal, New York will be the first home health agency to implement the new automated faxing system later this month. SecureCare CEO Dennis Nasto predicts Twin Tier will realize savings of up to 95% in administration time and up to 80% of the cost of manual faxing.

By automating the task of sending and receiving fax-based communications, Sfax™ meets HIPAA guidelines for electronic exchange of patient health information and delivers NDoc® 485 documents without the need to print and manually process. "All Sfax™ transmissions are encrypted and a built-in audit and log trail mean instant access to data in the event of an audit," Nasto said.

(Who is Dennis?)
"When we met Dennis at last October's NAHC meeting, we told him we were interested in a collaboration but did not want to merely write another third-party interface," said Thornberry president Tom Peth. "SecureCare does have agreements with other home care software companies so we made it clear that, If we were going to put in this much effort, we wanted to end up with something that no one else had yet done. I think this tight of an integration between the two products gives us the right to claim we have accomplished that."

According to a cost study conducted by SecureCare, almost 15 billion fax pages are sent, received, printed, signed and re-faxed every year between healthcare providers, greatly increasing costs and reducing efficiency.
Homecare Homebase announces partnership with growing, six-state hospice.
SolAmor Hospice operates out of nine locations in six states, including Oklahoma, Colorado,
Massachusetts, New Mexico, New Hampshire, and Connecticut. SolAmor joined the Sun Healthcare Group family of companies in September 2006.
This week, the organization announced that it has selected Homecare Homebase to provide its software system.

(Glen Cavallo.....hmmmmmmm what a history this one has)
"As our organization continues to grow, we realized the current system would not uphold the level of quality care for which we are known and continue to pursue," said SolAmor president Glen Cavallo. His Oklahoma administrator, Jeffery Holm, agreed, "From an administrators standpoint, we now have the ability to eliminate repetitive, distracting tasks which will significantly increase our time spent attending to our patients and their loved ones."

Dallas-based Homecare Homebase offers a web-based software system running on handheld computers to track volunteer hours, prepare IDT reviews and coordinate the bereavement process. Founded in 1999, Homecare Homebase supports real-time, wireless information exchange, automates workflow processes and provides billing checks and balances to improve accuracy.
Healthcare Automation celebrates 20 years supporting the Home Infusion industry.
Rhode Island-based Healthcare Automation, Inc. (HAI) is marking its 20th anniversary this year as a provider of home care software.

Headquartered in Warwick, RI, HAI was founded in 1988 to address the home infusion therapy industry's need for automation. "Our first product, The I.V. Solution, was developed to meet the need for affordable, comprehensive software systems for both small and complex home infusion providers," recalls HAI CEO and founder, Ken Pereira. The company's inaugural product is currently in use around the world, Pereira added.

Soon after, Pereira added outsourced reimbursement and collections services and regulatory consulting through the Healthcare Automation Reimbursement Center. Pereira brought in Jeanne Lugli, a former client and reimbursement expert who complemented the software offering.

HAI entered the Windows era with HomecareNet in 2002. Rather than convert old data structures and screens, the new product was entirely rewritten in JAVA atop a SQL Server database. After beta testing, it was expanded to support home nursing and home medical equipment functionality.

"We’re incredibly proud of the team we've built and the products we provide to our clients," Pereira concluded. "These first 20 years have given us insight into the industry that we are able to give back every day."

Contact Us | ©2006 Stony Hill Publishing

Thursday, May 29, 2008

FBI reports that Health care fraud ranks among the highest priority investigations within the FBI's white collar crime unit, behind only public corrup

FBI releases annual healthcare fraud statistics and information
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Editor: Mike Bothwell
Profession: Qui Tam Attorney

May 28, 2008

By Julie Keeton Bracker

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The FBI recently published its annual Financial Crimes Report to the Public for the Fiscal Year 2007, showing that health care fraud is of continued concern.

The mission of the Financial Crimes Section (FCS) of the FBI is to oversee the investigation of financial fraud and to facilitate the forfeiture of assets from those engaging in federal crimes. The FCS is divided into three units: the Economic Crimes Unit - I, Economic Crimes Unit - II (formerly Financial Institution Fraud and Asset Forfeiture/Money Laundering Units), and the Health Care Fraud Unit. The report, which is published annually, provides an overview of each of these sections showing statistical accomplishments and examples of the identified priority crime problems.

The Healthcare Fraud Unit estimates that fraudulent billing accounts for between 3% and 10% of all healthcare expenditures nationwise. The Centers for Medicare and Medicaid Services (CMS) estimates $2.26 trillion was spent on healthcare in fiscal year 2007, leading to the conclusion that as much as $226 billion per year is fraudulently billed over the course of the year.

The FBI identified the most common types of healthcare fraud as: (1) billing for services not rendered; (2) upcoding (charging a higher value for services than is appropriate); (3) duplicate claims; (4) unbundling; (5) excessive services; (6) medically unnecessary services; and (7) kickbacks. Other areas of concern include durable medical equipment, hospital fraud, physician fraud, home health agencies, beneficiary-sharing, chiropractic, pain management and associated drug diversion, physical therapists, prescription drugs, multi-disciplinary fraud, and identity theft which involve physician identifiers used to fraudulently bill government and private insurance programs.

