Posted: Dec 16, 2008 05:18 PM CST
NASHVILLE (WATE) -- A man and woman from Athens have been charged with 2 from Athens charged with TennCare fraud
Posted: Dec 16, 2008 05:18 PM CST
NASHVILLE (WATE) -- A man and woman from Athens have been charged with TennCare fraud in separate cases.
John V. Davis, 25, is charged with three counts of using TennCare to get controlled substances by doctor shopping.
According to the indictment, Davis failed to disclose to his doctor that he'd seen other doctors within a 30-day period, receiving prescriptions for the painkillers Oxycodone and Hydrocodone.
Investigators say Davis received a prescription for Oxycodone during a visit to a hospital emergency room, which was paid for by TennCare.
They also say Davis used TennCare twice to pay for prescriptions for Hydrocodone.
Kristie Smithers, 31, is charged with three counts of TennCare fraud for using it to pay for fake prescriptions.
Smithers is accused of using TennCare to pay for fake prescriptions written for Hydrocodone three times.
If convicted, each could each spend up to two years per charge in prison.
Showing posts with label HCA - The Healthcare Company. Show all posts
Showing posts with label HCA - The Healthcare Company. Show all posts
Friday, December 19, 2008
Friday, September 5, 2008
Healthfirst largest health plan for Medicaid beneficiaries pay $35 million FRAUD
Health plan settles fraud charges with state
A related indictment accuses a former Healthfirst executive of concealing a practice of paying employees based on productivity, which is prohibited to protect consumers from aggressive sales tactics.
Healthfirst, New York state’s largest health plan for Medicaid beneficiaries, agreed to pay $35 million to settle charges by the attorney general that it had submitted false marketing plans.
A former senior executive of Healthfirst was also indicted earlier this year on related charges, the attorney general’s office said.
Last November, the state Department of Health temporarily shut down enrollment in all but Healthfirst’s Medicare plans after the attorney general’s investigation was revealed. The company, which has about $1 billion in annual premium revenues, provides coverage for about 500,000 people in New York and New Jersey.
In the wake of the shutdown, which ended in March, Healthfirst’s chief executive and founder, Paul Dickstein, and chief operating officer James Boothe stepped down.
It was Mr. Boothe who was indicted in May for first degree insurance fraud, a felony.
The indictment alleges that Mr. Boothe caused Healthfirst to submit false marketing plans to the state and to local government agencies, and concealed the information that Healthfirst paid its marketing representatives based on their productivity, which is prohibited. According to the indictment, the payment plan violated the company’s contract with the state from 1999 through 2003. Healthfirst management reported the violations to the state, and the company cooperated with the attorney general’s investigation.
The rules governing the marketing of Medicaid plans are designed to protect people from aggressive sales tactics.
In January, Patricia Wang, then a senior vice president at Greater New York Hospital Association, was named Mr. Dickstein’s successor.
“None of the conduct involved relates to current practices of Healthfirst, and the company is in complete compliance with all relevant regulatory requirements,” said a spokesman for Healthfirst, whose owners include Beth Israel Medical Center, Mount Sinai Medical Center and The New York City Health and Hospitals Corp.
A related indictment accuses a former Healthfirst executive of concealing a practice of paying employees based on productivity, which is prohibited to protect consumers from aggressive sales tactics.
Healthfirst, New York state’s largest health plan for Medicaid beneficiaries, agreed to pay $35 million to settle charges by the attorney general that it had submitted false marketing plans.
A former senior executive of Healthfirst was also indicted earlier this year on related charges, the attorney general’s office said.
Last November, the state Department of Health temporarily shut down enrollment in all but Healthfirst’s Medicare plans after the attorney general’s investigation was revealed. The company, which has about $1 billion in annual premium revenues, provides coverage for about 500,000 people in New York and New Jersey.
In the wake of the shutdown, which ended in March, Healthfirst’s chief executive and founder, Paul Dickstein, and chief operating officer James Boothe stepped down.
It was Mr. Boothe who was indicted in May for first degree insurance fraud, a felony.
The indictment alleges that Mr. Boothe caused Healthfirst to submit false marketing plans to the state and to local government agencies, and concealed the information that Healthfirst paid its marketing representatives based on their productivity, which is prohibited. According to the indictment, the payment plan violated the company’s contract with the state from 1999 through 2003. Healthfirst management reported the violations to the state, and the company cooperated with the attorney general’s investigation.
