Tuesday, April 28, 2009

Bigger then Enron- Richard Scott

New Commercial for Richard Scott

Conservatives for Patients' Rights

Remember who Richard is:

The Epitome of Fraud- Waste-Abuse:

2009 - WSJ reported that Richard Scott, "the former CEO of HCA Inc," had formed the non-profit organization-

Conservatives for Patients' Rights

as part of a "lobbying campaign to derail or modify" health care reform.

non-profit? What a joke.

Not this thief: THURSDAY, JUNE 26, 2003; WWW.USDOJ.GOV;
HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company)
Note: Hospital Corporation of America (HCA) was acquired by Columbia in 1994.

He features a doctor from England. I wonder why?

HCA International
242 Marylebone Road London, NW1 6JL
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With six world-class hospitals and four outpatient medical centres in London, we are the private hospitals of choice for the successful treatment of serious and complex medical conditions. We also achieve some of the highest patient outcome and survival rates in the UK and our hospitals are virtually MRSA-free*

Monday, April 27, 2009

President and CEO of Doctor’s Hospital in Bremen--Fraud

Two medical offices got surprise visits today from federal agents. That’s because two doctors are being investigated for major healthcare fraud.

U.S. Attorney Donald Schmid says for over a year, federal authorities have been investigating Dr. Jamie Gottlieb and Dr. Cameron Gilbert. Schmid says the doctors are suspected of health care billing fraud, improper patient referrals and illegal kickbacks to doctors.
Federal officials took an “evidence collecting” tour of Michiana today, stopping at the doctors’ officers and homes.

Gilbert is the President and CEO of Doctor’s Hospital in Bremen. We found agents walking in the hospital with folded boxes and out of the hospital with full ones.

Doctor’s Hospital CEO John Day says in a written statement, “We appreciate the process and we are respectfully cooperating with the Department of Health and Human Services. We intend to continue our business of providing quality patient care and feel confident in the outcome of this situation.”

Newscenter 16 contacted the Department of Health and Human Services and officials there did confirm the agency is part of the investigation and the search.

Investigators also stopped at Gilbert’s two homes in Knox and Mishawaka.

"I got here at about a quarter until eight this morning and there was about six police officers here and they were trying to get access into one of the homes,” explains Jeff Bavar, housing project manager for Kamm Island Park, where Gilbert lives. “They produced a search warrant. And with that, I figured it was better to let them in the building than let them knock the door down."

Officials also made their way to Dr. Jamie Gottlieb’s home off Roosevelt in South Bend. You can see tire marks in the grass from cars driving around the gate.

Gottlieb is an orthopedic surgeon and founded I-Spine Institute in Elkhart. Inside the doors there is a sign that reads, “I-Spine is closed due to a sudden emergency.”

It isn’t clear if the two doctors are connected, but Dr. Jamie Gottlieb is part owner of Doctor’s Hospital and is listed as a physician on the hospital’s website. That’s the facility owned by the other doctor, Cameron Gilbert.

Thursday, April 23, 2009

A variety of schemes to defraud Medicaid.

For Immediate Release
April 22, 2009 United States Attorney's Office
Southern District of Indiana
Contact: (317) 226-6333
Indiana Man Sentenced for Medicaid Fraud

Timothy M. Morrison, United States Attorney for the Southern District of Indiana, and Greg Zoeller, Indiana Attorney General, announced that DENNIS LENNARTZ, 55, Anderson, Indiana, was sentenced to 43 months imprisonment today by U.S. District Judge William T. Lawrence following his guilty plea to medicaid fraud. This case was the result of a six month investigation by the Health and Human Services Administration, Office of Inspector General, and the Federal Bureau of Investigation.

From August of 2006 through December of 2008, LENNARTZ, submitted false and misleading representations regarding transportation services he or his agents had purportedly provided to Medicaid patients of approximately $964,852.59.

The investigation of LENNARTZ revealed a variety of schemes to defraud Medicaid.

For example LENNARTZ was billing Medicaid for transporting patients receiving radiation treatments claiming that the distance was 300 miles per trip when, in fact, the trip was 31 miles. LENNARTZ also billed Medicaid for transporting a patient for rehabilitation claiming the distance was 220 miles when, in fact, it was only 33 miles. Another medicaid recipient LENNARTZ transported to Riley Hospital once a month resulted in Medicaid being billed for mileage claims 42 times in a period of three months.