The report identified two trends for the 2007 fiscal year: an increased willingness to profit at the expense of the patient, and evolving schemes relating to new technologies. The FBI reported that investigations in several of its offices are focusing on subjects who conduct unnecessary surgeries, prescribe dangerous drugs without medical necessity, and engage in abusive or sub-standard care practices. Examples of the increasingly technical schemes being purpetrated involve medical data theft and other fraud schemes facilitated through the use of computers. The report also mentions increasing concerns regarding The Medicare Prescription Drug Program (Part D), which was implemented in 2006 and so is relatively new.

The FBI reports that Health care fraud ranks among the highest priority investigations within the FBI's white collar crime unit, behind only public corruption and corporate fraud. As a result there are a number of national initiatives, including the Internet Pharmacy Fraud Initiative, the Auto Accident Insurance Fraud Initiative, and the Outpatient Surgery Center Initiative. The overall goal of the Internet Pharmacy Fraud Initiative is to identify fraudulent Internet pharmacies and target physicians who are willing to write prescriptions outside of the doctor/patient relationship. This group also heads investigations into the sale of counterfeit and diverted pharmaceuticals on the Internet. The Auto Accident Insurance Fraud Initiative was launched in 2005 in response to increasingly sophisticated staged accident schemes, which present a danger on the road as well as the economic harm of the fraud (which includes the rising cost of private insurance).

Overall, the FBI reported that Fiscal Year 2007 saw it investigating 2,493 cases, resulting in 839 indictments and 635 convictions of health care fraud criminals, with some cases still pending. In the area of health care fraud the report states that FBI investigations resulted in $1.12 billion in restitutions, $4.4 million in recoveries, $34 million in fines, and 308 seizures valued at $61.2 million.

In conclusion, the FBI offered the following tips to protect yourself against Health Care Fraud:

• Protect your health insurance information card like a credit card.
• Beware of free services--is it too good to be true?
• Review your medical bills, such as your "explanation of bill," after receiving healthcare services. Check to ensure the dates and services are correct to ensure you get what you paid for.
• If you suspect Health Care Fraud, call 1-877-327-2583. For more information,
visit the web site at

Tuesday, May 27, 2008

Open letter to Texas newspapers about peak oil: 'Why aren’t you listening?'
by Jeffrey J. Brown

April 2, 2006

Mr. Wesley R. Turner, President & Publisher
Fort Worth Star Telegram

Mr. James H. Moroney , III, Publisher & CEO
The Dallas Morning News

Subject: What Are Two Texas Billionaires,
Richard Rainwater & T. Boone Pickens,
Saying About Peak Oil & Why Aren’t You Listening?


I realize that I don’t have to introduce Richard Rainwater and Boone Pickens to you two gentlemen, but for the benefit of those who may not be familiar with Messrs. Rainwater and Pickens, following are brief introductions.

Richard Rainwater is the Texas based businessman who was chiefly responsible for turning the Bass Family’s inheritance of $50 into a $5 billion dollar fortune. Mr. Rainwater was therefore indirectly responsible for the remarkable urban renaissance of downtown Fort Worth, as a result of the Bass family’s massive investments. Mr. Rainwater also had a material role in George W. Bush’s selection as Managing Partner of the Texas Rangers Baseball Team, which launched Mr. Bush on his way to the Governor’s Mansion and then to the White House.

Mr. Pickens, now based in Dallas, has had a long and storied career in the oil and gas industry. Like most Texas oilmen, Mr. Pickens has had his ups and downs. Most recently he has been on an up cycle, via his investment firm, BP Capital.

These two gentlemen share an uncanny and proven ability to accurately predict future trends. The only real mistake that I am aware of is Mr. Pickens’ timing regarding natural gas prices some years ago. He was right about the price move, but he was just a little early.

Mr. Rainwater was profiled in the 12/14/05 issue of Fortune Magazine, “The Rainwater Prophecy.” Mr. Rainwater is deeply concerned about Peak Oil. In the article, Mr. Rainwater said, “This is the first scenario I’ve seen where I question the survivability of mankind.” Mr. Rainwater first became concerned about Peak Oil after reading “The Long Emergency” by James Howard Kunstler.

According to Bill McKenzie, with the Dallas Morning News, the primary reason that President Bush used the “Addicted to OIl” phrase in his state of the Union Speech was the Fortune article about Richard Rainwater, and again Mr. Rainwater became concerned about Peak Oil after reading Mr. Kunstler’s book.

On November 1, 2005 the Greater Dallas Planning Council and the Southern Methodist University Environmental Sciences Department cosponsored a symposium featuring Mr. Kunstler and Matthew R. Simmons entitled “The Unfolding Energy Crisis and its Impact on Development Patterns.” Mr. Pickens, via BP Capital, was one of the lead underwriters of the event.

Mr. Pickens, several of his associates, and several other notable Dallas businessmen such as Herbert Hunt were at the Simmons/Kunstler symposium, but no one from your respective editorial and news departments were able to make the event--despite multiple notices of the event.

In any case, Mr. Pickens has publicly stated that he believes that the world is at peak oil production. Mr. Pickens has publicly suggested increasing the gasoline tax, in an attempt to reduce oil consumption, with offsetting tax cuts elsewhere.

I certainly don’t speak for either Richard Rainwater or Boone Pickens, but my impression of these two gentlemen--along with Matt Simmons and Jim Kunstler--is that they are American patriots, in the truest sense of the word, who are trying to warn their fellow Americans about the dangers posed by Peak Oil.