The rules governing the marketing of Medicaid plans are designed to protect people from aggressive sales tactics.
In January, Patricia Wang, then a senior vice president at Greater New York Hospital Association, was named Mr. Dickstein’s successor.
“None of the conduct involved relates to current practices of Healthfirst, and the company is in complete compliance with all relevant regulatory requirements,” said a spokesman for Healthfirst, whose owners include Beth Israel Medical Center, Mount Sinai Medical Center and The New York City Health and Hospitals Corp.
Tuesday, June 17, 2008
Cracking down on home health care fraud.....REALLY?
Cracking down on home health care fraud
Updated: 06/12/2008 09:21 AM
By: Ken Jubie
NEW YORK STATE -- Dr. Hedy Migden thought she had done everything right when trying to find a Certified Nursing Assistant to take care of her then 84-year-old Parkinson's inflicted mother. She used a reputable agency, listed specific needs and was assured that the aide's background checked out. But even after doing her due diligence, Migden and her mother became victims of the fraud Attorney General Andrew Cuomo and state leaders are hoping to prevent.
At first, Dr. Migden and her mom were very happy with their home health aide, Tracey Uzel.
“She seemed competent. She slept on a cot in my mom's room. She seemed attentive and appropriate,” Midgen said.
Cracking down on home health care fraud
State lawmakers and the Attorney General are proposing legislation to crack down on fraud in the home health care industry. Ken Jubie sat down with a woman who used a reputable agency to hire a Certified Nursing Assistant to take care of her then 84-year-old mother, only to become a victim of the fraud Cuomo and state leaders are hoping to prevent.
But about a week later, Migden said her service started to slip. Then on the Saturday morning of Uzel's third week, she found her mother's house a mess and her debit card and other personal items were gone. They were stolen by the caretaker.
“We called the police, had her arrested and with the police interrogating her, she indeed produced the debit card,” Migden said.
About an hour later, the police revealed even more about the woman trusted to take care of her mother.
“Tracey Uzel is in fact Jonathan Uzel. And that Jonathan Uzel had a very extensive rap sheet including assault, prostitution,” said Migden.
Now, six years later, Attorney General Andrew Cuomo and state lawmakers are joining together to create legislation preventing others from feeling the same senses of guilt and betrayal Migden has experienced since entrusting her mother's care to a criminal.
Cuomo said 152,000 New Yorkers receive this kind of aide and his investigation led to more than 50 arrests for industry fraud. To stop it, he's proposing an Internet registry, listing aides and the schools that certified them.
“Part of the registry will require the school to certify that the aide was trained in accordance with state regulations,” Cuomo said.
The New York CARES Act will also list employment history, prior instances of abuse, mistreatment or neglect and past Department of Health decisions on employment based on criminal history.
“If the home care person doesn't have credibility coming into your home, that creates a huge discomfort for everybody,” said Senate Majority Leader Joe Bruno.
“I think to have a central registry would prevent those who have more serious offenses from even presenting to an agency for hire,” Migden said.
Migden said the state is taking a solid first step to save other families from the pain she and her mother have experienced. Her mother, by the way, is now 90 and doing well in a nursing home and Migden said she hopes lawmakers will also consider stronger requirements for people responsible for caring for one of our most vulnerable populations.
Updated: 06/12/2008 09:21 AM
By: Ken Jubie
NEW YORK STATE -- Dr. Hedy Migden thought she had done everything right when trying to find a Certified Nursing Assistant to take care of her then 84-year-old Parkinson's inflicted mother. She used a reputable agency, listed specific needs and was assured that the aide's background checked out. But even after doing her due diligence, Migden and her mother became victims of the fraud Attorney General Andrew Cuomo and state leaders are hoping to prevent.
At first, Dr. Migden and her mom were very happy with their home health aide, Tracey Uzel.
“She seemed competent. She slept on a cot in my mom's room. She seemed attentive and appropriate,” Midgen said.
Cracking down on home health care fraud
State lawmakers and the Attorney General are proposing legislation to crack down on fraud in the home health care industry. Ken Jubie sat down with a woman who used a reputable agency to hire a Certified Nursing Assistant to take care of her then 84-year-old mother, only to become a victim of the fraud Cuomo and state leaders are hoping to prevent.
