For Immediate Release
July 17, 2009 United States Attorney's Office
Southern District of Texas
Contact: (713) 567-9000
Two Houston Area Doctors Charged in Conspiracy to Illegally Distribute Narcotics and Medicare/Medicaid Fraud
HOUSTON—Dr. Arun Sharma and his wife, Dr. Kiran Sharma, M.D., both 54, have been charged in a 29-count indictment alleging conspiracy to unlawfully dispense and distribute controlled substances outside the scope of professional practice and not for a legitimate medical purpose, United States Attorney Tim Johnson, Drug Enforcement Administration (DEA) Special Agent in Charge Zoran B. Yankovich and Texas Attorney General Greg Abbott announced today. The indictment alleges the two doctors illegally distributed 1.3 million tablets of hydrocodone and further charges the two doctors with conspiracy to defraud Medicare, Medicaid and several private health insurance companies of $31 million by filing false claims for medical procedures that were never performed.
"This indictment reflects the DEA's effort to identify and target doctors who discredit the medical health profession who are nothing more than drug peddlers in doctors' gowns motivated by greed with no regard for the well being of the public," said DEA Special Agent in Charge Zorn B. Yankovich. "By obtaining the voluntary surrender of DEA registration's from questionable doctors, the DEA Tactical Diversion Squad is able to put these illegal practices out of business. The DEA will continue to pursue these pain clinic-pill mill operations that have taken root in the Houston area."
According to the allegations in the indictment returned by a federal grand jury late yesterday afternoon, the Sharmas operate the Allergy, Asthma, Arthritis and Pain Centers located at on Cole Street in Webster, Texas, and another on Garth Road in Baytown, Texas. The indictment alleges that Dr. Arun Sharma routinely saw in excess of 70 patients per day and that he routinely wrote prescriptions for hydrocodone that were not for a legitimate medical purpose in exchange for cash payments. Dr. Sharma allegedly received the cash payments for his hydrocodone prescriptions directly from the patient and that he instructed his patients to take the prescriptions to certain pharmacies to be filled.
Arun and Kiran Sharma, according to the indictment, stored large amounts of cash received from the sale of hydrocodone prescriptions at their home. Kiran Sharma allegedly transported large amounts of cash received from the sale of the hydrocodone prescriptions to two safe deposit boxes - one each at Bank of America and Prosperity Bank.
The doctors also were charged with specific counts of illegal drug distribution for hydrocodone prescriptions written to specific patients. In one count, they are charged with prescribing more than 8,000 tablets of hydrocodone to one patient over an eight month period. In two other counts, they are charged with prescribing 540 tablets of hydrocodone to one patient on May 23, 2005, and another 540 tablets to the same patient on Dec. 5, 2005.
Both doctors are also accused of conspiring to defraud Medicare, Medicaid and private healthcare insurers including Blue Cross Blue Shield of Texas, Aetna, Cigna and United Healthcare of more than $31 million for facet joint injections and other medical procedures that were allegedly never performed.
The United States also gave notice in the indictment to the doctors that it intended to forfeit their interest in all of the proceeds of the fraud and the drug distribution.
The court has ordered that a summons issue directing the Sharma's to appear in federal court for arraignment on Aug. 3, 2009.
Upon conviction, each of the 17 health care fraud counts and the healthcare conspiracy charge carries a maximum penalty of 10 years in a federal prison and a $250,000 fine. The drug conspiracy and each of the 10 drug distribution counts carries a penalty of five years imprisonment and a $250,000 fine. Parole has been abolished in the federal prison system.
The criminal charges are the result of a joint investigation being conducted by agents of the FBI, the DEA, the Department of Health and Human Services-Office of Inspector General and the Medicare Fraud Control Unit of the Texas Attorney General's Office in conjunction with the Webster, League City and Baytown Police Departments. The case will be prosecuted by Assistant United States Attorney Al Balboni.
An indictment is an accusation of criminal conduct, not evidence.
A defendant is presumed innocent unless and until convicted through due process of law.
Wednesday, July 22, 2009
Wednesday, July 15, 2009
My letter to President Obama– Organizing for America
President – Organizing for America
Remember 1997? Balanced Budget Act of 1997- In 1997, HCA (Hospital Corporation of America) – was the LARGEST HOME HEALTH CARE Company in our country.
HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company)
Note: Hospital Corporation of America (HCA) was acquired by Columbia in 1994.
Columbia/HCA was a partnership of financier Richard Rainwater of Ft. Worth and lawyer Richard Scott.
Under the Balanced Budget Act of 1997- Home health - was struggling; about 1,400 agencies closed nationwide in 1998.
On Sept 8, 1998 Standard and Poors downgraded the bonds of Charter/HCA
Rainwater also owned a large stake in Magellan Health Care which controls Charter Medical. Magellan, run by Darla Moore, is the largest network of psychiatric hospitals in the country. They are becoming more and more involved in obtaining government money for services formerly not covered as health care, according to Fortune Magazine.
(Note: Rick Scott was terminated by Darla Moore, the wife of Richard Rainwater in 1997. According to Fortune Magazine, the “Toughest Babe in the Business”, Moore created the Corporate Bankruptcy Finance Tool- DIP- (Debtor in Possession), while employed at a Chase bank on Wall Street.