"As this sentencing demonstrates yet again, those who would defraud taxpayers by preying on government health care programs can expect the scales of justice to weigh heavily against them," said Lamont Pugh III, Special Agent in Charge for the Chicago region of the U.S. Department of Health and Human Services Office of Inspector General which oversees the State of Indiana.

"This case was a joint effort by our state investigators and attorneys of the Indiana Medicaid Fraud Control Unit of the Office of the Attorney General and by the federal government. I want to commend all involved for their hard work in unraveling this scheme to drain funds away from legitimate Medicaid purposes," Indiana Attorney General Greg Zoeller said. "At a time when every public dollar is precious, we are sending a strong message that overbilling is an affront to the taxpayers and will be dealt with seriously."

Indiana Medicaid pays for the transportation services of its beneficiaries to and from Medicaid covered services. Transportation providers who bill for services to Indiana Medicaid must first undergo an enrollment process, agree to abide by the program's rules and regulations, and then become approved providers. These approved providers receive provider manuals which detail the Indiana Medicaid Program's rules and regulations as well as provide instruction on how to appropriately bill for services. These providers also receive periodic regulation "bulletins" from the Indiana Medicaid Program which are designed to remind providers of existing regulations or inform them of any changes.

Non-emergency transportation services are generally billed as either a Commercial / Common Ambulatory Service (CAS) or as a Non-Ambulatory Service (NAS). Indiana Medicaid regulations state that CAS services are to be billed when beneficiaries are ambulatory. That is, they are able to walk. This service is billed under a particular procedure code and providers are paid $10.00 for each one-way transport. However, in addition to billing this code, CAS providers can bill separately for mileage, as well as waiting time, and receive additional reimbursement. Mileage is reimbursed based on the amount of "loaded miles" which are the miles driven when the patient is in the transportation vehicle.

FBI Indianapolis Special Agent in Charge Michael S. Welch said, "The FBI is addressing Health Care Fraud through investigations just like this one. We will continue to work with partnering law enforcement agencies to ensure that we are safeguarding taxpayers' money."

According to Assistant U.S. Attorney Bradley P. Shepard who prosecuted the case for the government, Judge Lawrence also imposed three years supervised release following LENNARTZ’s release from imprisonment.

Wednesday, April 15, 2009

Miami forensic accountant - Rachlin Fraud on the Fraud...incredible

A federal judge has sharply criticized a Miami forensic accountant overseeing a massive forfeiture stemming from a health care fraud, saying she placed her firm's financial interests ahead of her role as court-appointed receiver.

U.S. District Court Judge B. Avant Edenfield in Savannah, Ga., also criticized Miami-based Rachlin, saying the firm purposely refused to file tax returns until it was paid, racking up fines and penalties.

Marta Alfonso, a partner in the firm's advisory services division, was appointed receiver after Edenfield ordered convicted officials of Miami-based Bio-Med Plus to pay forfeiture, fines and restitution following their convictions for bilking state and federal agencies on expensive AIDS and hemophilia treatments that were never administered.

Alfonso became involved in the case early, testifying as a defense expert, and made the unusual transition to receiver. She did well, recovering $54.1 million thus far on the forfeiture order.

She hired Miami attorney Thomas Tew, one of Tew Cardenas' name partners, as her lawyer in the receivership and farmed out the tax services to her firm.

Alfonso ran into trouble with the judge after filing an emergency motion Feb. 4 to pay Rachlin. The motion was filed after a court-appointed monitor overseeing the forfeiture refused to pay the bill for tax preparation. The monitor cited cost overruns and late filings.

Alfonso told the court that Rachlin should be paid $191,354, of which $127,397 is outstanding. The monitor had set a $76,500 budget cap for the tax returns prepared by Rachlin.

In an April 7 order to show cause, Edenfield said that Alfonso demonstrated a clear conflict of interest by lobbying the monitor on behalf of her firm. "The receiver's conflict has burdened the receivership not only by enabling an excessive budget overrun and the incurrence of unnecessary expenses, but also by causing additional receiver's fees, monitor's fees and attorney fees," the judge wrote.

The judge issued the order after asking both the receiver and monitor to file detailed explanations. Edenfield said the monitor's response was supported by affidavits and other documentation while the receiver's filing by Tew Cardenas attorney Dennis Nowak "was both untimely and unresponsive."

A call to Rachlin for comment was not returned by deadline.

Alfonso is a salaried Rachlin employee who does not share in the firm's profits. She did not return phone calls for comment.

In his order, the judge noted that Alfonso defended her firm, acknowledging mistakes may have been made but saying it was an internal Rachlin issue. She also said the services were reasonably priced even though invoices were $100,000 over budget and late.

