Edem James Etuk, 54, the owner of PMS Medical Equipment Distributors
Etuk admitted that as the owner of PMS, a durable medical equipment company, he participated in a conspiracy that resulted in fraudulent billing of Medicare of approximately $3.8 million.
Medicare paid approximately $1,627,000 to PMS over the course of the conspiracy.
As part of his agreement with the federal government, Etuk has agreed to pay $1,627,053 in restitution to Medicare and to cooperate with the government in its continuing investigation and prosecution of individuals committing fraud against the Medicare and Medicaid programs.
HOUSTON, TEXAS—Edem James Etuk, 54, the owner of PMS Medical Equipment Distributors has pleaded guilty to conspiring to defraud Medicare and health care fraud through a “motorized wheelchair scheme”.
At a hearing before U. S. District Judge Lynn N. Hughes, Etuk admitted that as the owner of PMS, a durable medical equipment company, he participated in a conspiracy that resulted in fraudulent billing of Medicare of approximately $3.8 million.
Prosecutors say that during the course of a 14-month period, Etuk and several individuals, including a Houston doctor presently under separate indictment and pending trial in April 2008, conspired to commit health care fraud, wire fraud and to illegally pay kick-backs in relation to the Medicare program. Etuk admitted he engaged in a scheme to defraud Medicare by billing Medicare for motorized wheelchairs which were either not required by the Medicare beneficiary or not delivered, or both.
Etuk purchased falsified Certificates of Medical Necessity (CMN), which are required to bill Medicare, for $200 each from several doctors. The Medicare beneficiaries in this case were recruited illegally by marketers. Etuk admitted paying Houston marketers for recruiting beneficiaries and even purchased CMNs directly from the marketers for $600 to $1000 each. The fraudulent CMNs were used by Etuk to falsely bill Medicare for approximately $3,880,000 in power wheelchairs and accessories. Medicare paid approximately $1,627,000 to PMS over the course of the conspiracy.
As part of his agreement with the federal government, Etuk has agreed to pay $1,627,053 in restitution to Medicare and to cooperate with the government in its continuing investigation and prosecution of individuals committing fraud against the Medicare and Medicaid programs.
The health care fraud count carries a maximum penalty of 10 years in a federal prison and a $250,000 fine. The conspiracy carries a penalty of five years imprisonment and a $250,000 fine. Parole has been abolished in the federal prison system. Sentencing has been scheduled for Jan. 14. 10-17-07
Showing posts with label OBAMA. Show all posts
Showing posts with label OBAMA. Show all posts
Friday, December 5, 2008
Friday, September 5, 2008
Banks Are Uniquely Positioned to Prevent Health Care Fraud
How about Banks assist with Health Care Fraud? Perfect example is NCFE missing the Founder and CEO and also an "Executive" James K Happ.....the person who assisted GW Bush's ex-partner Richard Rainwater in the "PONZI SCHEME" as noted by Federal Prosecutors involved in the case they would like to to reference as "an end to an era".
Not so fast.....so much more to KNOW! James K Happ....(Smoking GUN)
Banks Are Uniquely Positioned to Prevent Health Care Fraud
By Matt Squire
Bank compliance professionals are in a prime position to uncover health care fraud if they are aware of the tell-tale signs and report the related suspicious activity to law enforcement, say fraud investigators.
Health care fraud accounts for around 10 percent or $100 billion of the $1 trillion spent annually in the health care industry, according to the U.S. Government Accountability Office.
Not so fast.....so much more to KNOW! James K Happ....(Smoking GUN)
Banks Are Uniquely Positioned to Prevent Health Care Fraud
By Matt Squire
Bank compliance professionals are in a prime position to uncover health care fraud if they are aware of the tell-tale signs and report the related suspicious activity to law enforcement, say fraud investigators.
Health care fraud accounts for around 10 percent or $100 billion of the $1 trillion spent annually in the health care industry, according to the U.S. Government Accountability Office.
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, July 15, 2008
Since Poulsen's trial is now set to begin Oct. 1, it pushes the trial of James K. Happ, another former National Century executive....
Now why is this delay for Happ occurring? After the NOVEMBER election of course. Does any reporter really know where Happ is form or what his job at NCFE really was? If so, no one has yet to connect the dot!
Who does Happ really know? (Hint: Bush Connection)
The former CEO of National Century Financial Enterprises Inc. has successfully put off his trial on fraud-related charges by two months.
A federal judge ruled Friday that Lance Poulsen, the leader of the Dublin-based health-care financing company before it collapsed in 2002, will begin facing charges of securities fraud and conspiracy on Oct. 1 instead of Aug. 4. U.S. District Court Judge Algenon Marbley granted Poulsen's July 7 continuance request after Poulsen's attorneys argued they needed more time to review 40 boxes of documents the government is scheduled to make available between now and August.
"A two-month continuance will ensure that Poulsen has the time to obtain and review the documents that he plausibly claims are central to his theories of defense," Marbley wrote in his July 11 order.
Since Poulsen's trial is now set to begin Oct. 1, it pushes the trial of James K. Happ, another former National Century executive, to Dec. 1. Poulsen and Happ have both pleaded not guilty.
Poulsen, 65, co-founded National Century in 1991, building it into a major health-care financing company. It specialized in buying receivables from medical providers at a discount, which gave the health-care businesses the quick cash they needed. The receivables were then packaged as asset-backed bonds and sold to investors.
But National Century fell into Chapter 11 bankruptcy six years ago. The Justice Department alleged Poulsen and other executives ran a sophisticated Ponzi scheme that bilked investors out of nearly $2 billion. Poulsen pleaded not guilty to charges of conspiracy, securities fraud, wire fraud, money laundering conspiracy and concealment of money laundering.
Five other former National Century executives were found guilty in March of running a multiyear securities fraud at National Century. Poulsen was scheduled to go on trial with them, but his day in court on those charges was delayed because the government also accused him of trying to tamper with a witness.