“They are becoming more and more involved in obtaining government money for services formerly not covered as health care, according to Fortune Magazine. “
2003-WWW.USDOJ.GOV - HCA INVESTIGATION - LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
HCA not only robbed the country’s Medicare/Medicaid system, but the entire Healthcare system and its tentacles.
Connect- Healthcare Finance Fraud, SEC Fraud, Bankruptcy Fraud, Financial Fraud and Mortgage Fraud- all for ‘market driven healthcare’ in America?
2009 - The Wall Street Journal reported that Richard Scott, "the former chief executive of HCA Inc," had formed the non-profit organization Conservatives for Patients' Rights as part of a "lobbying campaign to derail or modify" President Obama's health care proposals,...
In 1997, Rick Scott was terminated by Darla Moore. As part of Richard Scott's severance package from Columbia he was paid $5.13 million and given a five year consulting contract at $950,000 per year.
1997 + 5 = 2002
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio
“This case is one of the largest corporate fraud investigations involving a privately held company headquartered in small town America,” said Assistant Director Kenneth W. Kaiser of the FBI Criminal Investigative Division.
In October 2008- Leo Wise, now at the OCE ---stated "Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated.
Guess where ALL of Richard Scott's & Richard Rainwater’s Columbia/ HCA and certain subsidiaries and joint ventures were?
National Century Financial Enterprises, Inc.! (NCFE).
One prosecutor stated ‘…’NCFE- the largest corporate fraud investigations involving a privately held company and no one has ever heard of.’
NO ONE HAS EVER HEARD OF? (The largest corporate fraud investigation…)
Why is that?
Richard Rainwater was GW Bush’s ex- partner with the Rangers.
October 2008, Leo Wise now at the OCE office prosecuted the CEO and co-founder of National Century Financial Enterprises - CEO Sentenced to 30 Years in Prison
12 Executives/co-Founders already found guilty-
December 18, 2008, almost one month before GW Bush leaves office- the last person to stand trial, the ONE and ONLY acquittal- James K Happ!
Jurors stated 'PROSECUTOR DID NOT DO HIS JOB'-
Prosecutors' case fell short juror says-National Century fraud case produces 1st and only acquittal The "not guilty" verdicts that came in federal court yesterday were not so much a vindication of the last National Century Financial Enterprises executive to stand trial, a juror said.
Instead, they were more a belief that federal prosecutors had not done their job, ...
"He very well may have been guilty. A lot of us thought he was," said the juror who wouldn't give his name...
While Richard Scott was at Columbia in 1997 - James K Happ was CFO of Columbia Homecare Group, Inc.
James K Happ, only acquittal at National Century Financial Enterprises, Inc‘s who just so happened to be the CFO of Columbia Homecare Group.
Remember 1997? Balanced Budget Act of 1997- In 1997, HCA (Hospital Corporation of America) – was the LARGEST HOME HEALTH CARE Company in our country.
HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company)
Note: Hospital Corporation of America (HCA) was acquired by Columbia in 1994.
Columbia/HCA was a partnership of financier Richard Rainwater of Ft. Worth and lawyer Richard Scott.
Under the Balanced Budget Act of 1997- Home health - was struggling; about 1,400 agencies closed nationwide in 1998.
On Sept 8, 1998 Standard and Poors downgraded the bonds of Charter/HCA
Rainwater also owned a large stake in Magellan Health Care which controls Charter Medical. Magellan, run by Darla Moore, is the largest network of psychiatric hospitals in the country. They are becoming more and more involved in obtaining government money for services formerly not covered as health care, according to Fortune Magazine.
(Note: Rick Scott was terminated by Darla Moore, the wife of Richard Rainwater in 1997. According to Fortune Magazine, the “Toughest Babe in the Business”, Moore created the Corporate Bankruptcy Finance Tool- DIP- (Debtor in Possession), while employed at a Chase bank on Wall Street.
“They are becoming more and more involved in obtaining government money for services formerly not covered as health care, according to Fortune Magazine. “
2003-WWW.USDOJ.GOV - HCA INVESTIGATION - LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
HCA not only robbed the country’s Medicare/Medicaid system, but the entire Healthcare system and its tentacles.
Connect- Healthcare Finance Fraud, SEC Fraud, Bankruptcy Fraud, Financial Fraud and Mortgage Fraud- all for ‘market driven healthcare’ in America?
2009 - The Wall Street Journal reported that Richard Scott, "the former chief executive of HCA Inc," had formed the non-profit organization Conservatives for Patients' Rights as part of a "lobbying campaign to derail or modify" President Obama's health care proposals,...
In 1997, Rick Scott was terminated by Darla Moore. As part of Richard Scott's severance package from Columbia he was paid $5.13 million and given a five year consulting contract at $950,000 per year.
1997 + 5 = 2002
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio
“This case is one of the largest corporate fraud investigations involving a privately held company headquartered in small town America,” said Assistant Director Kenneth W. Kaiser of the FBI Criminal Investigative Division.
In October 2008- Leo Wise, now at the OCE ---stated "Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated.
Guess where ALL of Richard Scott's & Richard Rainwater’s Columbia/ HCA and certain subsidiaries and joint ventures were?
National Century Financial Enterprises, Inc.! (NCFE).
One prosecutor stated ‘…’NCFE- the largest corporate fraud investigations involving a privately held company and no one has ever heard of.’
NO ONE HAS EVER HEARD OF? (The largest corporate fraud investigation…)
Why is that?
Richard Rainwater was GW Bush’s ex- partner with the Rangers.