Speaking on her behalf, Tew said this is the first dispute between Alfonso and the monitor in three years since she was appointed. He said the receivership would respond to the show cause order by Friday.

Tew said it is commonplace for receivers to tap their own firms for tax services.

Attorneys who are appointed receivers regularly hire their own firms as legal counsel.

"There has been no wrongdoing," Tew said. "We do not believe there is a conflict."

The judge set a hearing for next Tuesday, April 21, so Alfonso can show cause why she should not be removed as receiver and why the court should not seek to recover any wasted assets.

Rachlin bills itself as one of the largest independent public accounting and advisory service firms in the Southeast with 25 partners and more than 225 professionals in South and Central Florida.

Bio-Med Plus was a medical supply company based in Miami and Savannah with about 100 employees. It was acquired by Novis Pharmaceuticals in 2007 after three top Bio-Med officials were accused of cheating users of life-saving blood products. The officials were prosecuted for health care fraud in Georgia, Florida and California.

In his order, Edenfield chastised Alfonso for submitting several bills from Rachlin, ranging from $98,992 to $171,379 for the same tax services. Rachlin filed late tax returns for the receivership for 2006 and 2007, incurring $231,226 in interest and penalties.

The monitor, Madison Associates of Woodbridge, Va., raised questions about the bills after a routine review from April through mid-September 2008.

"Through e-mails, memoranda, revised, re-revised and thrice-revised invoices, the receiver and Rachlin offered a stream of unresponsive and obfuscatory answers to the monitor's inquirers reminiscent of the 'Who's on First?' Abbott and Costello comedy routine," Edenfield wrote in his order.

In a series of e-mails last year, Alfonso declared "we have been paid nothing" for the 2007 tax services after giving blanket approval for a series of misstated and miscalculated Rachlin invoices. She later conceded invoices had been paid, Edenfield said.

Edenfield concluded Rachlin did little from April to July 2008.

"This inactivity suggests that Rachlin negligently allowed late penalties and interest to accrue while it waited for the receiver's collection of its fees in excess of the [$76,500] cap," Edenfield wrote.

The monitor suggested last September that an outside arbiter be engaged in resolving the conflict over the tax return issue with Rachlin, but Alfonso declined the recommendation, the judge's order said.

Alfonso proposed an independent review earlier this month of Rachlin's work to render an opinion on reasonable fees, Tew said.

Edenfield responded in his order, "The opportunity for such review, however, has come and gone."

Rachlin- Accounting frim in on it- really? Is that a surprise?

Federal Judge Raps Court-Appointed Receiver for Conflict of Interest
April 15, 2009

A federal judge has sharply criticized a Miami forensic accountant overseeing a massive forfeiture stemming from a health care fraud, saying she placed her firm's financial interests ahead of her role as court-appointed receiver.

The judge also criticized Miami-based accounting firm Rachlin, which, with the receiver, "offered a stream of unresponsive and obfuscatory answers to the monitor's inquirers reminiscent of the 'Who's on First?' Abbott and Costello comedy routine," the judge wrote in his order.

Saturday, April 11, 2009

fined Urciuoli $30,000 and ordered him to perform eight hours a week of community service during two years of court supervision following his release

October, a federal jury found Urciuoli guilty of conspiracy and 35 counts of mail fraud.

Not a bad deal.....

News Release
U.S. Department of Justice
United States Attorney
District of Rhode Island

April 10, 2009
WWW.USDOJ.GOV/USAO/MAContact: Thomas Connell
PHONE: 401-709-5032
E-MAIL: Thomas.connell@usdoj.gov

A federal judge today sentenced Robert A. Urciuoli, the former president of Roger Williams Medical Center, to three years in federal prison for corruptly employing former Rhode Island Senator John Celona to advance the Medical Center’s interests in the General Assembly.

United States Attorney Robert Clark Corrente announced the sentence, which Chief U.S. District Court Judge Mary M. Lisi imposed in U.S. District Court, Providence. Judge Lisi also fined Urciuoli $30,000 and ordered him to perform eight hours a week of community service during two years of court supervision following his release from prison.

In October, a federal jury found Urciuoli guilty of conspiracy and 35 counts of mail fraud. During the trial, First Assistant U.S. Attorneys Luis M. Matos and Assistant U.S. Attorney Dulce Donovan presented evidence that Urciuoli hired Celona in 1998, ostensibly to work for the Village at Elmhurst, an assisted living center affiliated with Roger Williams. The evidence showed, however, that Urciuoli actually hired Celona to advance the Medical Center’s political agenda and by doing so, deprived the citizens of Rhode Island of their right to Celona’s honest services.