Shortly after the March convictions of the five executives, Poulsen stood trial on the witness tampering charges. A jury found him and an associate, Karl Demmler, guilty of trying to bribe a government witness who is planning to testify against Poulsen in his securities fraud trial.
Who does Happ really know? (Hint: Bush Connection)
The former CEO of National Century Financial Enterprises Inc. has successfully put off his trial on fraud-related charges by two months.
A federal judge ruled Friday that Lance Poulsen, the leader of the Dublin-based health-care financing company before it collapsed in 2002, will begin facing charges of securities fraud and conspiracy on Oct. 1 instead of Aug. 4. U.S. District Court Judge Algenon Marbley granted Poulsen's July 7 continuance request after Poulsen's attorneys argued they needed more time to review 40 boxes of documents the government is scheduled to make available between now and August.
"A two-month continuance will ensure that Poulsen has the time to obtain and review the documents that he plausibly claims are central to his theories of defense," Marbley wrote in his July 11 order.
Since Poulsen's trial is now set to begin Oct. 1, it pushes the trial of James K. Happ, another former National Century executive, to Dec. 1. Poulsen and Happ have both pleaded not guilty.
Poulsen, 65, co-founded National Century in 1991, building it into a major health-care financing company. It specialized in buying receivables from medical providers at a discount, which gave the health-care businesses the quick cash they needed. The receivables were then packaged as asset-backed bonds and sold to investors.
But National Century fell into Chapter 11 bankruptcy six years ago. The Justice Department alleged Poulsen and other executives ran a sophisticated Ponzi scheme that bilked investors out of nearly $2 billion. Poulsen pleaded not guilty to charges of conspiracy, securities fraud, wire fraud, money laundering conspiracy and concealment of money laundering.
Five other former National Century executives were found guilty in March of running a multiyear securities fraud at National Century. Poulsen was scheduled to go on trial with them, but his day in court on those charges was delayed because the government also accused him of trying to tamper with a witness.
Shortly after the March convictions of the five executives, Poulsen stood trial on the witness tampering charges. A jury found him and an associate, Karl Demmler, guilty of trying to bribe a government witness who is planning to testify against Poulsen in his securities fraud trial.
Saturday, June 28, 2008
MCCAIN BACKS LEAHY AMENDMENT AGAINST CORPORATE AND CRIMINAL FRAUD
For Immediate Release
Wednesday, Jul 10, 2002
Washington, DC – U.S. Senator John McCain (R-AZ) today continued his fight against corporate corruption in the marketplace by supporting the "Corporate and Criminal Fraud Accountability Act of 2002" sponsored by Sen. Patrick Leahy (D-VT). His floor statement follows:
"Our publicly owned companies are an essential component to the economic health of our country. As we have seen over the past few months, the continued lapses of our corporate leaders, whether they are ethical, criminal or just plain ignorant, have a significant, sometimes crippling, effect on the welfare of our nation. We must make some fundamental changes in the current system of corporate oversight to protect Americans from avarice, greed, ignorance and criminal behavior. Now is the time for Congress to restore investor confidence and take the necessary action to protect the interests of the public shareholders and place those interests above the personal interests of those entrusted with managing and advising those companies. The deterioration of the checks and balances that safeguard the public against corporate abuses must be reversed.
"We have to address the shortcomings in federal law and send the message that prosecutors now have the tools to incarcerate persons who defraud investors or alter or destroy evidence in certain Federal investigations. This amendment is a step in the right direction. It creates two new criminal statutes that would clarify current criminal laws relating to the destruction or fabrication of evidence and the preservation of financial and audit records. The Enron debacle clearly indicated that there were gaping holes in the current framework. There will be a 10 year criminal penalty for the destruction or creation of evidence with the intent to obstruct a federal investigation. There will be a new 5 year criminal penalty for the willful failure to preserve, for a minimum of five years, audit papers of companies that issue securities.
"The amendment also provides for the review and enhancement of criminal penalties in cases involving obstruction of justice and serious fraud cases. All of these actions are necessary to deter future criminal action. Until somebody responsible goes to jail for a significant amount of time, I am not sure that these people are going to get the message. Defrauding the shareholder has to carry a penalty of more than a fine. Many corporate decision-makers are making millions of dollars a year. A relatively small fine is not a deterrent; it's a slap on the wrist. The threat of jail is a deterrent that will make people pay attention.
"This amendment also creates a new securities fraud offense. This provision makes it easier, in a limited class of cases, to prove securities fraud. Currently prosecutors are forced to resort to a patchwork of technical offenses and regulations that criminalize particular violations of securities law, or to treat the cases as generic mail or wire fraud that results in a five-year maximum penalty. This new provision would criminalize any scheme or artifice to defraud persons in connection with securities of publicly traded companies or to obtain their money or property. This new ten-year felony is comparable to existing bank and health care fraud statutes. To those who'd say that it's hard to define a scheme or artifice to defraud, I'd say that full and honest disclosure of material dealings and accounting treatments is the best way for the officers who run America's corporations to protect themselves and those who invest in their companies. There are plenty of felony laws on the books that provide long prison terms for crimes that cause less damage than the losses to shareholders in Enron or WorldCom.
"It is important to emphasize that when criminal charges are pursued, it is not necessarily the firm that should be charged but the individuals at the helm of the corporate ship who should be prosecuted. If they are the ones making the decisions out of self-interest, they are the ones that should be held accountable. I also believe that we must protect the "corporate whistleblower" from being punished for having the moral courage to break the corporate code of silence. This amendment does that.
"This amendment also extends the current statute of limitations for matters concerning securities fraud, deceit or manipulation. The current statute of limitations for securities fraud cases is unfairly short given the complexity of many of these matters. Innocent, defrauded investors may be wrongly stopped short in their attempts to recoup their losses under current law. The existing statute of limitations for most securities fraud cases is one year after the fraud was discovered but no more than three years from the date of the fraud regardless of when it was discovered. Because this statute of limitations is so short, the worst offenders may avoid accountability and be rewarded if they can successfully cover up their misconduct for merely three years. The more complex the case, the easier it will be for these wrongdoers to get away with fraud. According to at least one state Attorney General, the current short statute of limitations has forced some states to forgo claims against Enron based on alleged securities fraud in 1997 and 1998.