October 2008, Leo Wise now at the OCE office prosecuted the CEO and co-founder of National Century Financial Enterprises - CEO Sentenced to 30 Years in Prison
12 Executives/co-Founders already found guilty-
December 18, 2008, almost one month before GW Bush leaves office- the last person to stand trial, the ONE and ONLY acquittal- James K Happ!
Jurors stated 'PROSECUTOR DID NOT DO HIS JOB'-
Prosecutors' case fell short juror says-National Century fraud case produces 1st and only acquittal The "not guilty" verdicts that came in federal court yesterday were not so much a vindication of the last National Century Financial Enterprises executive to stand trial, a juror said.
Instead, they were more a belief that federal prosecutors had not done their job, ...
"He very well may have been guilty. A lot of us thought he was," said the juror who wouldn't give his name...
While Richard Scott was at Columbia in 1997 - James K Happ was CFO of Columbia Homecare Group, Inc.
James K Happ, only acquittal at National Century Financial Enterprises, Inc‘s who just so happened to be the CFO of Columbia Homecare Group.
Cigna Whistleblower to Testify
http://www.pbs.org/moyers/journal/07102009/profile.html
July 10, 2009
Last month, testimony in front of the U.S. Senate Committee on Commerce, Science and Transportation by a former health insurance insider named Wendell Potter made news even before it occurred: CBS NEWS headlined: "Cigna Whistleblower to Testify." After Potter's testimony the industry scrambled to do damage control: "Insurers defend rescissions, take heat for lack of transparency."
In his first extended television interview since leaving the health insurance industry, Wendell Potter tells Bill Moyers why he left his successful career as the head of Public Relations for CIGNA, one of the nation's largest insurers, and decided to speak out against the industry. "I didn't intend to [speak out], until it became really clear to me that the industry is resorting to the same tactics they've used over the years, and particularly back in the early '90s, when they were leading the effort to kill the Clinton plan."
Potter began his trip from health care spokesperson to reform advocate while back home in Tennessee. Potter attended a "health care expedition," a makeshift health clinic set up at a fairgrounds, and he tells Bill Moyers, "It was absolutely stunning. When I walked through the fairground gates, I saw hundreds of people lined up, in the rain. It was raining that day. Lined up, waiting to get care, in animal stalls. Animal stalls."
Looking back over his long career, Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage — every dollar they don't pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year. Under these conditions, Potter says, "You don't think about individual people. You think about the numbers, and whether or not you're going to meet Wall Street's expectations."
You can view Wendel Potter's congressional testimony online or read the text.
You can learn more about Remote Area Medical, the organization that put on the "health care expedition" here.
AHIP Strategy Memos
During the interview, Bill Moyers read from confidential documents drafted by America's Health Insurance Plans (AHIP) in May and June of 2007. The documents outline a unified strategy for AHIP members to prepare for the release of Michael Moore's documentary, SICKO on June 29, 2007.
You can download and read the full AHIP documents by clicking here and here (PDFs).
Red-Flagging and Rescission
Among the other testimony heard by the Committee on Commerce, Science and Transportation was that of Robin Beaton. It reflected some of the insurance company tactics condemned by Potter.
It was a nightmare scenario. The day before she was scheduled to undergo a double mastectomy for invasive breast cancer, Robin Beaton's health insurance company informed her that she was "red flagged" and they wouldn't pay for her surgery. The hospital wanted a $30,000 deposit before they would move forward. Beaton had no choice but to forgo the life-saving surgery.
Beaton had dutifully signed up for individual insurance when she retired from nursing to start a small business. She had never missed a payment, but that didn't matter. Blue Cross cited two earlier, unrelated conditions that she hadn't reported to them when signing up — acne and a fast beating heart — and rescinded her policy.
Beaton pleaded with the company and had her doctors write letters on her behalf to no avail. It was not until Rep. Joe Barton (R-TX) personally called Blue Cross that her policy was reinstated and she could undergo surgery. In that year, Beaton's tumor doubled in size, leading to further complications necessitating the removal of her lymph glands as well.
>>Watch Robin Beaton's testimony to the House Energy and Commerce Subcommittee on Oversight and Investigations.
The practice is called "rescission" and Beaton's is not an isolated case. The House Energy and Commerce Committee found that the major private health insurers had rescinded the policies of approximately 20,000 people in a five year period, to avoid paying out approximately $300 million in benefit claims.
Appearing before the same committee, CEOs of the major health insurance companies stated that they would continue to use rescission, arguing that it is a necessary protection against fraud and abuse.
>>Watch the health care CEOs appear before the House Energy and Commerce Subcommittee on Oversight and Investigations.
Wendell Potter
Wendell Potter has served since May 2009 as the Center for Media and Democracy in Madison, Wisconsin's senior fellow on health care. After a 20-year career as a corporate public relations executive, last year he left his job as head of communications for one of the nation's largest health insurers to try his hand at helping socially responsible organizations — including those advocating for meaningful health care reform — achieve their goals.
Based in Philadelphia, Potter provides strategic communications counsel and planning services as an independent consultant. He also speaks out on both the need for a fundamental overhaul of the American health care system and on the dangers to American democracy and society of the decline of the media as watchdog, which has contributed to the growing and increasingly unchecked influence of corporate PR.
Before his switch, Potter held a variety of positions at CIGNA Corporation over 15 years, serving most recently as head of corporate communications and as the company's chief corporate spokesman.