In the Fortune interview, Mr. Rainwater was quoted as follows, “I believe in Hubbert’s Peak. I came out of Texas. I watched oil fields reach peak and go over, and I’ve watched how people would do all they could, put whatever amount of money into the field, and they couldn’t do anything about it.”

Much of the Peak Oil debate is based on pioneering work done by a famous Texas born geoscientist, M. King Hubbert. My coauthor, “Khebab,” and I wrote an article that was published on the Energy Bulletin website, “M. King Hubbert's Lower 48 Prediction Revisited: What can 1970 and Earlier Lower 48 Oil Production Data Tell Us About Post-1970 Lower 48 Oil Production?” Following is an excerpt from that article.

Fifty years ago this week, on March 8, 1956, at a meeting of the American Petroleum Institute in San Antonio, Texas, M. King Hubbert, in the preprinted version of his prepared remarks, had the following statement, "According to the best currently available information, the production of petroleum and natural gas on a world scale will probably pass its climax within the order of a half century (i.e., by 2006), while for both the United States and for Texas, the peaks of production may be expected to occur with the next 10 or 15 years (i.e., 1966 to 1971)." As more and more people are learning, Lower 48 oil production, as predicted by Dr. Hubbert, peaked in 1970, and it has fallen fairly steadily since 1970.

Kenneth Deffeyes, in Chapter Three of his recent book, "Beyond Oil: The View From Hubbert's Peak," described a simplified way of predicting the production peaks for various regions and for their subsequent declines. One simply plots annual production (P) divided by cumulative production to date (Q) on the vertical axis, or P/Q, versus Q on the horizontal axis. Stuart Staniford, on The Oil Drum Blog, has described this technique as "Hubbert Linearization" or HL.

With time, a HL data set starts to show a linear progression, and one can extrapolate the data down to where P is effectively zero, which gives one Qt, or ultimate recoverable reserves for the region. Based on the assumption that production tends to peak at about 50% of Qt, one can generate a predicted production profile for the region. The Lower 48 peaked at 48.5% of Qt.

Using the HL technique, Dr. Deffeyes, an associate of Dr. Hubbert, predicted that the world crossed the mathematical 50% of Qt mark on December 16, 2005. In other words, Dr. Deffeyes believes that the world is now where the Lower 48 was at in the early Seventies.

We used the HL method to predict post-1970 Lower 48 cumulative oil production, using only 1970 and earlier production data. Our work indicated that the HL method was 98.7% accurate in predicting post-1970 Lower 48 cumulative oil production.

We need to differentiate between conventional and nonconventional oil. Perhaps the best way to differentiate the two types of oil is to classify it the following way. Conventional--the oil will move to a wellbore on its own. Nonconventional--the oil and oil-like solids have to be surface mined or heated in order to move to a wellbore (or synthesized from lighter hydrocarbons).

Dr. Deffeyes estimates that we that we have two trillion barrels of recoverable conventional oil reserves worldwide and that we have used half of this amount.

Fossil fuels can be viewed as a continuum, from natural gas, to natural gas liquids, to condensate, to light sweet crude oil to heavy sour crude oil to bitumen to coal. (Kerogen, a precursor to bitumen, can also be processed to yield oil.) This list is a progression from gas, to liquid to solid. It is also a progression from cleanest, natural gas, to dirtiest, coal.

The world wants Liquid Transportation Fuels (LTF’s)--gasoline, diesel and jet fuel. LTF’s can be obtained for the least expenditures of energy and capital from light sweet crude. It only makes sense that light sweet crude will peak before heavy sour, and based on the current historically high spreads between light sweet crude and heavy sour crude, that appears to be the case.

The world is increasingly turning toward the endpoints--natural gas/natural gas liquids on the light end and bitumen/coal on the heavy end--in an attempt to maintain and increase our supply of LTF’s. There are several problems. These are hugely capital intensive programs that tend to produce liquids at very low rates compared to conventional oil sources, and on the heavy end there are some fairly severe environmental consequences. Another point that is often overlooked is that every fossil fuel resource, except for kerogen, is currently being commercially exploited. In other words, we are simply talking about increasing our rate of extraction of our finite fossil fuel resource base in a desperate attempt to maintain the current American way of life of driving $50,000 SUV’s on 50 mile roundtrips to and from $500,000 mortgages.

Currently, the most significant source of nonconventional oil is the tar sands play in Alberta, Canada, where bitumen is being extracted via surface mining or via the injection of steam into deeper beds.

From fossil fuel and nuclear sources, the world currently uses the energy equivalent of a billion barrels of oil (Gb) every five days. The mighty East Texas Oil Field, the foundation of so many Dallas fortunes, the largest oil field in the Lower 48, and the field that was largely responsible for providing the oil to power the Allies victory over the Axis powers in World War II, made about 5.5 Gb. The field is currently producing 1.2 million barrels of water per day, with a 1% oil cut. It took about 75 years to pretty much fully deplete the East Texas Field. In terms of oil equivalent, the Barnett Shale Gas Play in North Texas should ultimately produce, over several decades, on the order of 4-5 Gbe.

The world uses, from nuclear and fossil fuel sources, the energy equivalent of the recoverable reserves in the East Texas oil Field or the Barnett Shale Play in less than 30 days.