"This situation essentially encourages offenders to attempt to cover up their misdeeds however they can, including by using questionable accounting procedures and financial shell games. Furthermore, in some cases, the facts of a case simply do not come to light until years after the fraud. If a person does not and cannot know they have been defrauded, it is unfair to bar them from the courthouse.
"These limitations are even more unfair when considered in light of the obstacles that current law can place between a victim and the courthouse in securities fraud cases. By the time a victim learns enough facts to file a complaint, survives a motion to dismiss, begins discovery, and learns that an additional wrongdoer or theory should be added to the case, that claim may be barred and the wrongdoer is able to avoid liability. Thus, current law sets up a perverse incentive for victims to race into court, so as not to be barred by time. Indeed, the short statute of limitations may even encourage frivolous cases, as a plaintiff operating in bad faith would have little trouble meeting the one-year deadline simply by naming every possible defendant and asserting every possible claim. We need to recognize the sophistication and complexity of modern-day schemes designed to defraud investors. It is long past time to give innocent victims a more reasonable chance to recover their losses.
"Finally, this provision amends the federal bankruptcy code to prevent the corporate wrongdoer, the CEO or CFO, from sheltering their assets under the umbrella of bankruptcy and protecting them from judgments and settlements arising from federal and state securities law violations. Too many of these highly paid corporate officers are using bankruptcy laws to protect their assets while maintaining their high-rise penthouses and ski chalets. It is time to force accountability and punish the person, not the institution, who is not willing to abide by the moral and legal codes that accompany leadership and public trust."
For Immediate Release
Wednesday, Jul 10, 2002
Washington, DC – U.S. Senator John McCain (R-AZ) today continued his fight against corporate corruption in the marketplace by supporting the "Corporate and Criminal Fraud Accountability Act of 2002" sponsored by Sen. Patrick Leahy (D-VT). His floor statement follows:
"Our publicly owned companies are an essential component to the economic health of our country. As we have seen over the past few months, the continued lapses of our corporate leaders, whether they are ethical, criminal or just plain ignorant, have a significant, sometimes crippling, effect on the welfare of our nation. We must make some fundamental changes in the current system of corporate oversight to protect Americans from avarice, greed, ignorance and criminal behavior. Now is the time for Congress to restore investor confidence and take the necessary action to protect the interests of the public shareholders and place those interests above the personal interests of those entrusted with managing and advising those companies. The deterioration of the checks and balances that safeguard the public against corporate abuses must be reversed.
"We have to address the shortcomings in federal law and send the message that prosecutors now have the tools to incarcerate persons who defraud investors or alter or destroy evidence in certain Federal investigations. This amendment is a step in the right direction. It creates two new criminal statutes that would clarify current criminal laws relating to the destruction or fabrication of evidence and the preservation of financial and audit records. The Enron debacle clearly indicated that there were gaping holes in the current framework. There will be a 10 year criminal penalty for the destruction or creation of evidence with the intent to obstruct a federal investigation. There will be a new 5 year criminal penalty for the willful failure to preserve, for a minimum of five years, audit papers of companies that issue securities.
"The amendment also provides for the review and enhancement of criminal penalties in cases involving obstruction of justice and serious fraud cases. All of these actions are necessary to deter future criminal action. Until somebody responsible goes to jail for a significant amount of time, I am not sure that these people are going to get the message. Defrauding the shareholder has to carry a penalty of more than a fine. Many corporate decision-makers are making millions of dollars a year. A relatively small fine is not a deterrent; it's a slap on the wrist. The threat of jail is a deterrent that will make people pay attention.
"This amendment also creates a new securities fraud offense. This provision makes it easier, in a limited class of cases, to prove securities fraud. Currently prosecutors are forced to resort to a patchwork of technical offenses and regulations that criminalize particular violations of securities law, or to treat the cases as generic mail or wire fraud that results in a five-year maximum penalty. This new provision would criminalize any scheme or artifice to defraud persons in connection with securities of publicly traded companies or to obtain their money or property. This new ten-year felony is comparable to existing bank and health care fraud statutes. To those who'd say that it's hard to define a scheme or artifice to defraud, I'd say that full and honest disclosure of material dealings and accounting treatments is the best way for the officers who run America's corporations to protect themselves and those who invest in their companies. There are plenty of felony laws on the books that provide long prison terms for crimes that cause less damage than the losses to shareholders in Enron or WorldCom.
"It is important to emphasize that when criminal charges are pursued, it is not necessarily the firm that should be charged but the individuals at the helm of the corporate ship who should be prosecuted. If they are the ones making the decisions out of self-interest, they are the ones that should be held accountable. I also believe that we must protect the "corporate whistleblower" from being punished for having the moral courage to break the corporate code of silence. This amendment does that.
"This amendment also extends the current statute of limitations for matters concerning securities fraud, deceit or manipulation. The current statute of limitations for securities fraud cases is unfairly short given the complexity of many of these matters. Innocent, defrauded investors may be wrongly stopped short in their attempts to recoup their losses under current law. The existing statute of limitations for most securities fraud cases is one year after the fraud was discovered but no more than three years from the date of the fraud regardless of when it was discovered. Because this statute of limitations is so short, the worst offenders may avoid accountability and be rewarded if they can successfully cover up their misconduct for merely three years. The more complex the case, the easier it will be for these wrongdoers to get away with fraud. According to at least one state Attorney General, the current short statute of limitations has forced some states to forgo claims against Enron based on alleged securities fraud in 1997 and 1998.
"This situation essentially encourages offenders to attempt to cover up their misdeeds however they can, including by using questionable accounting procedures and financial shell games. Furthermore, in some cases, the facts of a case simply do not come to light until years after the fraud. If a person does not and cannot know they have been defrauded, it is unfair to bar them from the courthouse.