But about a week later, Migden said her service started to slip. Then on the Saturday morning of Uzel's third week, she found her mother's house a mess and her debit card and other personal items were gone. They were stolen by the caretaker.
“We called the police, had her arrested and with the police interrogating her, she indeed produced the debit card,” Migden said.
About an hour later, the police revealed even more about the woman trusted to take care of her mother.
“Tracey Uzel is in fact Jonathan Uzel. And that Jonathan Uzel had a very extensive rap sheet including assault, prostitution,” said Migden.
Now, six years later, Attorney General Andrew Cuomo and state lawmakers are joining together to create legislation preventing others from feeling the same senses of guilt and betrayal Migden has experienced since entrusting her mother's care to a criminal.
Cuomo said 152,000 New Yorkers receive this kind of aide and his investigation led to more than 50 arrests for industry fraud. To stop it, he's proposing an Internet registry, listing aides and the schools that certified them.
“Part of the registry will require the school to certify that the aide was trained in accordance with state regulations,” Cuomo said.
The New York CARES Act will also list employment history, prior instances of abuse, mistreatment or neglect and past Department of Health decisions on employment based on criminal history.
“If the home care person doesn't have credibility coming into your home, that creates a huge discomfort for everybody,” said Senate Majority Leader Joe Bruno.
“I think to have a central registry would prevent those who have more serious offenses from even presenting to an agency for hire,” Migden said.
Migden said the state is taking a solid first step to save other families from the pain she and her mother have experienced. Her mother, by the way, is now 90 and doing well in a nursing home and Migden said she hopes lawmakers will also consider stronger requirements for people responsible for caring for one of our most vulnerable populations.
Medicare Fraud Runs Rampant
Medicare Fraud Runs Rampant
Posted Jun 13, 08 1:34 PM CDT in Science & Health, Crime & Courts, US
(Newser) – Health care fraud is rampant, especially in South Florida and the LA area, and surprisingly easy to pull off, reports the Washington Post. The 11-digit annual price tag could be smaller if investigators focused more on the fact that Medicare, for example, is "highly vulnerable" to scam artists and less on billing irregularities and unorthodox treatments, experts say.
Authorities have moved aggressively against crooks and have seen some success, but the problem remains massive. “The sheer number of zeroes following the dollar sign is irresistible to crooks and con men,” says AG Michael Mukasey. “For every crooked company we bust, there is another one to replace it before the ink on the indictment is dry.”
Source Washington Post
Posted Jun 13, 08 1:34 PM CDT in Science & Health, Crime & Courts, US
(Newser) – Health care fraud is rampant, especially in South Florida and the LA area, and surprisingly easy to pull off, reports the Washington Post. The 11-digit annual price tag could be smaller if investigators focused more on the fact that Medicare, for example, is "highly vulnerable" to scam artists and less on billing irregularities and unorthodox treatments, experts say.
Authorities have moved aggressively against crooks and have seen some success, but the problem remains massive. “The sheer number of zeroes following the dollar sign is irresistible to crooks and con men,” says AG Michael Mukasey. “For every crooked company we bust, there is another one to replace it before the ink on the indictment is dry.”
Source Washington Post
The Real Criminals: Corporate CEOs
It’s not the two-bit petty criminal whose causing the real danger in our lives and neighborhoods, it’s the Corporate criminals. The guys in suits, two steps removed from the people they are inflicting life threatening damage to that are wrecking havoc on our lives and our nation.
Corporate crime is often violent crime with very real victims. Mokhiber points out that while the FBI estimates that 16,000 Americans are murdered every year “56,000 Americans die every year on the job or from occupational diseases such as black lung and asbestosis while tens of thousands of other Americans fall victim to the silent violence of pollution, contaminated foods, hazardous consumer products, and hospital malpractice.” -Gene Racz
Literally thousands of people dying because of purposeful oversight and ignorance by those whose only concern is often the bottom line. And your probably thinking, “It’s a good thing are government is taking care of them,” wondering how many CEOs will come to the same fate as Skilling and Lay (of Enron). And then you find out this tidbit:
The New York Times recently reported that the government has basically stopped prosecuting corporations for crimes despite the fact that costs of corporate crime far outweighs street crime. Eric Lichtblau, writing for the Times, noted that during the last three years, the U.S. Justice Department has put off prosecuting more than 50 corporations on charges ranging from bribery to fraud. Instead, it has been entering into so-called deferred prosecution agreements and non-prosecution agreements, in which companies are allowed to pay fines and hire monitors to watch over them.