In the 4/2/06 Star Telegram, Automotive Journalist Ed Wallace, in the classified advertising section, wrote a rebuttal to the Peak Oil theories. Mr. Wallace’s two basic points: (1) improved technology will increase recoverable conventional reserves by 50% to 3,000 Gb and (2) nonconventional oil sources will add another 3,000 Gb. Therefore, based on Mr. Wallace’s estimates, we have used 1,000 Gb out of a 6,000 Gb resource base.

In the Viewpoints (Op-Ed) section of the Dallas Morning News, similar “cornucopian” energy abundance articles were published last year making basically the same points that Mr. Wallace made.

In regard to the technology issue, this assertion is directly contradicted by our experience in Texas (peaked at 54% of Qt), the overall Lower 48 (peaked at 49% of Qt) and the North Sea (peaked at 52% of Qt). Nothing the industry has tried in these regions has reversed the production declines once about half of the oil reserves were consumed. The reason is best illustrated by the East Texas field, now producing water with a 1% oil cut. What can better technology do to help a field that has watered out?

In regard to the nonconventional sources of oil, Mr. Wallace is primarily focused on the Canadian tar sands and shale oil (kerogen). The tar sands play is a proven commercial success, that is however hugely energy intensive and that is also yielding vast amounts of contaminated waste water. Mr. Wallace cites the most widely used estimate of 175 Gb in recoverable reserves (note that this should be discounted by about 35% to 50% to get net energy equivalent). He also cited a vague estimate by a Shell executive of 2,000 Gb, that can’t be currently recovered. There is one interesting research program testing some new shale oil technologies, but there is nothing commercial yet.

In any case, let’s look at past and current estimates of Canadian tar sands production. In 2003, the US Energy Information Agency (EIA) estimated that total Canadian oil production--driven by increasing tar sands production--would increase by 700,000 BOPD from 2003 to 2005. The reality? Total Canadian oil production fell from 2003 to 2005. The tar sands production fell short of estimates, and the increasing tar sands production the Canadians had could not make up for the decline in conventional Canadian oil production.

The Canadians themselves are estimating that tar sands production will only increase to about three million BOPD (mbpd) in 2016 from one mbpd today. Note that we will probably start losing a net two mbpd to four mbpd in conventional oil production per year, starting this year. Again, note that you have to discount the tar sands production by 35% to 50% to get net energy.

In effect, Mr. Wallace, and the other energy cornucopians see no problem with the $50,000 Hummer, $500,000 mortgage way of life.

Messrs. Rainwater and Pickens disagree. I can’t speak for them, but I assume that they believe that while nonconventional oil will help, it will only serve to slow the rate of decline of total oil production.

Some types of ethanol production (not from corn sources) appear have some possibilities, but there are a number of problems. Among the problems is a basic conflict between land devoted to food production and land devoted to fuel production. By the way, the US is probably now a net food importer. Currently, the US uses up to 10 calories of fossil fuels to produce one calorie of food. Ponder the impact on our food supply of a declining oil supply.

I realize that US media companies are facing severe economic pressures, and I realize that you are heavily dependent on advertising revenues from the housing/auto industries and from related companies. However, in my opinion we have hit the iceberg. The US media can lash themselves to the sinking ship, by failing to face reality, or you can face the reality of finite energy resources and start heading for the lifeboats.

I am supporting a proposal to abolish the Payroll (Social Security + Medicare) Tax and to replace it with an energy tax, principally a tax on liquid transportation fuels. This would unleash powerful economic forces against profligate energy use. Since it is in effect a consumption tax, it would tax those who currently don’t pay the Payroll Tax, by using cash. Instead of taxing payrolls to fund the Social Security and Medicare systems, we would instead tax energy consumption.

Alan Drake, a consulting engineer, has written a compelling article advocating a crash program of electrifying our transportation system, with special emphasis on Urban Rail.

I am working with a small group regarding the possibility of a Fall symposium on the Energy Tax and Urban Rail proposals, and we would be delighted to have support from The Fort Worth Star Telegram and/or The Dallas Morning News.

Note that these two proposals would address: the Social Security/Medicare crisis; the Peak Oil crisis; the loss of farmland due to suburban sprawl and Global Warming issues. We would replace “dumb growth” with “smart growth,” New Urbanism projects along mass transit lines.

In addition, I would at least ask you to give your readers a balanced report on the Peak Oil issue. Two leading citizens of your respective cities--Richard Rainwater and T. Boone Pickens--are deeply concerned about Peak Oil. The stated mission of the Fort Worth Star Telegram is: “Earning the People’s Trust Daily.” I assume that the Dallas Morning New concurs with this mission statement.

In my opinion, the US media have two choices regarding the Peak Oil issue. To paraphrase Winston Churchill, you can now have either your honor or the status quo. If you do nothing regarding Peak Oil, you will soon have neither the status quo nor your honor.


Jeffrey J. Brown

Fortune: The Rainwater Prophecy

Brown & Khebab: M. King Hubbert's Lower 48 Prediction Revisited

Wallace: A Theory Like Y2K, But For Cars...