Prior to joining CIGNA, Potter headed communications at Humana Inc., another large for-profit health insurer and was director of public relations and advertising for The Baptist Health System of East Tennessee. He also has been a partner in an Atlanta public relations firm, a press secretary to a Democratic nominee for governor of Tennessee and a lobbyist in Washington for the organizers of the 1982 World's Fair in Knoxville, Tenn.
Wendell Potter first worked as a journalist. When fresh out of college, he worked for Scripps-Howard's afternoon paper in Memphis. He wrote about Memphis businesses and local government before being sent to Nashville to cover the governor's office and state legislature. Two years later he was promoted to the Scripps-Howard News Bureau in Washington where he covered Congress, the White House and the Supreme Court and wrote a weekly political column.
Wendell Potter is a native of Tennessee and a graduate of the University of Tennessee in Knoxville where he received a B.A. degree in communications and did postgraduate work in journalism and public relations. He holds an APR, which means he is accredited in public relations by the Public Relations Society of America, and is still a dues-paying member of the Society of Professional Journalists and the National Press Club in Washington.
Guest photos by Robin Holland.
July 10, 2009
Last month, testimony in front of the U.S. Senate Committee on Commerce, Science and Transportation by a former health insurance insider named Wendell Potter made news even before it occurred: CBS NEWS headlined: "Cigna Whistleblower to Testify." After Potter's testimony the industry scrambled to do damage control: "Insurers defend rescissions, take heat for lack of transparency."
In his first extended television interview since leaving the health insurance industry, Wendell Potter tells Bill Moyers why he left his successful career as the head of Public Relations for CIGNA, one of the nation's largest insurers, and decided to speak out against the industry. "I didn't intend to [speak out], until it became really clear to me that the industry is resorting to the same tactics they've used over the years, and particularly back in the early '90s, when they were leading the effort to kill the Clinton plan."
Potter began his trip from health care spokesperson to reform advocate while back home in Tennessee. Potter attended a "health care expedition," a makeshift health clinic set up at a fairgrounds, and he tells Bill Moyers, "It was absolutely stunning. When I walked through the fairground gates, I saw hundreds of people lined up, in the rain. It was raining that day. Lined up, waiting to get care, in animal stalls. Animal stalls."
Looking back over his long career, Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage — every dollar they don't pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year. Under these conditions, Potter says, "You don't think about individual people. You think about the numbers, and whether or not you're going to meet Wall Street's expectations."
You can view Wendel Potter's congressional testimony online or read the text.
You can learn more about Remote Area Medical, the organization that put on the "health care expedition" here.
AHIP Strategy Memos
During the interview, Bill Moyers read from confidential documents drafted by America's Health Insurance Plans (AHIP) in May and June of 2007. The documents outline a unified strategy for AHIP members to prepare for the release of Michael Moore's documentary, SICKO on June 29, 2007.
You can download and read the full AHIP documents by clicking here and here (PDFs).
Red-Flagging and Rescission
Among the other testimony heard by the Committee on Commerce, Science and Transportation was that of Robin Beaton. It reflected some of the insurance company tactics condemned by Potter.
It was a nightmare scenario. The day before she was scheduled to undergo a double mastectomy for invasive breast cancer, Robin Beaton's health insurance company informed her that she was "red flagged" and they wouldn't pay for her surgery. The hospital wanted a $30,000 deposit before they would move forward. Beaton had no choice but to forgo the life-saving surgery.
Beaton had dutifully signed up for individual insurance when she retired from nursing to start a small business. She had never missed a payment, but that didn't matter. Blue Cross cited two earlier, unrelated conditions that she hadn't reported to them when signing up — acne and a fast beating heart — and rescinded her policy.
Beaton pleaded with the company and had her doctors write letters on her behalf to no avail. It was not until Rep. Joe Barton (R-TX) personally called Blue Cross that her policy was reinstated and she could undergo surgery. In that year, Beaton's tumor doubled in size, leading to further complications necessitating the removal of her lymph glands as well.
>>Watch Robin Beaton's testimony to the House Energy and Commerce Subcommittee on Oversight and Investigations.
The practice is called "rescission" and Beaton's is not an isolated case. The House Energy and Commerce Committee found that the major private health insurers had rescinded the policies of approximately 20,000 people in a five year period, to avoid paying out approximately $300 million in benefit claims.
Appearing before the same committee, CEOs of the major health insurance companies stated that they would continue to use rescission, arguing that it is a necessary protection against fraud and abuse.
>>Watch the health care CEOs appear before the House Energy and Commerce Subcommittee on Oversight and Investigations.
Wendell Potter
Wendell Potter has served since May 2009 as the Center for Media and Democracy in Madison, Wisconsin's senior fellow on health care. After a 20-year career as a corporate public relations executive, last year he left his job as head of communications for one of the nation's largest health insurers to try his hand at helping socially responsible organizations — including those advocating for meaningful health care reform — achieve their goals.
Based in Philadelphia, Potter provides strategic communications counsel and planning services as an independent consultant. He also speaks out on both the need for a fundamental overhaul of the American health care system and on the dangers to American democracy and society of the decline of the media as watchdog, which has contributed to the growing and increasingly unchecked influence of corporate PR.
Before his switch, Potter held a variety of positions at CIGNA Corporation over 15 years, serving most recently as head of corporate communications and as the company's chief corporate spokesman.