Noware corrupt, but simply that it’s a terrible statement about our society that those with money are allowed to keep stealing from the rest of us and not be prosecuted for it. Seriously, they are stealing from all of us, not only on the product side of things but also in our tax dollars:
Health-care fraud alone, he said, costs Americans $100 billion to $400 billion a year. The taxpayer bill to clean up the savings and loan fraud was anywhere from $300 billion to $500 billion.
Not only do we need to speak up to our Justice Department about how this is unjust and unfair, but this knowledge should change and challenge the way you talk about and think about criminals. You should either conjure up the same disgust and suspicion of CEO’s as you currently have of street criminals and those you think look like criminals, or you should try and balance your perspective on both to a more understanding, but equally just perspective on both.
Corporate crime is often violent crime with very real victims. Mokhiber points out that while the FBI estimates that 16,000 Americans are murdered every year “56,000 Americans die every year on the job or from occupational diseases such as black lung and asbestosis while tens of thousands of other Americans fall victim to the silent violence of pollution, contaminated foods, hazardous consumer products, and hospital malpractice.” -Gene Racz
Literally thousands of people dying because of purposeful oversight and ignorance by those whose only concern is often the bottom line. And your probably thinking, “It’s a good thing are government is taking care of them,” wondering how many CEOs will come to the same fate as Skilling and Lay (of Enron). And then you find out this tidbit:
The New York Times recently reported that the government has basically stopped prosecuting corporations for crimes despite the fact that costs of corporate crime far outweighs street crime. Eric Lichtblau, writing for the Times, noted that during the last three years, the U.S. Justice Department has put off prosecuting more than 50 corporations on charges ranging from bribery to fraud. Instead, it has been entering into so-called deferred prosecution agreements and non-prosecution agreements, in which companies are allowed to pay fines and hire monitors to watch over them.
Noware corrupt, but simply that it’s a terrible statement about our society that those with money are allowed to keep stealing from the rest of us and not be prosecuted for it. Seriously, they are stealing from all of us, not only on the product side of things but also in our tax dollars:
Health-care fraud alone, he said, costs Americans $100 billion to $400 billion a year. The taxpayer bill to clean up the savings and loan fraud was anywhere from $300 billion to $500 billion.
Not only do we need to speak up to our Justice Department about how this is unjust and unfair, but this knowledge should change and challenge the way you talk about and think about criminals. You should either conjure up the same disgust and suspicion of CEO’s as you currently have of street criminals and those you think look like criminals, or you should try and balance your perspective on both to a more understanding, but equally just perspective on both.
Cato Institute puts health care fraud at over $60 billion per year
Fraud, and certainly abuse
The Cato Institute gets its knickers in a knot about Medicare fraud, citing a report that puts health care fraud at over $60 billion per year.Let's put this number in a bit of perspective:
Medicare actually lost about seven cents of every dollar spent to fraud, waste and mistakes in 1998, government auditors said earlier this month.
That amounts to more than $12 billion -- but it's only about half of what was lost by the government's health insurance program for the elderly and disabled just two years ago.
Yep, a fivefold increase in less than a decade.
Let's see, what happened in that decade?
Oh, yes, the administrators at the top changed.
You don't send Republicans to do a man's job.
Update: Medicare reduces costs for providers, it turns out. I guess the Bush League couldn't fix that.
The Cato Institute gets its knickers in a knot about Medicare fraud, citing a report that puts health care fraud at over $60 billion per year.Let's put this number in a bit of perspective:
Medicare actually lost about seven cents of every dollar spent to fraud, waste and mistakes in 1998, government auditors said earlier this month.
That amounts to more than $12 billion -- but it's only about half of what was lost by the government's health insurance program for the elderly and disabled just two years ago.
Yep, a fivefold increase in less than a decade.
Let's see, what happened in that decade?
Oh, yes, the administrators at the top changed.
You don't send Republicans to do a man's job.