Between 1998 and 2004, Roger Williams paid Celona approximately $260,000 in consultant fees and, in return, Celona took steps to kill bills deemed harmful to Roger Williams and to advance legislation that Urciuoli considered favorable.

Celona worked to kill legislation that would have prohibited Medical Center officials from serving on the board of a for-profit hospital in the event of a merger. Celona also helped Urciuoli pressure medical insurance companies to increase their reimbursements to Roger Williams for health care services.

The trial in October was the second one stemming from a 2006 indictment. Convictions in October 2006 were reversed by the Court of Appeals for the First Circuit on an issue of how broadly to define the scope of honest services.

In September 2005, Celona pleaded guilty to federal fraud charges. He recently completed a 30-month prison sentence.

The Federal Bureau of Investigation and the Rhode Island State Police conducted the investigation.

Sunday, April 5, 2009

Violating the Food, Drug and Cosmetic Act,

MARCH 30, 2009

PHONE: (617)748-3356


BOSTON, MA - A Branchburg, NJ, woman agreed to plead guilty to violating the Food, Drug and Cosmetic Act, for marketing the drug Bextra for uses and dosages that were not approved by the Food and Drug Administration.

United States Attorney Michael J. Sullivan; Warren T. Bamford, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division; Susan J. Waddell, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General; Leigh-Alistair Barzey, Resident Agent in Charge of the Defense Criminal Investigative Service; Kim Rice, Special Agent in Charge of the Food and Drug Administration, Office of Criminal Investigations; Jeffrey Hughes, Special Agent in Charge of the U.S. Department of Veterans Affairs, Office of Inspector General, Office of Investigations - Northeast Field Office; Joseph Finn, Special Agent in Charge of the United States Postal Service, Office of Inspector General, Boston Field Office; and Drew Grimm, Special Agent in Charge of the U.S. Office of Personnel Management, Office of Inspector General - Eastern Operations, announced today that MARY HOLLOWAY, age 47, of Branchburg, New Jersey, has plead guilty to a one count Information charging her with distribution of a misbranded drug.

According to the Information from approximately November 2001, through April 2005, HOLLOWAY was employed as a Regional Manager at a pharmaceutical company and was responsible for sales in her region of the drug Bextra. Bextra was a Cox-II inhibitor and had been approved in by the Food and Drug Administration (FDA) in November 2001 for the signs and symptoms of osteoarthritis, adult rheumatoid arthritis, at 10 mgs and primary dysmennorhea at 20 mgs, twice a day as needed. The Information charges that, in 2001, the FDA specifically denied the request of the pharmaceutical company to approve it for acute pain, including the pain of surgery. The FDA told the pharmaceutical company that it could not approve it for these other indications because the safety in these other uses had not been established. Specifically, the FDA was concerned about the results of a study in which there was an excess of cardiovascular events in patients who had undergone coronary artery bypass graft surgery and used Bextra. Bextra was withdrawn from the market in April 2005.

HOLLOWAY was aware of the FDA’s safety concerns, but that she nonetheless had her sales staff of approximately 100 employees sell Bextra for precisely the uses that the FDA refused to approve. For example, HOLLOWAY trained and encouraged her sales teams to promote Bextra by obtaining protocols from doctors that instructed that Bextra be used for the pain of surgery, an unapproved use, and at 20 mgs, an unapproved dose. HOLLOWAY also instructed her staff to market Bextra for use before, during and after surgery to reduce the risk of deep vein thrombosis, which is a form of life threatening blood clots, even though she knew there were no studies showing that Bextra was safe and effective for this use. Finally, HOLLOWAY encouraged her staff to make false safety claims about Bextra in order to sell the drug.

HOLLOWAY faces up to six months’ imprisonment, to be followed by not more than 3 years of supervised release and a maximum fine of $100,000 or twice the amount of gross loss or gross gain.

The case was investigated by the Federal Bureau of Investigation, the Office of Inspector General for the Department of Health and Human Services, Special Prosecutions Staff for the Food and Drug Administration, the Office of Inspector General for the Department of Veterans Affairs, the Defense Criminal Investigative Service, the Office of Inspector General for the United States Postal Service and the Office of Inspector General for the U.S. Office of Personnel Management. It is being prosecuted by Assistant U.S. Attorneys Sara Miron Bloom and Susan M. Poswistilo of Sullivan’s Health Care Fraud Unit.