Drake: Electrification of transportation as a response to peaking of world oil production

~~~~~~~~~~~~~~~ Editorial Notes ~~~~~~~~~~~~~~~~~~~

Jeffrey J. Brown is an independent petroleum geologist in the Dallas area. He can be contacted at .

He encourages readers to borrow freely from his letter and to write their own letters to media organizations.


$58 Million Settlement Over Vioxx ....Peanuts!!!

Merck Agrees To $58 Million Settlement Over Vioxx Ad Claims
North Carolina will get $1.8 million from the settlement.

Harrisburg, PA -- Merck & Co. has agreed to pay $58 million as part of a multistate settlement of allegations that its ads for the once-popular painkiller Vioxx deceptively played down the health risks.

The agreement announced Tuesday also calls for Merck to submit all new TV commercials for its drugs to the Food and Drug Administration for review before they can be aired.

The civil settlement ends a joint three-year investigation by 29 states, including North Carolina, and the District of Columbia into Merck's advertising practices involving Vioxx, Pennsylvania Attorney General Tom Corbett said.

Vioxx was taken off the market in 2004 after research showed it doubled the risk of heart attacks and strokes. That triggered thousands of lawsuits against Whitehouse Station, N.J.-based Merck. A pending $4.85 billion settlement would end the bulk of those personal injury suits.

Thanks to aggressive marketing through direct-to-consumer television ads begun in 1999, hundreds of thousands of consumers demanded Vioxx prescriptions before doctors had a chance to understand the side effects, Corbett said.

"Consumers need clear information about the risks associated with prescription drugs so that they can make well-informed decisions about their health care," Corbett said.

The FDA does not require drug companies to submit advertisements for advance approval except in cases where it has pursued enforcement actions over false and misleading claims, agency spokeswoman Rita Chappelle said.

The agreement calls for Merck to submit all new TV commercials for its drugs to the FDA for review and follow through with any changes the agency recommends before airing them for seven years. Additionally, for a 10-year period Merck must comply with any FDA recommendations to delay television advertising for newly approved pain medications.

Merck is also prohibited from "ghostwriting," a practice in which people who worked for the company or were otherwise connected to it allegedly wrote positive articles and studies about Vioxx, Corbett said.

Merck is not admitting any wrongdoing under the settlement and defended its marketing of Vioxx in a statement Tuesday.

"Today's agreement enables Merck to put this matter behind us and focus on what Merck does best, developing new medicines," said Bruce Kuhlik, Merck's executive vice president and general counsel.

Corbett's spokesman, Kevin Harley, said the settlement does not require approval by any court.

Democrats in Congress have intensified their scrutiny of the drug industry, expressing support for tighter regulation of consumer-directed drug advertisements, among other things.

Last year, they tried unsuccessfully to pass a law that would ban such advertisements in the three years after a drug's approval. They are expected to make a similar push later this year.

Most of the settlement cost will be covered by a $55 million pretax charge that Merck said it took in the first quarter. Pennsylvania officials could not immediately provide a breakdown of how the $58 million will be divided.

In February, Merck agreed to pay $671 million to settle claims it overcharged the government for Vioxx and three other popular drugs and bribed doctors to prescribe its drugs. The announcement by federal prosecutors was one of the biggest U.S. health care fraud settlements ever.

In addition to Pennsylvania, the states included in Tuesday's settlement are Arkansas, Arizona, California, Connecticut, Florida, Hawaii, Idaho, Illinois, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, Oregon, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington and Wisconsin.

Merck shares fell 26 cents to $39.76 in afternoon trading Tuesday.

Source: Associated Press

Copyright: 2008

MORGAN STANLEY , Genesis Healthcare Corporation (

The FBI investigates matters relating to fraud, theft, or embezzlement occurring within or against the national and international financial community. These crimes are characterized by deceit, concealment, or violation of trust and are not dependent upon the application or threat of physical force or violence. Such acts are committed by individuals and organizations to obtain personal or business advantage. The FBI focuses its financial crimes investigations on such criminal activities as corporate fraud, securities and commodities fraud, health care fraud, financial institution fraud, mortgage fraud, insurance fraud, mass marketing fraud, and money laundering." This report covers the financial crimes that occurred between October 1, 2006, and September 30, 2007. It begins with an overview of the FBI's Financial Crimes Section, then focuses on each of the previously listed subcategories of financial fraud.

XUJIA WANG, VICE PRESIDENT OF FINANCE - MORGAN STANLEY (NEW YORK): This investigation was initiated on the basis of regulatory reporting related to suspicious options trading activity in Genesis Healthcare Corporation (GHC) immediately preceding the acquisition of GHC by private equity firms. Through her employment as Vice President of Finance for Morgan Stanley, Xujia Wang obtained material non-public information on GHC and other acquisitions, which she and her husband, Ruopian Chen, used to execute illicit trades in an account held in the name of a family member. On September 5, 2007, Wang and Chen pleaded guilty to charges of securities fraud and conspiracy to commit securities fraud for their roles in this insider trading scheme that resulted in illicit trading profits in excess of $600,000. On December 4, 2007, Wang and Chen were each sentenced to 18 months imprisonment and required to forfeit $611,248.

Klein also agreed to a criminal forfeiture of $250,000....

But how much did this "DOCTOR" really rip us off?