Update: Medicare reduces costs for providers, it turns out. I guess the Bush League couldn't fix that.
Monday, February 18, 2008
United Health Care, nation's largest health insurer
Hmmmmm......lets put it together ,,,,,,,real soon
Suspecting Fraud, NY Attorney General Investigates United Health Care
Filed under: Health Care
New York Attorney General Andrew Cuomo announced today that he has opened an investigation into whether Minneapolis-based United Health Care, the nation's largest health insurer, has been fleecing patients on out-of-network charges for the last decade.
NOTE:
Remember, HCA - The Healthcare Company, HCA Inc., Hosptical Corporation of America, or whatever other names they have used , was once the largest Healthcare Provider in the US also has a history of fraud.
AS of today, we have NCFE, the largest fraudulent scheme in the history of this country, even larger than Enron is currently at trial. (One of the executives, not yet on trial until OCTOBER, (Who knows why) came from ......HCA!!!!
Oh yea!!!
LETS WAKE UP!!!
Suspecting Fraud, NY Attorney General Investigates United Health Care
Filed under: Health Care
New York Attorney General Andrew Cuomo announced today that he has opened an investigation into whether Minneapolis-based United Health Care, the nation's largest health insurer, has been fleecing patients on out-of-network charges for the last decade.
NOTE:
Remember, HCA - The Healthcare Company, HCA Inc., Hosptical Corporation of America, or whatever other names they have used , was once the largest Healthcare Provider in the US also has a history of fraud.
AS of today, we have NCFE, the largest fraudulent scheme in the history of this country, even larger than Enron is currently at trial. (One of the executives, not yet on trial until OCTOBER, (Who knows why) came from ......HCA!!!!
Oh yea!!!
LETS WAKE UP!!!
$1.9 billion fraud case
AFX News Limited
Former executive wants house arrest
02.15.08, 6:21 PM ET
COLUMBUS, Ohio (AP) - A former health care executive facing trial in a wants to be released from jail so he can have more time to prepare his defense.
Lance Poulsen, former president of National Century Financial (other-otc: CYFL.PK - news - people ) Enterprises near Columbus, says he's only getting access to a work room at the Ross County jail in southern Ohio for two hours a day and no time on weekends.
U.S. District Judge Algenon Marbley last month denied Poulsen's request for house arrest but ordered a room be reserved for use eight hours a day, seven days a week.
A message was left with the jail seeking comment.
Former executives of National Century are currently on trial. Poulsen faces a witness-tampering trial next month and his own fraud trial in August.
Copyright 2007 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Neither the Subscriber nor AFX News warrants the completeness or accuracy of the Service or the suitability of the Service as a trading aid and neither accepts any liability for losses howsoever incurred. The content on this site, including news, quotes, data and other information, is provided by AFX News and its third party content providers for your personal information only, and neither AFX News nor its third party content providers shall be liable for any errors, inaccuracies or delays in content, or for any actions taken in reliance thereon.
Former executive wants house arrest
02.15.08, 6:21 PM ET
COLUMBUS, Ohio (AP) - A former health care executive facing trial in a wants to be released from jail so he can have more time to prepare his defense.
Lance Poulsen, former president of National Century Financial (other-otc: CYFL.PK - news - people ) Enterprises near Columbus, says he's only getting access to a work room at the Ross County jail in southern Ohio for two hours a day and no time on weekends.
U.S. District Judge Algenon Marbley last month denied Poulsen's request for house arrest but ordered a room be reserved for use eight hours a day, seven days a week.
A message was left with the jail seeking comment.
Former executives of National Century are currently on trial. Poulsen faces a witness-tampering trial next month and his own fraud trial in August.
Copyright 2007 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Neither the Subscriber nor AFX News warrants the completeness or accuracy of the Service or the suitability of the Service as a trading aid and neither accepts any liability for losses howsoever incurred. The content on this site, including news, quotes, data and other information, is provided by AFX News and its third party content providers for your personal information only, and neither AFX News nor its third party content providers shall be liable for any errors, inaccuracies or delays in content, or for any actions taken in reliance thereon.
Friday, February 1, 2008
Financial Fraud? Look deeper......where is Mr. Happ?
Maybe we need to 'investigate' a little deeper into what really occurred here?