Prior to joining CIGNA, Potter headed communications at Humana Inc., another large for-profit health insurer and was director of public relations and advertising for The Baptist Health System of East Tennessee. He also has been a partner in an Atlanta public relations firm, a press secretary to a Democratic nominee for governor of Tennessee and a lobbyist in Washington for the organizers of the 1982 World's Fair in Knoxville, Tenn.
Wendell Potter first worked as a journalist. When fresh out of college, he worked for Scripps-Howard's afternoon paper in Memphis. He wrote about Memphis businesses and local government before being sent to Nashville to cover the governor's office and state legislature. Two years later he was promoted to the Scripps-Howard News Bureau in Washington where he covered Congress, the White House and the Supreme Court and wrote a weekly political column.
Wendell Potter is a native of Tennessee and a graduate of the University of Tennessee in Knoxville where he received a B.A. degree in communications and did postgraduate work in journalism and public relations. He holds an APR, which means he is accredited in public relations by the Public Relations Society of America, and is still a dues-paying member of the Society of Professional Journalists and the National Press Club in Washington.
Guest photos by Robin Holland.
Monday, June 29, 2009
EIGHT MORE MIAMI-AREA RESIDENTS
June 28, 2009 by Robert David Malove
EIGHT MORE MIAMI-AREA RESIDENTS CHARGED IN $22 MILLION MEDICARE FRAUD SCHEME INVOLVING HOME HEALTH CARE
MIAMI, FL (June 26) - Gladys Zambrana, Javier Zambrana, Enrique Perez, Alejandro Hernandez Quiros aka Alex Hernandez, Vanessa Estrada, Vicenta Tellechea, Modesto Hidalgo and Carlos Castaneda were indicted in connection with an alleged $22 million Medicare fraud scheme operated out of Miami businesses purporting to specialize in home health care services.
Gladys Zambrana was also charged with four counts of health care fraud. Gladys Zambrana and Hernandez Quiros were charged with three counts each of paying health care kickbacks, while Perez, Hidalgo and Tellechea were charged with one count each of paying health care kickbacks. Gladys Zambrana, Perez, Alejandro Quiros, Tellechea and Castaneda were also charged with conspiracy to launder health care fraud proceeds.
According to the indictment, Gladys Zambrana, Perez and Hernandez Quiros operated ABC Home Health Care Inc. (ABC), listing Javier Zambrana as the owner; and Gladys Zambrana and Castaneda operated Florida Home Health Care Providers Inc. (Florida Home Health), listing Tellechea as the owner. Both ABC and Florida Home Health purported to be home health agencies that catered to Medicare beneficiaries. The indictment alleges that at both agencies, beneficiaries were recruited and paid kickbacks and bribes to arrange for their Medicare beneficiary numbers to be used by their co-conspirators to file claims with Medicare for purported home health care services. The indictment alleges that the services were not provided and were not medically necessary.
The indictment alleges that in addition to exerting ownership and control of the home health agencies, Hernandez Quiros and Castaneda acted as Medicare beneficiary recruiters for ABC and Florida Home Health, respectively; and Hidalgo, a medical assistant, falsified medical tests and records to make it appear that the services were needed. The indictment alleges that ABC billed more than $17 million to the Medicare program for services provided from January 2006 through December 2008 that were medically unnecessary and were not actually provided. During that time frame, Medicare paid more than $11 million on those fraudulent claims submitted by ABC. The indictment also alleges that from October 2007 through March 2009, Florida Home Health billed more than $5 million to the Medicare program for services that were medically unnecessary and not actually provided. During that time frame, Medicare paid more than $4 million on those fraudulent claims submitted by Florida Home Health.
The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years. Each charged count of health care fraud carries a maximum prison sentence of 10 years and each count of paying health care kickbacks carries a maximum prison sentence of five years. Conspiracy to launder health care fraud proceeds carries a maximum prison sentence of 10 years per count.
In conjunction with the criminal case, on June 24, 2009, the U.S. Attorney’s Office also filed a civil complaint for injunctive relief under the fraud injunction statute and obtained a temporary restraining order freezing the assets of ABC, Florida Home Health, Gladys Zambrana, Javier Zambrana, Perez, Hernandez Quiros, Castaneda and Tellechea. In addition, that temporary restraining order also freezes certain financial assets of four other companies the defendants owned or controlled and allegedly used to launder money fraudulently obtained from Medicare. The temporary restraining order is intended to preserve the remaining proceeds of the fraud for recovery by the United States as part of the criminal case and any related civil proceedings.
According to Acting U.S. Attorney Jeffrey H. Sloman, the “[c]oordinated criminal and civil action delivers an effective one-two punch to health care fraudsters: they were not only caught and criminally charged, but they are also being stripped of their illegal proceeds.”
Posted by Robert David Malove | Permalink | Email This Post
Posted In: Home Health Care Fraud
EIGHT MORE MIAMI-AREA RESIDENTS CHARGED IN $22 MILLION MEDICARE FRAUD SCHEME INVOLVING HOME HEALTH CARE
MIAMI, FL (June 26) - Gladys Zambrana, Javier Zambrana, Enrique Perez, Alejandro Hernandez Quiros aka Alex Hernandez, Vanessa Estrada, Vicenta Tellechea, Modesto Hidalgo and Carlos Castaneda were indicted in connection with an alleged $22 million Medicare fraud scheme operated out of Miami businesses purporting to specialize in home health care services.