"These limitations are even more unfair when considered in light of the obstacles that current law can place between a victim and the courthouse in securities fraud cases. By the time a victim learns enough facts to file a complaint, survives a motion to dismiss, begins discovery, and learns that an additional wrongdoer or theory should be added to the case, that claim may be barred and the wrongdoer is able to avoid liability. Thus, current law sets up a perverse incentive for victims to race into court, so as not to be barred by time. Indeed, the short statute of limitations may even encourage frivolous cases, as a plaintiff operating in bad faith would have little trouble meeting the one-year deadline simply by naming every possible defendant and asserting every possible claim. We need to recognize the sophistication and complexity of modern-day schemes designed to defraud investors. It is long past time to give innocent victims a more reasonable chance to recover their losses.
"Finally, this provision amends the federal bankruptcy code to prevent the corporate wrongdoer, the CEO or CFO, from sheltering their assets under the umbrella of bankruptcy and protecting them from judgments and settlements arising from federal and state securities law violations. Too many of these highly paid corporate officers are using bankruptcy laws to protect their assets while maintaining their high-rise penthouses and ski chalets. It is time to force accountability and punish the person, not the institution, who is not willing to abide by the moral and legal codes that accompany leadership and public trust."
A letter to my Senators.......
Sent: Wednesday, May 10, 2006 1:18 PM
Subject: letter to Durbin and Obama
Listening to Lamar Alexander of TN and others regarding the reason many people must travel miles to get to a physician is because of all the malpractice law suits filed in this country. This could be no further from the truth!
I would beg you to please take a look at Bill Frist's family empire/monopoly. HCA, INC. It is because of this conglomerate that our health system is in the crisis it is in and I implore you to bring up the reason people have to travel miles to a physician is not because of the malpractice but because of the monopoly HCA has been able to build in this country for the last 25-30 years. Not to mention the Billions, and possibly trillions of dollars in Medicare/Medicaid fraud, some of which has been exposed, most of which has not.
I would be more than happy to discuss my research and proof of my statements. This will be exposed, sooner or later with or without your assistance.
Thank You-
Susan Golden
708-453-1640
Subject: letter to Durbin and Obama
Listening to Lamar Alexander of TN and others regarding the reason many people must travel miles to get to a physician is because of all the malpractice law suits filed in this country. This could be no further from the truth!
I would beg you to please take a look at Bill Frist's family empire/monopoly. HCA, INC. It is because of this conglomerate that our health system is in the crisis it is in and I implore you to bring up the reason people have to travel miles to a physician is not because of the malpractice but because of the monopoly HCA has been able to build in this country for the last 25-30 years. Not to mention the Billions, and possibly trillions of dollars in Medicare/Medicaid fraud, some of which has been exposed, most of which has not.
I would be more than happy to discuss my research and proof of my statements. This will be exposed, sooner or later with or without your assistance.
Thank You-
Susan Golden
708-453-1640
Tuesday, June 17, 2008
South Florida region bills Medicare more than $2 billion each year
Miami - Home to the largest health-care fraud by one person by B.A.C., 06/13/2008
Hats off to our local High School dropout Rita Campos Ramirez for orchestrating the largest single person Medicare fraud in US history! Rita managed to scam the government for $105 million over 4 years and treated herself to two condos and a benzo. As a result of her conviction by the man the government has been able to convict others who were implicitly involved in her scheme. It seems Rita isn't the only one milking the system here in Miami either;
Investigators and prosecutors trained their focus on Miami after noticing two troubling patterns:
HHS investigators discovered that nearly half of 1,581 medical equipment companies they visited in the Miami area did not comply with basic Medicare requirements to be open during scheduled hours and to have a telephone number. The inspector general and the Government Accountability Office have flagged weak oversight of these kinds of suppliers for a dozen years, according to congressional testimony.
The South Florida region bills Medicare more than $2 billion each year for injectable HIV medications. That figure is 22 times as high as the amount of similar claims in the rest of the country, and is far out of line with demographic data in a population of 2 million people in Miami-Dade County, HHS statistics show.
Now thats the American dream ladies and gentleman. Drop out of school yet still be savvy enough to swindle the American government for $104 mil. I am applauding you at this moment Rita and I'm certain many other dropouts here in Miami are ready to take your place and lead the charge for the continued labeling of Miami as the only third world city in the USA.
[MSNBC 'Rags to riches' through Medicare fraud]
Hats off to our local High School dropout Rita Campos Ramirez for orchestrating the largest single person Medicare fraud in US history! Rita managed to scam the government for $105 million over 4 years and treated herself to two condos and a benzo. As a result of her conviction by the man the government has been able to convict others who were implicitly involved in her scheme. It seems Rita isn't the only one milking the system here in Miami either;
Investigators and prosecutors trained their focus on Miami after noticing two troubling patterns:
HHS investigators discovered that nearly half of 1,581 medical equipment companies they visited in the Miami area did not comply with basic Medicare requirements to be open during scheduled hours and to have a telephone number. The inspector general and the Government Accountability Office have flagged weak oversight of these kinds of suppliers for a dozen years, according to congressional testimony.
The South Florida region bills Medicare more than $2 billion each year for injectable HIV medications. That figure is 22 times as high as the amount of similar claims in the rest of the country, and is far out of line with demographic data in a population of 2 million people in Miami-Dade County, HHS statistics show.
Now thats the American dream ladies and gentleman. Drop out of school yet still be savvy enough to swindle the American government for $104 mil. I am applauding you at this moment Rita and I'm certain many other dropouts here in Miami are ready to take your place and lead the charge for the continued labeling of Miami as the only third world city in the USA.
[MSNBC 'Rags to riches' through Medicare fraud]
Thursday, May 29, 2008
FBI reports that Health care fraud ranks among the highest priority investigations within the FBI's white collar crime unit, behind only public corrup
FBI releases annual healthcare fraud statistics and information
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Editor: Mike Bothwell
Profession: Qui Tam Attorney
May 28, 2008
By Julie Keeton Bracker
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The FBI recently published its annual Financial Crimes Report to the Public for the Fiscal Year 2007, showing that health care fraud is of continued concern.