May 23, 2008
Convicted doctor gets more time for threat to murder prosecutor
An incarcerated Houston doctor who solicited a fellow inmate to kill a federal prosecutor and later pleaded guilty to the charge of threatening to murder a law enforcement officer was sentenced on Thursday to 30 months in federal prison for the offense, according to a U.S. Department of Justice press release. Ira Klein, a 62-year-old former gastroentinologist, admitted in his guilty plea that while in federal custody in May 2006, he solicited a fellow inmate to arrange to have Sam Louis, an assistant U.S. Attorney, run over by an 18-wheeler. He also solicited the inmate to throw acid in the face of FBI Special Agent Jayme Poteet, who investigated the health-care fraud case. U.S. District Judge Sim Lake of the Southern District of Texas ordered that Klein serve 12 of the 30 months consecutively to a 135-month federal prison sentence imposed on Aug. 2, 2007, for health-care fraud and mail fraud violations. The remaining 18 months will be served concurrently. In his guilty plea, Klein also agreed to a criminal forfeiture of $250,000.-- Jonathan Fox

100,000+ vs wehre are the BILLIONS?????

Department of Justice
Eastern District of Virginia

Alexandria Newport News Norfolk Richmond


Jim Rybicki
Public Information Officer
Phone (703) 842-4050 Fax: (703) 549-5202
Web Address:

May 21, 2008
Further Information Contact:
Deanna Warren
Phone: (757) 441-6331

Medicaid Provider Pleads Guilty to Health Care Fraud(Norfolk, VA) - Sharon M. Honeycutt, age 54, of Portsmouth, pled guilty today in United States District Court to health care fraud in connection with her operation of a Portsmouth home healthcare business. Chuck Rosenberg, United States Attorney for the Eastern District of Virginia, made the announcement after Honeycutt's plea was tendered to United States Magistrate Judge Tommy E. Miller. Honeycutt will be sentenced on September 23, 2008.
According to court documents, Honeycutt is the owner and operator of Ace Homecare, a Medicaid provider of durable medical equipment, including catheters, gloves, nutritional supplements and adult diapers. Under a Medicaid provider agreement, Ace Homecare, located in Portsmouth, Virginia, was entitled to receive payment from Medicaid for providing these items to Medicaid recipients in accordance with a physician's written order. Between March 2003 and September 2005, Honeycutt filed claims for providing these items when there was no written order from a physician. She filed these claims not only in the name of her own company, but also through another Medicaid provider in an arrangement which she concealed from Medicaid. When the records of Ace Homecare and the other Medicaid provider were audited, Honeycutt prepared for submission to Medicaid auditors 22 false Certificates of Medical Necessity which included forged physician signatures and false patient information. A total of approximately 1,500 fraudulent claims were filed for 22 Medicaid recipients, resulting in a loss to Medicaid of approximately $101,783.

This case was investigated by the Federal Bureau of Investigation and the Virginia Medicaid Fraud Control Unit. Assistant United States Attorney Alan M. Salsbury is prosecuting the case for the United States.

Tuesday, May 20, 2008


(202) 514-2007
TDD (202) 514-1888


WASHINGTON, D.C. - HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company) has agreed to pay the United States $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs, the Justice Department announced today.

This settlement marks the conclusion of the most comprehensive health care fraud investigation ever undertaken by the Justice Department, working with the Departments of Health and Human Services and Defense, the Office of Personnel Management and the states. The settlement announced today resolves HCA's civil liability for false claims resulting from a variety of allegedly unlawful practices, including cost report fraud and the payment of kickbacks to physicians.

Previously, on December 14, 2000, HCA subsidiaries pled guilty to substantial criminal conduct and paid more than $840 million in criminal fines, civil restitution and penalties. Combined with today's separate administrative settlement with the Centers for Medicare & Medicaid Services (CMS), under which HCA will pay an additional $250 million to resolve overpayment claims arising from certain of its cost reporting practices, the government will have recovered $1.7 billion from HCA, by far the largest recovery ever reached by the government in a health care fraud investigation.

"Health care providers and professionals hold a public trust, and when that trust is violated by fraud and abuse of program funds, and by the payment of kickbacks to the physicians on whom patients and the programs rely for uncompromised medical judgment, health care for all Americans suffers," Robert D. McCallum, Jr., Assistant Attorney General for the Civil Division said. "This settlement brings to a close the largest multi-agency investigation of a health care provider that the United States government has ever undertaken and demonstrates the Department of Justice's ongoing resolve and commitment to pursue all types of fraud on American taxpayers, and health care program beneficiaries."

"Let this case be a continuing reminder to all that in the fight against health care fraud this office will not be deterred," said Acting Principal Deputy Inspector General Dara Corrigan. “Medicare dollars paid to provide ever more expensive health care services to the country's taxpayers should never be fraudulently diverted. This is our job and our trust and we take these duties very seriously," Corrigan concluded.

This latest settlement resolves fraud allegations against HCA and HCA hospitals in nine False Claims Act qui tam or whistleblower lawsuits pending in federal court in the District of Columbia. Under the federal False Claims Act, private individuals may file suit on behalf of the United States and, if the case is successful, may recover a share of the proceeds for their efforts. Under the settlement, the whistleblowers will receive a combined share of $151,591,500, the highest combined qui tam award ever paid out by the government.