Gladys Zambrana was also charged with four counts of health care fraud. Gladys Zambrana and Hernandez Quiros were charged with three counts each of paying health care kickbacks, while Perez, Hidalgo and Tellechea were charged with one count each of paying health care kickbacks. Gladys Zambrana, Perez, Alejandro Quiros, Tellechea and Castaneda were also charged with conspiracy to launder health care fraud proceeds.
According to the indictment, Gladys Zambrana, Perez and Hernandez Quiros operated ABC Home Health Care Inc. (ABC), listing Javier Zambrana as the owner; and Gladys Zambrana and Castaneda operated Florida Home Health Care Providers Inc. (Florida Home Health), listing Tellechea as the owner. Both ABC and Florida Home Health purported to be home health agencies that catered to Medicare beneficiaries. The indictment alleges that at both agencies, beneficiaries were recruited and paid kickbacks and bribes to arrange for their Medicare beneficiary numbers to be used by their co-conspirators to file claims with Medicare for purported home health care services. The indictment alleges that the services were not provided and were not medically necessary.
The indictment alleges that in addition to exerting ownership and control of the home health agencies, Hernandez Quiros and Castaneda acted as Medicare beneficiary recruiters for ABC and Florida Home Health, respectively; and Hidalgo, a medical assistant, falsified medical tests and records to make it appear that the services were needed. The indictment alleges that ABC billed more than $17 million to the Medicare program for services provided from January 2006 through December 2008 that were medically unnecessary and were not actually provided. During that time frame, Medicare paid more than $11 million on those fraudulent claims submitted by ABC. The indictment also alleges that from October 2007 through March 2009, Florida Home Health billed more than $5 million to the Medicare program for services that were medically unnecessary and not actually provided. During that time frame, Medicare paid more than $4 million on those fraudulent claims submitted by Florida Home Health.
The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years. Each charged count of health care fraud carries a maximum prison sentence of 10 years and each count of paying health care kickbacks carries a maximum prison sentence of five years. Conspiracy to launder health care fraud proceeds carries a maximum prison sentence of 10 years per count.
In conjunction with the criminal case, on June 24, 2009, the U.S. Attorney’s Office also filed a civil complaint for injunctive relief under the fraud injunction statute and obtained a temporary restraining order freezing the assets of ABC, Florida Home Health, Gladys Zambrana, Javier Zambrana, Perez, Hernandez Quiros, Castaneda and Tellechea. In addition, that temporary restraining order also freezes certain financial assets of four other companies the defendants owned or controlled and allegedly used to launder money fraudulently obtained from Medicare. The temporary restraining order is intended to preserve the remaining proceeds of the fraud for recovery by the United States as part of the criminal case and any related civil proceedings.
According to Acting U.S. Attorney Jeffrey H. Sloman, the “[c]oordinated criminal and civil action delivers an effective one-two punch to health care fraudsters: they were not only caught and criminally charged, but they are also being stripped of their illegal proceeds.”
Posted by Robert David Malove | Permalink | Email This Post
Posted In: Home Health Care Fraud
Friday, June 19, 2009
Fraud ran for seven years
By JACK HEALY
Published: June 18, 2009
Four years ago, Richard M. Scrushy, the former chief executive of HealthSouth, walked out of a federal courthouse in Alabama and thanked God that he had been acquitted of criminal charges that he defrauded the company. But on Thursday, a state judge still found Mr. Scrushy responsible for the fraud and ordered him to pay $2.9 billion to the company’s shareholders.
In his decision, the judge, Allwin E. Horn, declared that Mr. Scrushy knew about and took part in concocting false financial statements that inflated HealthSouth’s earnings to meet Wall Street’s expectations and to buoy the stock.
The fraud ran for seven years, totaled $2.7 billion and was “remarkable and perhaps unique” in its size and scope, the judge wrote.
“Scrushy was the C.E.O. of the fraud,” Judge Horn wrote.
The ruling was a coda on an era of scandals at companies like Enron, WorldCom, Tyco International and ImClone.
“This is the last chapter in the great epic drama of major corporate scandals that we saw in the last 10 years,” said Robert J. Mintz, a former federal prosecutor who followed Mr. Scrushy’s criminal trial. “It in some ways closes the book on the wave of unprecedented corporate fraud we saw. This one has dragged out even longer than Enron.”
For prosecutors who failed to win a conviction of Mr. Scrushy and shareholders whose HealthSouth shares crumbled after the fraud was unmasked, the judge’s decision offered a belated, if anticlimactic, vindication.
“He was the orchestrator of this fraud,” said Alice H. Martin, the United States attorney who unsuccessfully prosecuted Mr. Scrushy on 36 criminal counts. Ms. Martin is retiring on Friday. “That’s what I’m calling my retirement gift.”
While Mr. Scrushy’s criminal trial in 2005 was a five-month drama that fascinated many in Alabama and drew throngs of reporters to the courtroom, this civil trial was a quieter proceeding. It lasted two weeks and was decided by a judge, and Mr. Scrushy was often not even present.
Mr. Scrushy had already been sentenced to nearly seven years in prison for bribing a former governor of Alabama, and he spent much of the civil trial in a holding cell away from the courtroom, lawyers said. He appeared in court only to testify in his own defense.