The mission of the Financial Crimes Section (FCS) of the FBI is to oversee the investigation of financial fraud and to facilitate the forfeiture of assets from those engaging in federal crimes. The FCS is divided into three units: the Economic Crimes Unit - I, Economic Crimes Unit - II (formerly Financial Institution Fraud and Asset Forfeiture/Money Laundering Units), and the Health Care Fraud Unit. The report, which is published annually, provides an overview of each of these sections showing statistical accomplishments and examples of the identified priority crime problems.
The Healthcare Fraud Unit estimates that fraudulent billing accounts for between 3% and 10% of all healthcare expenditures nationwise. The Centers for Medicare and Medicaid Services (CMS) estimates $2.26 trillion was spent on healthcare in fiscal year 2007, leading to the conclusion that as much as $226 billion per year is fraudulently billed over the course of the year.
The FBI identified the most common types of healthcare fraud as: (1) billing for services not rendered; (2) upcoding (charging a higher value for services than is appropriate); (3) duplicate claims; (4) unbundling; (5) excessive services; (6) medically unnecessary services; and (7) kickbacks. Other areas of concern include durable medical equipment, hospital fraud, physician fraud, home health agencies, beneficiary-sharing, chiropractic, pain management and associated drug diversion, physical therapists, prescription drugs, multi-disciplinary fraud, and identity theft which involve physician identifiers used to fraudulently bill government and private insurance programs.
The report identified two trends for the 2007 fiscal year: an increased willingness to profit at the expense of the patient, and evolving schemes relating to new technologies. The FBI reported that investigations in several of its offices are focusing on subjects who conduct unnecessary surgeries, prescribe dangerous drugs without medical necessity, and engage in abusive or sub-standard care practices. Examples of the increasingly technical schemes being purpetrated involve medical data theft and other fraud schemes facilitated through the use of computers. The report also mentions increasing concerns regarding The Medicare Prescription Drug Program (Part D), which was implemented in 2006 and so is relatively new.
The FBI reports that Health care fraud ranks among the highest priority investigations within the FBI's white collar crime unit, behind only public corruption and corporate fraud. As a result there are a number of national initiatives, including the Internet Pharmacy Fraud Initiative, the Auto Accident Insurance Fraud Initiative, and the Outpatient Surgery Center Initiative. The overall goal of the Internet Pharmacy Fraud Initiative is to identify fraudulent Internet pharmacies and target physicians who are willing to write prescriptions outside of the doctor/patient relationship. This group also heads investigations into the sale of counterfeit and diverted pharmaceuticals on the Internet. The Auto Accident Insurance Fraud Initiative was launched in 2005 in response to increasingly sophisticated staged accident schemes, which present a danger on the road as well as the economic harm of the fraud (which includes the rising cost of private insurance).
Overall, the FBI reported that Fiscal Year 2007 saw it investigating 2,493 cases, resulting in 839 indictments and 635 convictions of health care fraud criminals, with some cases still pending. In the area of health care fraud the report states that FBI investigations resulted in $1.12 billion in restitutions, $4.4 million in recoveries, $34 million in fines, and 308 seizures valued at $61.2 million.
In conclusion, the FBI offered the following tips to protect yourself against Health Care Fraud:
• Protect your health insurance information card like a credit card.
• Beware of free services--is it too good to be true?
• Review your medical bills, such as your "explanation of bill," after receiving healthcare services. Check to ensure the dates and services are correct to ensure you get what you paid for.
• If you suspect Health Care Fraud, call 1-877-327-2583. For more information,
visit the web site at http://www.bcbs.com/antifraud.
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Editor: Mike Bothwell
Profession: Qui Tam Attorney
May 28, 2008
By Julie Keeton Bracker
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The FBI recently published its annual Financial Crimes Report to the Public for the Fiscal Year 2007, showing that health care fraud is of continued concern.
The mission of the Financial Crimes Section (FCS) of the FBI is to oversee the investigation of financial fraud and to facilitate the forfeiture of assets from those engaging in federal crimes. The FCS is divided into three units: the Economic Crimes Unit - I, Economic Crimes Unit - II (formerly Financial Institution Fraud and Asset Forfeiture/Money Laundering Units), and the Health Care Fraud Unit. The report, which is published annually, provides an overview of each of these sections showing statistical accomplishments and examples of the identified priority crime problems.
The Healthcare Fraud Unit estimates that fraudulent billing accounts for between 3% and 10% of all healthcare expenditures nationwise. The Centers for Medicare and Medicaid Services (CMS) estimates $2.26 trillion was spent on healthcare in fiscal year 2007, leading to the conclusion that as much as $226 billion per year is fraudulently billed over the course of the year.
The FBI identified the most common types of healthcare fraud as: (1) billing for services not rendered; (2) upcoding (charging a higher value for services than is appropriate); (3) duplicate claims; (4) unbundling; (5) excessive services; (6) medically unnecessary services; and (7) kickbacks. Other areas of concern include durable medical equipment, hospital fraud, physician fraud, home health agencies, beneficiary-sharing, chiropractic, pain management and associated drug diversion, physical therapists, prescription drugs, multi-disciplinary fraud, and identity theft which involve physician identifiers used to fraudulently bill government and private insurance programs.
The report identified two trends for the 2007 fiscal year: an increased willingness to profit at the expense of the patient, and evolving schemes relating to new technologies. The FBI reported that investigations in several of its offices are focusing on subjects who conduct unnecessary surgeries, prescribe dangerous drugs without medical necessity, and engage in abusive or sub-standard care practices. Examples of the increasingly technical schemes being purpetrated involve medical data theft and other fraud schemes facilitated through the use of computers. The report also mentions increasing concerns regarding The Medicare Prescription Drug Program (Part D), which was implemented in 2006 and so is relatively new.