"We are grateful for the assistance given by the whistleblowers over the course of the past nine years of investigation and litigation,” McCallum said. “And we are proud of the work of government personnel as well as counsel for the whistleblowers, who together pursued these matters through investigation and strenuous litigation. This result demonstrates the commitment of the Department to the qui tam statute and that the statute works as Congress intended."

Under the first of three agreements announced today, which becomes effective upon the court's dismissal of the lawsuits, HCA will pay nearly $620 million to resolve eight whistleblower lawsuits in which the government had intervened alleging that HCA systematically defrauded Medicare, Medicaid and other federally funded health care programs through schemes dating back to the late 1980s. HCA will pay an additional $11 million to resolve separate allegations of improper HCA billing practices.

The settlement requires HCA to pay:

$356 million to resolve whistleblower lawsuits alleging that HCA engaged in a series of schemes to defraud Medicare, Medicaid and TRICARE, the military’s health care program, through hospital cost reports, the year end claims submitted by hospitals to the government to reconcile payments received throughout the year with amounts they claim are actually owed. In 2001, a subsidiary of Nashville-based HCA, Columbia Management Companies, Inc., pled guilty in the Middle District of Florida to related charges on eight counts of making false statements to the United States and paid $22.6 million in criminal fines. An additional amount of $20 million of the settlement is being paid toward a resolution of cost reporting fraud allegations pursued separately by James Alderson and John Schilling, the relators who filed the lawsuits. In total, the two relators are to receive a total of $100 million as their statutory share of the settlement.
$225.5 million to resolve lawsuits alleging that HCA hospitals and home health agencies unlawfully billed Medicare, Medicaid and TRICARE for claims generated by the payment of kickbacks and other illegal remuneration to physicians in exchange for referral of patients. In 2001, Columbia Management Companies, Inc., pled guilty to one count of conspiracy to pay kickbacks and other monetary benefits to doctors in violation of the Medicare Antikickback Statute and paid a $30 million criminal fine. Dr. James Thompson, a doctor who filed suit against the company in 1995, will receive $41.5 million as his statutory share of the settlement. Gary King, a former HCA employee, will receive $5 million and Ann Mroz, a former HCA nurse, will receive a share of $837,500.
$17 million to resolve allegations that certain company-owned hospitals billed Medicare for unallowable costs incurred by a contractor that operated HCA wound care centers, and for a non-covered drug that the contractor manufactured and sold to hospital patients. The 2001 Columbia Management Companies' guilty plea concerning cost report fraud included a charge related to wound care center costs. HCA's wound care center management contractor, Curative Healthcare Services, Inc., previously paid $16.5 million to resolve related allegations pending at one time in these same lawsuits. Joseph "Mickey" Parslow, a former HCA financial officer, will receive $2,990,000 and Francesco Lanni, a former Reimbursement Manager at the Wound Care Center at New York Methodist Hospital in Brooklyn, New York, will receive a share of $680,000.
$5 million to resolve allegations concerning the transfer of patients from HCA facilities to other facilities and the claiming of excessive costs for those transfers.
$5 million to resolve allegations that HCA's Lawnwood Regional Medical Center in Fort Pierce, Florida submitted false claims in Medicare cost reports by inflating its entitlement to funds to treat indigent patients and by shifting employee salary costs in order to increase its reimbursement from the federal health care program.
$950,000 to settle allegations made by Michael Marine that HCA improperly shifted its home office costs to hospitals. Marine will receive a share of $116,500.
Today's settlement agreement incorporates the terms of a Corporate Integrity Agreement executed by HCA and the Office of the Inspector General, Department of Health and Human Services in December 2000 that obligated the company to engage in significant and comprehensive compliance efforts into 2009.

In a separate agreement, HCA agreed to pay $1.5 million to resolve allegations that an Atlanta, Georgia hospital, West Paces Medical Center, paid kickbacks for the referral of diabetes patients. Those allegations had been pursued since 1996 by a whistleblower in a case in which the United States had declined to intervene, captioned U.S. ex rel. Pogue v. American Healthcorp, Inc. et al.. Pogue, a former employee of a co-defendant in the case, Diabetes Treatment Centers of America, will receive a share of $405,000 from the HCA settlement. Pogue continues to litigate claims against his former employer and a group of Atlanta physicians.

Additionally, a state negotiating team appointed by the National Association of Medicaid Fraud Control Units has reached agreement with HCA to resolve related issues with affected state Medicaid plans for $17.5 million, representing direct state losses. The terms of that agreement are being finalized by the parties and are not part of today's settlement.

Today's administrative agreement between HCA and CMS will require HCA to pay CMS $250 million in order to resolve claims they maintained against each other arising from HCA's hospital cost reports and home office cost statements for cost reporting periods ending July 31, 2001. These claims resulted from HCA cost reports that were not processed since 1997 as a result of the government's investigation.

Wednesday, May 14, 2008

Puerto Rico......US healthcare dollars ripoff occurred in Puerto Rico

Alleged Medicare fraud in Puerto Rico burns nearly 1 million US tax dollars; billions lost in other fraud