Lawyers said the judgment was the first time that Mr. Scrushy had been found liable in any courtroom for his actions at HealthSouth, which operates dozens of rehabilitation clinics and hospitals across the country. He has already been ordered to pay fines and to repay millions of dollars in bonuses. Several other executives of HealthSouth have been convicted in the case.
Mr. Scrushy has maintained his innocence and has said he knew nothing about the fraud. His lawyers did not return calls for comment on Thursday, but other lawyers connected to the case said they expected Mr. Scrushy to appeal. He is appealing his criminal conviction in the bribery case.
Lawyers for HealthSouth and shareholders said they were poised to go after Mr. Scrushy’s assets, but it is doubtful they will ever squeeze anything close to $2.9 billion from him. Mr. Scrushy has sold his shares of HealthSouth — which closed at $13.02 on Thursday — and was estimated to have $275 million in assets in 2005, said John Haley, a lawyer for shareholders.
“The only thing that remains now is collecting on it,” said Donald Q. Cochran, a law professor at Samford University in Birmingham, Ala.
Published: June 18, 2009
Four years ago, Richard M. Scrushy, the former chief executive of HealthSouth, walked out of a federal courthouse in Alabama and thanked God that he had been acquitted of criminal charges that he defrauded the company. But on Thursday, a state judge still found Mr. Scrushy responsible for the fraud and ordered him to pay $2.9 billion to the company’s shareholders.
In his decision, the judge, Allwin E. Horn, declared that Mr. Scrushy knew about and took part in concocting false financial statements that inflated HealthSouth’s earnings to meet Wall Street’s expectations and to buoy the stock.
The fraud ran for seven years, totaled $2.7 billion and was “remarkable and perhaps unique” in its size and scope, the judge wrote.
“Scrushy was the C.E.O. of the fraud,” Judge Horn wrote.
The ruling was a coda on an era of scandals at companies like Enron, WorldCom, Tyco International and ImClone.
“This is the last chapter in the great epic drama of major corporate scandals that we saw in the last 10 years,” said Robert J. Mintz, a former federal prosecutor who followed Mr. Scrushy’s criminal trial. “It in some ways closes the book on the wave of unprecedented corporate fraud we saw. This one has dragged out even longer than Enron.”
For prosecutors who failed to win a conviction of Mr. Scrushy and shareholders whose HealthSouth shares crumbled after the fraud was unmasked, the judge’s decision offered a belated, if anticlimactic, vindication.
“He was the orchestrator of this fraud,” said Alice H. Martin, the United States attorney who unsuccessfully prosecuted Mr. Scrushy on 36 criminal counts. Ms. Martin is retiring on Friday. “That’s what I’m calling my retirement gift.”
While Mr. Scrushy’s criminal trial in 2005 was a five-month drama that fascinated many in Alabama and drew throngs of reporters to the courtroom, this civil trial was a quieter proceeding. It lasted two weeks and was decided by a judge, and Mr. Scrushy was often not even present.
Mr. Scrushy had already been sentenced to nearly seven years in prison for bribing a former governor of Alabama, and he spent much of the civil trial in a holding cell away from the courtroom, lawyers said. He appeared in court only to testify in his own defense.
Lawyers said the judgment was the first time that Mr. Scrushy had been found liable in any courtroom for his actions at HealthSouth, which operates dozens of rehabilitation clinics and hospitals across the country. He has already been ordered to pay fines and to repay millions of dollars in bonuses. Several other executives of HealthSouth have been convicted in the case.
Mr. Scrushy has maintained his innocence and has said he knew nothing about the fraud. His lawyers did not return calls for comment on Thursday, but other lawyers connected to the case said they expected Mr. Scrushy to appeal. He is appealing his criminal conviction in the bribery case.
Lawyers for HealthSouth and shareholders said they were poised to go after Mr. Scrushy’s assets, but it is doubtful they will ever squeeze anything close to $2.9 billion from him. Mr. Scrushy has sold his shares of HealthSouth — which closed at $13.02 on Thursday — and was estimated to have $275 million in assets in 2005, said John Haley, a lawyer for shareholders.
“The only thing that remains now is collecting on it,” said Donald Q. Cochran, a law professor at Samford University in Birmingham, Ala.
Thursday, May 28, 2009
HCA International- Conservatives for Patients Rights
Conservatives for Patients' Rights commercial with the Doctor in England?
2008--- HCA International
Welcome to London's leading private hospitals- HCA International
Why we are London's No. 1 private hospital group- HCA International
� More than 3,000 top London and UK specialists in private practice- HCA International
No. 1 private hospital?- HCA International
This is what STUPID AMERICA gets:
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED; HCA INVESTIGATION
Note: Hospital Corporation of America (HCA) was acquired by Columbia in 1994.
1997- As part of Richard Scott's severance package from Columbia he was paid $5.13 million and given a five year consulting contract at $950,000 per year.
1997+5 years consulting =2002
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio.
National Century Financial Enterprises
Guess where ALL of Rick Scott’s Columbia homecare units were? National Century Financial Enterprises.
Largest fraud case the FBI has ever investigated-one acquittal- James K Happ, the ex-CFO of Columbia Homecare Group, Inc.
Jurors stated; "PROSECUTOR DID NOT DO HIS JOB"�hmm
Leo Wise , now at the ethics CBO ---jurors stated 'PROSECUTOR DID NOT DO HIS JOB'
"Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated. (Leo Wise )
The ONLY acquittal; James K Happ--the CFO of Columbia Homecare Group.