The FBI reports that Health care fraud ranks among the highest priority investigations within the FBI's white collar crime unit, behind only public corruption and corporate fraud. As a result there are a number of national initiatives, including the Internet Pharmacy Fraud Initiative, the Auto Accident Insurance Fraud Initiative, and the Outpatient Surgery Center Initiative. The overall goal of the Internet Pharmacy Fraud Initiative is to identify fraudulent Internet pharmacies and target physicians who are willing to write prescriptions outside of the doctor/patient relationship. This group also heads investigations into the sale of counterfeit and diverted pharmaceuticals on the Internet. The Auto Accident Insurance Fraud Initiative was launched in 2005 in response to increasingly sophisticated staged accident schemes, which present a danger on the road as well as the economic harm of the fraud (which includes the rising cost of private insurance).
Overall, the FBI reported that Fiscal Year 2007 saw it investigating 2,493 cases, resulting in 839 indictments and 635 convictions of health care fraud criminals, with some cases still pending. In the area of health care fraud the report states that FBI investigations resulted in $1.12 billion in restitutions, $4.4 million in recoveries, $34 million in fines, and 308 seizures valued at $61.2 million.
In conclusion, the FBI offered the following tips to protect yourself against Health Care Fraud:
• Protect your health insurance information card like a credit card.
• Beware of free services--is it too good to be true?
• Review your medical bills, such as your "explanation of bill," after receiving healthcare services. Check to ensure the dates and services are correct to ensure you get what you paid for.
• If you suspect Health Care Fraud, call 1-877-327-2583. For more information,
visit the web site at http://www.bcbs.com/antifraud.
Tuesday, May 20, 2008
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
--------------------------------------------------------------------------------
FOR IMMEDIATE RELEASE
THURSDAY, JUNE 26, 2003
WWW.USDOJ.GOV
CIV
(202) 514-2007
TDD (202) 514-1888
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
HCA INVESTIGATION NETS RECORD TOTAL OF $1.7 BILLION
WASHINGTON, D.C. - HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company) has agreed to pay the United States $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs, the Justice Department announced today.
This settlement marks the conclusion of the most comprehensive health care fraud investigation ever undertaken by the Justice Department, working with the Departments of Health and Human Services and Defense, the Office of Personnel Management and the states. The settlement announced today resolves HCA's civil liability for false claims resulting from a variety of allegedly unlawful practices, including cost report fraud and the payment of kickbacks to physicians.
Previously, on December 14, 2000, HCA subsidiaries pled guilty to substantial criminal conduct and paid more than $840 million in criminal fines, civil restitution and penalties. Combined with today's separate administrative settlement with the Centers for Medicare & Medicaid Services (CMS), under which HCA will pay an additional $250 million to resolve overpayment claims arising from certain of its cost reporting practices, the government will have recovered $1.7 billion from HCA, by far the largest recovery ever reached by the government in a health care fraud investigation.
"Health care providers and professionals hold a public trust, and when that trust is violated by fraud and abuse of program funds, and by the payment of kickbacks to the physicians on whom patients and the programs rely for uncompromised medical judgment, health care for all Americans suffers," Robert D. McCallum, Jr., Assistant Attorney General for the Civil Division said. "This settlement brings to a close the largest multi-agency investigation of a health care provider that the United States government has ever undertaken and demonstrates the Department of Justice's ongoing resolve and commitment to pursue all types of fraud on American taxpayers, and health care program beneficiaries."
"Let this case be a continuing reminder to all that in the fight against health care fraud this office will not be deterred," said Acting Principal Deputy Inspector General Dara Corrigan. “Medicare dollars paid to provide ever more expensive health care services to the country's taxpayers should never be fraudulently diverted. This is our job and our trust and we take these duties very seriously," Corrigan concluded.
This latest settlement resolves fraud allegations against HCA and HCA hospitals in nine False Claims Act qui tam or whistleblower lawsuits pending in federal court in the District of Columbia. Under the federal False Claims Act, private individuals may file suit on behalf of the United States and, if the case is successful, may recover a share of the proceeds for their efforts. Under the settlement, the whistleblowers will receive a combined share of $151,591,500, the highest combined qui tam award ever paid out by the government.
"We are grateful for the assistance given by the whistleblowers over the course of the past nine years of investigation and litigation,” McCallum said. “And we are proud of the work of government personnel as well as counsel for the whistleblowers, who together pursued these matters through investigation and strenuous litigation. This result demonstrates the commitment of the Department to the qui tam statute and that the statute works as Congress intended."
Under the first of three agreements announced today, which becomes effective upon the court's dismissal of the lawsuits, HCA will pay nearly $620 million to resolve eight whistleblower lawsuits in which the government had intervened alleging that HCA systematically defrauded Medicare, Medicaid and other federally funded health care programs through schemes dating back to the late 1980s. HCA will pay an additional $11 million to resolve separate allegations of improper HCA billing practices.
The settlement requires HCA to pay:
$356 million to resolve whistleblower lawsuits alleging that HCA engaged in a series of schemes to defraud Medicare, Medicaid and TRICARE, the military’s health care program, through hospital cost reports, the year end claims submitted by hospitals to the government to reconcile payments received throughout the year with amounts they claim are actually owed. In 2001, a subsidiary of Nashville-based HCA, Columbia Management Companies, Inc., pled guilty in the Middle District of Florida to related charges on eight counts of making false statements to the United States and paid $22.6 million in criminal fines. An additional amount of $20 million of the settlement is being paid toward a resolution of cost reporting fraud allegations pursued separately by James Alderson and John Schilling, the relators who filed the lawsuits. In total, the two relators are to receive a total of $100 million as their statutory share of the settlement.