Besides Lance Poulsen missing, Mr. James Happ is alos missing. One must really analyze who James Happ was and why he was placed at NCFE.
More to follow.......but in the meantime, we can read this!
By ANDREW WELSH-HUGGINS
Associated Press Writer
COLUMBUS, Ohio -- Six years after the collapse of the country's biggest health care finance company, a trial is nearing for five executives accused of a $1.9 billion fraud that helped bring the company down.
The case involves one of the largest alleged white-collar crimes after Enron or WorldCom, yet it is largely unknown to the public.
"I tell people all the time, this is the most important case that people have never heard of," said Kathy Patrick, whose Houston firm represents a group of investors that lost a total of $1.6 billion when National Century Financial Enterprises collapsed in 2002.
Two former owners of National Century and three former executives go on trial Monday in federal court in Columbus. The company was based in suburban Dublin.
Federal prosecutors say the officials conspired to defraud investors by diverting money from investors' funds for improper uses, fabricating data in investor reports, and moving money back and forth between accounts to conceal investor fund shortfalls.
The government expects to call 45 witnesses during the trial, which is expected to last six to eight weeks.
Missing from the trial will be National Century's former president and chief executive, Lance Poulsen, a chief target of the government's allegations.
Before his own trial on the fraud charges in August, Poulsen is scheduled for a March trial on charges of witness tampering.
U.S. Attorney Gregory Lockhart said Poulsen, of Port Charlotte, Fla., had a Columbus resident offer a government witness cash in exchange for her not giving damaging testimony against Poulsen. He has pleaded not guilty and is being held in a Ross County jail.
Poulsen is already fighting similar fraud charges in a civil case brought by the Securities and Exchange Commission.
Messages were left for Poulsen's attorney seeking comment.
The five executives going on trial Monday have pleaded not guilty to all charges and maintain their innocence.
Several other National Century executives charged in the scheme have pleaded guilty, and at least four may testify in the trial.
National Century had been the nation's largest source of financing to health care providers. Doctors, hospitals and other providers received money from the company rather than waiting for insurance payments, usually getting 80 or 90 cents on the dollar. National Century was then to collect and keep the full amount of the payments owed by insurance companies.
Providers, by going through National Century, received money owed them earlier than if they waited for full payment from insurance companies.
National Century raised the money to fund its business by selling bonds to investors, who received interest payments followed by a lump-sum payment.
The government alleges National Century executives routinely overpaid some health care providers, many of them entities the executives had a financial interest in. National Century told investors it was making the proper payments, according to the government.
During 2001 and 2002 alone, the government says, company executives provided more than $700 million in investor funds to health care providers.
These advances amounted to high-risk, unsecured loans that were hidden from investors, the government said.
"National Century's business became increasingly dependent upon keeping these certain health care provider clients in business, because the money owed to National Century far exceeded the possible collections from the accounts receivable purchased by National Century," the government said in a Jan. 22 court filing.
National Century's investors say they participated in the program because the investment risks were deemed low. They included the state of Arizona, banks, insurance companies and local governments such as cities and counties.
"These are investors who do not expect or take the risk associated with credit defaults," Patrick said. "These investors were told this was money market equivalent, safe, secure investments, and it evaporated."
Investors represented by Patrick have sued Credit Suisse First Boston over the $1.6 billion they say was lost in the National Century collapse.
Credit Suisse marketed $3 billion of National Century's asset-backed securities. The company declined comment.
Although the focus has been on money lost by investors, people shouldn't discount the blow to doctors and other medical practitioners that relied on National Century to keep their practices running, said W.C. Benton, an Ohio State University business professor who has followed the case.
Some health care companies filed for bankruptcy because of interrupted payments from National Century, and others have filed civil lawsuits against the company.
"It will be a major, major bump in the road in terms of financing health care," Benton said. "A lot of these small practices don't have extra cash. It's going to stop some of the growth in that area."
Besides Lance Poulsen missing, Mr. James Happ is alos missing. One must really analyze who James Happ was and why he was placed at NCFE.
More to follow.......but in the meantime, we can read this!
By ANDREW WELSH-HUGGINS
Associated Press Writer
COLUMBUS, Ohio -- Six years after the collapse of the country's biggest health care finance company, a trial is nearing for five executives accused of a $1.9 billion fraud that helped bring the company down.