Leo Wise , (now at the ethics CBO) stated "Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated.
Then- low and behold: December 18, 2008 The ONLY acquittal; James K Happ!...belief that federal prosecutors had not done their job, the juror said.
Columbia/HCA is a partnership of financier Richard Rainwater of Ft. Worth and lawyer Richard Scott. Scott was recently terminated by Darla Moore, the wife of Richard Rainwater.
Richard Rainwater, ex-partner of GW Bush with the Rangers
Leo Wise, now at the ethics CBO ---jurors stated 'PROSECUTOR DID NOT DO HIS JOB'
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio
"This case is one of the largest corporate fraud investigations involving a privately held company headquartered in small town America," said Assistant Director Kenneth W. Kaiser of the FBI Criminal Investigative Division.
Richard Scott -- sometimes called "the Bill Gates of health care" -- quit as chairman of Columbia/HCA Healthcare Corp. amid a massive federal investigation into the Medicare billing, physician recruiting and home-care practices of the nation's largest for-profit health care company.
Columbia/HCA is a partnership of financier Richard Rainwater of Ft. Worth and lawyer Richard Scott. Scott was recently terminated by Darla Moore, the wife of Richard Rainwater.
Rainwater also owned a large stake in Magellan Health Care which controls Charter Medical. Magellan, run by Darla Moore, is the largest network of psychiatric hospitals in the country. They are becoming more and more involved in obtaining government money for services formerly not covered as health care, according to Fortune Magazine.
1997 - Columbia/HCA Healthcare Corp. - the nation's largest for-profit health care company
2008--- HCA International
Welcome to London's leading private hospitals- HCA International
Why we are London's No. 1 private hospital group- HCA International
� More than 3,000 top London and UK specialists in private practice- HCA International
No. 1 private hospital?- HCA International
This is what STUPID AMERICA gets:
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED; HCA INVESTIGATION
Note: Hospital Corporation of America (HCA) was acquired by Columbia in 1994.
1997- As part of Richard Scott's severance package from Columbia he was paid $5.13 million and given a five year consulting contract at $950,000 per year.
1997+5 years consulting =2002
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio.
National Century Financial Enterprises
Guess where ALL of Rick Scott’s Columbia homecare units were? National Century Financial Enterprises.
Largest fraud case the FBI has ever investigated-one acquittal- James K Happ, the ex-CFO of Columbia Homecare Group, Inc.
Jurors stated; "PROSECUTOR DID NOT DO HIS JOB"�hmm
Leo Wise , now at the ethics CBO ---jurors stated 'PROSECUTOR DID NOT DO HIS JOB'
"Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated. (Leo Wise )
The ONLY acquittal; James K Happ--the CFO of Columbia Homecare Group.
Leo Wise , (now at the ethics CBO) stated "Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated.
Then- low and behold: December 18, 2008 The ONLY acquittal; James K Happ!...belief that federal prosecutors had not done their job, the juror said.
Columbia/HCA is a partnership of financier Richard Rainwater of Ft. Worth and lawyer Richard Scott. Scott was recently terminated by Darla Moore, the wife of Richard Rainwater.
Richard Rainwater, ex-partner of GW Bush with the Rangers
Leo Wise, now at the ethics CBO ---jurors stated 'PROSECUTOR DID NOT DO HIS JOB'
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio
"This case is one of the largest corporate fraud investigations involving a privately held company headquartered in small town America," said Assistant Director Kenneth W. Kaiser of the FBI Criminal Investigative Division.
Richard Scott -- sometimes called "the Bill Gates of health care" -- quit as chairman of Columbia/HCA Healthcare Corp. amid a massive federal investigation into the Medicare billing, physician recruiting and home-care practices of the nation's largest for-profit health care company.
Columbia/HCA is a partnership of financier Richard Rainwater of Ft. Worth and lawyer Richard Scott. Scott was recently terminated by Darla Moore, the wife of Richard Rainwater.
Rainwater also owned a large stake in Magellan Health Care which controls Charter Medical. Magellan, run by Darla Moore, is the largest network of psychiatric hospitals in the country. They are becoming more and more involved in obtaining government money for services formerly not covered as health care, according to Fortune Magazine.
1997 - Columbia/HCA Healthcare Corp. - the nation's largest for-profit health care company
Congressional Budget Office
Leo Wise , now at the ethics CBO said:
"Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated.
Then- low and behold: December 18, 2008 The ONLY acquittal; James K Happ!...belief that federal prosecutors had not done their job, the juror said.
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio
"This case is one of the largest corporate fraud investigations involving a privately held company headquartered in small town America," said Assistant Director Kenneth W. Kaiser of the FBI Criminal Investigative Division.
The ONLY acquittal; James K Happ- the CFO of Columbia Homecare Group.
"Ladies and gentlemen, this is a case of staggering fraud," 'It is one of the largest frauds the FBI has ever investigated.
Then- low and behold: December 18, 2008 The ONLY acquittal; James K Happ!...belief that federal prosecutors had not done their job, the juror said.
In 2002 FBI raided the offices of National Century Financial Enterprises in Dublin, Ohio
"This case is one of the largest corporate fraud investigations involving a privately held company headquartered in small town America," said Assistant Director Kenneth W. Kaiser of the FBI Criminal Investigative Division.
The ONLY acquittal; James K Happ- the CFO of Columbia Homecare Group.
Subscribe to:
Posts (Atom)