$225.5 million to resolve lawsuits alleging that HCA hospitals and home health agencies unlawfully billed Medicare, Medicaid and TRICARE for claims generated by the payment of kickbacks and other illegal remuneration to physicians in exchange for referral of patients. In 2001, Columbia Management Companies, Inc., pled guilty to one count of conspiracy to pay kickbacks and other monetary benefits to doctors in violation of the Medicare Antikickback Statute and paid a $30 million criminal fine. Dr. James Thompson, a doctor who filed suit against the company in 1995, will receive $41.5 million as his statutory share of the settlement. Gary King, a former HCA employee, will receive $5 million and Ann Mroz, a former HCA nurse, will receive a share of $837,500.
$17 million to resolve allegations that certain company-owned hospitals billed Medicare for unallowable costs incurred by a contractor that operated HCA wound care centers, and for a non-covered drug that the contractor manufactured and sold to hospital patients. The 2001 Columbia Management Companies' guilty plea concerning cost report fraud included a charge related to wound care center costs. HCA's wound care center management contractor, Curative Healthcare Services, Inc., previously paid $16.5 million to resolve related allegations pending at one time in these same lawsuits. Joseph "Mickey" Parslow, a former HCA financial officer, will receive $2,990,000 and Francesco Lanni, a former Reimbursement Manager at the Wound Care Center at New York Methodist Hospital in Brooklyn, New York, will receive a share of $680,000.
$5 million to resolve allegations concerning the transfer of patients from HCA facilities to other facilities and the claiming of excessive costs for those transfers.
$5 million to resolve allegations that HCA's Lawnwood Regional Medical Center in Fort Pierce, Florida submitted false claims in Medicare cost reports by inflating its entitlement to funds to treat indigent patients and by shifting employee salary costs in order to increase its reimbursement from the federal health care program.
$950,000 to settle allegations made by Michael Marine that HCA improperly shifted its home office costs to hospitals. Marine will receive a share of $116,500.
Today's settlement agreement incorporates the terms of a Corporate Integrity Agreement executed by HCA and the Office of the Inspector General, Department of Health and Human Services in December 2000 that obligated the company to engage in significant and comprehensive compliance efforts into 2009.
In a separate agreement, HCA agreed to pay $1.5 million to resolve allegations that an Atlanta, Georgia hospital, West Paces Medical Center, paid kickbacks for the referral of diabetes patients. Those allegations had been pursued since 1996 by a whistleblower in a case in which the United States had declined to intervene, captioned U.S. ex rel. Pogue v. American Healthcorp, Inc. et al.. Pogue, a former employee of a co-defendant in the case, Diabetes Treatment Centers of America, will receive a share of $405,000 from the HCA settlement. Pogue continues to litigate claims against his former employer and a group of Atlanta physicians.
Additionally, a state negotiating team appointed by the National Association of Medicaid Fraud Control Units has reached agreement with HCA to resolve related issues with affected state Medicaid plans for $17.5 million, representing direct state losses. The terms of that agreement are being finalized by the parties and are not part of today's settlement.
Today's administrative agreement between HCA and CMS will require HCA to pay CMS $250 million in order to resolve claims they maintained against each other arising from HCA's hospital cost reports and home office cost statements for cost reporting periods ending July 31, 2001. These claims resulted from HCA cost reports that were not processed since 1997 as a result of the government's investigation.
FOR IMMEDIATE RELEASE
THURSDAY, JUNE 26, 2003
WWW.USDOJ.GOV
CIV
(202) 514-2007
TDD (202) 514-1888
LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED
HCA INVESTIGATION NETS RECORD TOTAL OF $1.7 BILLION
WASHINGTON, D.C. - HCA Inc. (formerly known as Columbia/HCA and HCA - The Healthcare Company) has agreed to pay the United States $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs, the Justice Department announced today.
This settlement marks the conclusion of the most comprehensive health care fraud investigation ever undertaken by the Justice Department, working with the Departments of Health and Human Services and Defense, the Office of Personnel Management and the states. The settlement announced today resolves HCA's civil liability for false claims resulting from a variety of allegedly unlawful practices, including cost report fraud and the payment of kickbacks to physicians.
Previously, on December 14, 2000, HCA subsidiaries pled guilty to substantial criminal conduct and paid more than $840 million in criminal fines, civil restitution and penalties. Combined with today's separate administrative settlement with the Centers for Medicare & Medicaid Services (CMS), under which HCA will pay an additional $250 million to resolve overpayment claims arising from certain of its cost reporting practices, the government will have recovered $1.7 billion from HCA, by far the largest recovery ever reached by the government in a health care fraud investigation.
"Health care providers and professionals hold a public trust, and when that trust is violated by fraud and abuse of program funds, and by the payment of kickbacks to the physicians on whom patients and the programs rely for uncompromised medical judgment, health care for all Americans suffers," Robert D. McCallum, Jr., Assistant Attorney General for the Civil Division said. "This settlement brings to a close the largest multi-agency investigation of a health care provider that the United States government has ever undertaken and demonstrates the Department of Justice's ongoing resolve and commitment to pursue all types of fraud on American taxpayers, and health care program beneficiaries."
"Let this case be a continuing reminder to all that in the fight against health care fraud this office will not be deterred," said Acting Principal Deputy Inspector General Dara Corrigan. “Medicare dollars paid to provide ever more expensive health care services to the country's taxpayers should never be fraudulently diverted. This is our job and our trust and we take these duties very seriously," Corrigan concluded.
This latest settlement resolves fraud allegations against HCA and HCA hospitals in nine False Claims Act qui tam or whistleblower lawsuits pending in federal court in the District of Columbia. Under the federal False Claims Act, private individuals may file suit on behalf of the United States and, if the case is successful, may recover a share of the proceeds for their efforts. Under the settlement, the whistleblowers will receive a combined share of $151,591,500, the highest combined qui tam award ever paid out by the government.
"We are grateful for the assistance given by the whistleblowers over the course of the past nine years of investigation and litigation,” McCallum said. “And we are proud of the work of government personnel as well as counsel for the whistleblowers, who together pursued these matters through investigation and strenuous litigation. This result demonstrates the commitment of the Department to the qui tam statute and that the statute works as Congress intended."