The case involves one of the largest alleged white-collar crimes after Enron or WorldCom, yet it is largely unknown to the public.
"I tell people all the time, this is the most important case that people have never heard of," said Kathy Patrick, whose Houston firm represents a group of investors that lost a total of $1.6 billion when National Century Financial Enterprises collapsed in 2002.
Two former owners of National Century and three former executives go on trial Monday in federal court in Columbus. The company was based in suburban Dublin.
Federal prosecutors say the officials conspired to defraud investors by diverting money from investors' funds for improper uses, fabricating data in investor reports, and moving money back and forth between accounts to conceal investor fund shortfalls.
The government expects to call 45 witnesses during the trial, which is expected to last six to eight weeks.
Missing from the trial will be National Century's former president and chief executive, Lance Poulsen, a chief target of the government's allegations.
Before his own trial on the fraud charges in August, Poulsen is scheduled for a March trial on charges of witness tampering.
U.S. Attorney Gregory Lockhart said Poulsen, of Port Charlotte, Fla., had a Columbus resident offer a government witness cash in exchange for her not giving damaging testimony against Poulsen. He has pleaded not guilty and is being held in a Ross County jail.
Poulsen is already fighting similar fraud charges in a civil case brought by the Securities and Exchange Commission.
Messages were left for Poulsen's attorney seeking comment.
The five executives going on trial Monday have pleaded not guilty to all charges and maintain their innocence.
Several other National Century executives charged in the scheme have pleaded guilty, and at least four may testify in the trial.
National Century had been the nation's largest source of financing to health care providers. Doctors, hospitals and other providers received money from the company rather than waiting for insurance payments, usually getting 80 or 90 cents on the dollar. National Century was then to collect and keep the full amount of the payments owed by insurance companies.
Providers, by going through National Century, received money owed them earlier than if they waited for full payment from insurance companies.
National Century raised the money to fund its business by selling bonds to investors, who received interest payments followed by a lump-sum payment.
The government alleges National Century executives routinely overpaid some health care providers, many of them entities the executives had a financial interest in. National Century told investors it was making the proper payments, according to the government.
During 2001 and 2002 alone, the government says, company executives provided more than $700 million in investor funds to health care providers.
These advances amounted to high-risk, unsecured loans that were hidden from investors, the government said.
"National Century's business became increasingly dependent upon keeping these certain health care provider clients in business, because the money owed to National Century far exceeded the possible collections from the accounts receivable purchased by National Century," the government said in a Jan. 22 court filing.
National Century's investors say they participated in the program because the investment risks were deemed low. They included the state of Arizona, banks, insurance companies and local governments such as cities and counties.
"These are investors who do not expect or take the risk associated with credit defaults," Patrick said. "These investors were told this was money market equivalent, safe, secure investments, and it evaporated."
Investors represented by Patrick have sued Credit Suisse First Boston over the $1.6 billion they say was lost in the National Century collapse.
Credit Suisse marketed $3 billion of National Century's asset-backed securities. The company declined comment.
Although the focus has been on money lost by investors, people shouldn't discount the blow to doctors and other medical practitioners that relied on National Century to keep their practices running, said W.C. Benton, an Ohio State University business professor who has followed the case.
Some health care companies filed for bankruptcy because of interrupted payments from National Century, and others have filed civil lawsuits against the company.
"It will be a major, major bump in the road in terms of financing health care," Benton said. "A lot of these small practices don't have extra cash. It's going to stop some of the growth in that area."
Tuesday, January 15, 2008
HCA - The Healthcare Company
FOR IMMEDIATE RELEASE
CIV
FRIDAY, JUNE 1, 2001
(202) 514-2007
WWW.USDOJ.GOV
TDD (202) 514-1888
JUSTICE DEPARTMENT ANNOUNCES SETTLEMENTS
AGAINST SEVEN HOSPITALS FOR OVER $5 MILLION
WASHINGTON, DC - Seven hospitals located around the country have agreed to pay the United States $5,476,637 to settle claims that they unlawfully charged federal health care programs for surgical procedures using experimental cardiac devices, the Justice Department announced today.