The latest alleged US healthcare dollars ripoff occurred in Puerto Rico, to the tune of $922,882.00. On May 1st, a grand jury returned a 27-count indictment charging four doctors and two other individuals with conspiracy, health care fraud, soliciting and receiving kickbacks in relation to the Medicare Program, false statements and forfeiture allegations. This is a drop in the mega bucket of wasted dollars.

Healthcare dollars wasted in virtual barbecue
I’ve often pointed out that if the federal government was a more responsible steward of our tax dollars, the money saved could fill many needs, such as health insurance for the working poor. The alleged Puerto Rican healthcare grifters worked in a similar manner to some Medicaid thieves in South Florida. Government officials say recent reports show as much as $2 billion a year may be lost in Florida’s $16 billion Medicaid program to fraud and abuse. So we’re talking one US government territory and one US state and more than $2 billion in fraud. Take a look at any other state and you’ll find your tax dollars are being burned with pleasure. In New York in 2006, indictments were issued for a Medicaid fraud ring involving a doctor, pharmacists, several city pharmacies, millions in fraudulent Medicaid billings and large monetary transfers to individuals in Pakistan. Sixteen individuals and five corporations have been indicted in the ongoing investigation and a civil action has been filed against twenty individuals and entities freezing assets and seeking the recovery of more than $22 million.

Consider this—these are the fraudulent bucks we know about largely thanks to cooperative investigations among top-notch law enforcement agencies and basically every level, from local cops to the US Justice Dept. Wanna have some fun? Enter the name of any state or US territory in your search bar and add the words, ‘Medicare fraud.’ Have fun and have lunch, dinner and breakfast the following morning while you’re at it. It’ll take you that long to read all the results for Medicare fraud in a single state.Puerto Rican company sold durable medical equipment
In the Puerto Rico case, Doctor's Medical Supplies was a durable medical equipment (DME) company authorized to do business in Puerto Rico with its business office located in Luquillo, Puerto Rico, and registered as an authorized Medicare Part B DME supplier. Doctor's Medical Supplies submitted claims to Medicare, seeking reimbursements for DME, including oxygen services, motorized wheelchairs, and hospital beds, that were allegedly provided and medically necessary. During the time period listed in the indictment, Doctor's Medical Supplies submitted false claims for DME and received approximately $922,882.00 in Medicare reimbursements.

The main defendant, Rabindranaut Amrud-Ríos, also known as Rabin, submitted and caused the submission of false and fraudulent claims to Medicare. He is the owner and president of Doctor's Medical Supplies. Amrud-Rios oversaw the business and financial operations of Doctor's Medical Supplies. The "Physician Signers," as used in the Indictment, would sign prescriptions and certificates of medical necessity (CMNs) and were paid kickbacks by Amrud-Rios to sign the false CMNs. Amrud-Rios along with the other defendants listed in the indictment falsely and fraudulently represented that the medical conditions of the Medicare beneficiaries were such that DME, which included oxygen services, power wheelchairs, and hospital beds, were medically necessary when in fact the Medicare beneficiaries were either dead or did not suffer from such medical conditions and did not qualify to receive the DME under the Medicare regulations.

The names of the four doctors involved in the conspiracy are: Jaime Belardo, Narciso Reyes-Carrillo, José Figueroa-Pacheco, and Rafael Esteva-Heal. Also charged is Gladys Avilés, an employee of Doctor's Medical Supplies. The licensed doctors are charged with signing blank or previously completed false prescriptions and CMNs for Doctor's Medical Supplies. Each of the doctors was paid kickbacks by co-defendant Amrud-Ríos in exchange for signing blank or previously completed false CMNs for Doctor's Medical Supplies. Defendant Gladys Avilés was the employee of Doctor's Medical Supplies who completed blank and false CMNs for Doctor's Medical Supplies and submitted claims to Medicare based on those false CMNs.

Why aren’t the presidential candidates talking about this issue?
Health insurance is a hot topic as our presidential election draws near. Until the feds can manage the money we taxpayers already ante up, I really hope members of congress steer clear of raising income taxes. It’s like the same hope I have to win the lottery—ain’t gonna happen. But I’m already paying for mistakes that can actually be corrected at a basic level. That’s why we have federal government workers. It’s obvious Medicare needs better oversight. Why aren’t the candidates doing something about the fraud that could help those who need healthcare and can’t afford it? Sen. John McCain is a Republican. Here's a wakeup call, GOP—this is an issue handed to you on a silver platter. Especially since we read Sen. Barack Obama’s lips and he guarantees us he’ll raise our taxes. We anticipate he'll have lots of help from the tax loving members of congress.

Why shouldn’t we focus on saving these dollars? Why don't politicians ever talk about it? Because it’s easier to just tax us? What do you think should be done to stop the burning of US tax dollars in healthcare fraud?

--filed by Kay B.Day

Copyright © 2008, Kay B. Day. All rights reserved.

HCA INC/TN ....take a good look at the 'formerly knonw as' companies

HCA INC/TN (0000860730)
State location: TN | State of Inc.: DE | Fiscal Year End: 1231
formerly: COLUMBIA HCA HEALTHCARE CORP (filings through 2000-05-19)
formerly: COLUMBIA HCA HEALTHCARE CORP/ (filings through 2000-02-16)
formerly: COLUMBIA HEALTHCARE CORP (filings through 1994-03-01)
formerly: HCA THE HEALTHCARE CO (filings through 2001-05-21)
formerly: HCA-THE HEALTHCARE CO (filings through 2001-02-14)

(Assistant Director Office No 1)

three years' probation jail time???

A federal judge sentenced a Murrysville dentist Friday to three years' probation for health care fraud. Roberto Michienzi, 37, submitted fraudulent reimbursement claims to insurance companies for dental work never performed, prosecutors said. The Tribune-Review has more details.