The devices had not been approved for marketing by the Food and Drug Administration (FDA) at the time the procedures were performed between 1987 and 1994. The United States maintained that the hospitals violated the False Claims Act by knowingly seeking federal reimbursement for services when they knew that Medicare and TRICARE, the military health care program, considered the procedures to be non-reimbursable.
Holy Cross Hospital in Ft. Lauderdale, Florida, will pay $2,830,208. HCA - The Healthcare Company, which operated Green Hospital of Scripps Clinic in San Diego, California, until November, 1991, and also owned Healthwest Regional Medical Center in Phoenix, Arizona; West Florida Regional Medical Center in Pensacola, Florida; and Miami Heart Institute in Miami, will pay $1,929,255. South Miami Hospital will pay $450,000 and Mt. Sinai Hospital, also in Miami, will pay $267,174.
The government had previously entered into settlements with other hospitals engaged in similar conduct. These other settlements resulted in payments of almost $13 million.
"Taxpayer-funded health insurers have a right and a duty to set responsible limits on the goods and services they will pay for," said Acting Assistant Attorney General Stuart Schiffer. "The hospitals in this case disregarded clear government coverage limitations in order to bill federal health care programs for procedures that they knew were not reimbursable. The Justice Department intends to pursue other hospitals that have engaged in the same conduct."
The settlement announced today stems from a qui tam or whistleblower lawsuit filed by Kevin Cosens, a former medical device salesman. Under the False Claims Act, private citizens can bring suit on behalf of the government and share in any awards that are obtained through that legal action. Mr. Cosens will receive $1,095,327. His attorneys will also receive reimbursement for legal fees from the settling hospitals.
The government's investigation was conducted by the Civil Division of the Department of Justice; the United States Attorney's Offices in the Southern District of Florida, the Southern District of California, and the Western District of Washington; the Office of Inspector General of the Department of Health and Human Services, and the Defense Criminal Investigative Service.
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01-242
CIV
FRIDAY, JUNE 1, 2001
(202) 514-2007
WWW.USDOJ.GOV
TDD (202) 514-1888
JUSTICE DEPARTMENT ANNOUNCES SETTLEMENTS
AGAINST SEVEN HOSPITALS FOR OVER $5 MILLION
WASHINGTON, DC - Seven hospitals located around the country have agreed to pay the United States $5,476,637 to settle claims that they unlawfully charged federal health care programs for surgical procedures using experimental cardiac devices, the Justice Department announced today.
The devices had not been approved for marketing by the Food and Drug Administration (FDA) at the time the procedures were performed between 1987 and 1994. The United States maintained that the hospitals violated the False Claims Act by knowingly seeking federal reimbursement for services when they knew that Medicare and TRICARE, the military health care program, considered the procedures to be non-reimbursable.
Holy Cross Hospital in Ft. Lauderdale, Florida, will pay $2,830,208. HCA - The Healthcare Company, which operated Green Hospital of Scripps Clinic in San Diego, California, until November, 1991, and also owned Healthwest Regional Medical Center in Phoenix, Arizona; West Florida Regional Medical Center in Pensacola, Florida; and Miami Heart Institute in Miami, will pay $1,929,255. South Miami Hospital will pay $450,000 and Mt. Sinai Hospital, also in Miami, will pay $267,174.
The government had previously entered into settlements with other hospitals engaged in similar conduct. These other settlements resulted in payments of almost $13 million.
"Taxpayer-funded health insurers have a right and a duty to set responsible limits on the goods and services they will pay for," said Acting Assistant Attorney General Stuart Schiffer. "The hospitals in this case disregarded clear government coverage limitations in order to bill federal health care programs for procedures that they knew were not reimbursable. The Justice Department intends to pursue other hospitals that have engaged in the same conduct."
The settlement announced today stems from a qui tam or whistleblower lawsuit filed by Kevin Cosens, a former medical device salesman. Under the False Claims Act, private citizens can bring suit on behalf of the government and share in any awards that are obtained through that legal action. Mr. Cosens will receive $1,095,327. His attorneys will also receive reimbursement for legal fees from the settling hospitals.
The government's investigation was conducted by the Civil Division of the Department of Justice; the United States Attorney's Offices in the Southern District of Florida, the Southern District of California, and the Western District of Washington; the Office of Inspector General of the Department of Health and Human Services, and the Defense Criminal Investigative Service.
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01-242
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