Under the first of three agreements announced today, which becomes effective upon the court's dismissal of the lawsuits, HCA will pay nearly $620 million to resolve eight whistleblower lawsuits in which the government had intervened alleging that HCA systematically defrauded Medicare, Medicaid and other federally funded health care programs through schemes dating back to the late 1980s. HCA will pay an additional $11 million to resolve separate allegations of improper HCA billing practices.
The settlement requires HCA to pay:
$356 million to resolve whistleblower lawsuits alleging that HCA engaged in a series of schemes to defraud Medicare, Medicaid and TRICARE, the military’s health care program, through hospital cost reports, the year end claims submitted by hospitals to the government to reconcile payments received throughout the year with amounts they claim are actually owed. In 2001, a subsidiary of Nashville-based HCA, Columbia Management Companies, Inc., pled guilty in the Middle District of Florida to related charges on eight counts of making false statements to the United States and paid $22.6 million in criminal fines. An additional amount of $20 million of the settlement is being paid toward a resolution of cost reporting fraud allegations pursued separately by James Alderson and John Schilling, the relators who filed the lawsuits. In total, the two relators are to receive a total of $100 million as their statutory share of the settlement.
$225.5 million to resolve lawsuits alleging that HCA hospitals and home health agencies unlawfully billed Medicare, Medicaid and TRICARE for claims generated by the payment of kickbacks and other illegal remuneration to physicians in exchange for referral of patients. In 2001, Columbia Management Companies, Inc., pled guilty to one count of conspiracy to pay kickbacks and other monetary benefits to doctors in violation of the Medicare Antikickback Statute and paid a $30 million criminal fine. Dr. James Thompson, a doctor who filed suit against the company in 1995, will receive $41.5 million as his statutory share of the settlement. Gary King, a former HCA employee, will receive $5 million and Ann Mroz, a former HCA nurse, will receive a share of $837,500.
$17 million to resolve allegations that certain company-owned hospitals billed Medicare for unallowable costs incurred by a contractor that operated HCA wound care centers, and for a non-covered drug that the contractor manufactured and sold to hospital patients. The 2001 Columbia Management Companies' guilty plea concerning cost report fraud included a charge related to wound care center costs. HCA's wound care center management contractor, Curative Healthcare Services, Inc., previously paid $16.5 million to resolve related allegations pending at one time in these same lawsuits. Joseph "Mickey" Parslow, a former HCA financial officer, will receive $2,990,000 and Francesco Lanni, a former Reimbursement Manager at the Wound Care Center at New York Methodist Hospital in Brooklyn, New York, will receive a share of $680,000.
$5 million to resolve allegations concerning the transfer of patients from HCA facilities to other facilities and the claiming of excessive costs for those transfers.
$5 million to resolve allegations that HCA's Lawnwood Regional Medical Center in Fort Pierce, Florida submitted false claims in Medicare cost reports by inflating its entitlement to funds to treat indigent patients and by shifting employee salary costs in order to increase its reimbursement from the federal health care program.
$950,000 to settle allegations made by Michael Marine that HCA improperly shifted its home office costs to hospitals. Marine will receive a share of $116,500.
Today's settlement agreement incorporates the terms of a Corporate Integrity Agreement executed by HCA and the Office of the Inspector General, Department of Health and Human Services in December 2000 that obligated the company to engage in significant and comprehensive compliance efforts into 2009.
In a separate agreement, HCA agreed to pay $1.5 million to resolve allegations that an Atlanta, Georgia hospital, West Paces Medical Center, paid kickbacks for the referral of diabetes patients. Those allegations had been pursued since 1996 by a whistleblower in a case in which the United States had declined to intervene, captioned U.S. ex rel. Pogue v. American Healthcorp, Inc. et al.. Pogue, a former employee of a co-defendant in the case, Diabetes Treatment Centers of America, will receive a share of $405,000 from the HCA settlement. Pogue continues to litigate claims against his former employer and a group of Atlanta physicians.
Additionally, a state negotiating team appointed by the National Association of Medicaid Fraud Control Units has reached agreement with HCA to resolve related issues with affected state Medicaid plans for $17.5 million, representing direct state losses. The terms of that agreement are being finalized by the parties and are not part of today's settlement.
Today's administrative agreement between HCA and CMS will require HCA to pay CMS $250 million in order to resolve claims they maintained against each other arising from HCA's hospital cost reports and home office cost statements for cost reporting periods ending July 31, 2001. These claims resulted from HCA cost reports that were not processed since 1997 as a result of the government's investigation.
Friday, April 18, 2008
Attorney General Andrew Cuomo ....home-health care industry bills the state $3.8 billion a year in Medicaid costs,
Cuomo Issuing Subpoenas On Home Health Industry
Attorney General Andrew Cuomo just called to say he’s in Buffalo and Rochester today to announce that he’s issuing 27 subpoenas to home-health companies across upstate over allegations of fraud and mistreatment of patients.
Cuomo said the home-health care industry bills the state $3.8 billion a year in Medicaid costs, yet Cuomo believes there is “rampant fraud throughout the system.”
He mentioned instances where home-health agencies bill patients but never even show up. He said there’s one case in Rochester where there was $70,000 in over billing.
“It’s a double fraud,” Cuomo said. “It’s victimizing elderly people, disabled people who are home bound for the most part, and you rip off the taxpayers.”
He said the subpoenas will seek records and information from home-health care companies about their billing practices and work with patients.
The home-health care industry is the latest target by Cuomo, who earlier this week expanded his probe into whether local governments and schools are bilking taxpayers by putting consultants on the payroll in order to receive state benefits, such as health care and pensions.
Attorney General Andrew Cuomo just called to say he’s in Buffalo and Rochester today to announce that he’s issuing 27 subpoenas to home-health companies across upstate over allegations of fraud and mistreatment of patients.
Cuomo said the home-health care industry bills the state $3.8 billion a year in Medicaid costs, yet Cuomo believes there is “rampant fraud throughout the system.”
He mentioned instances where home-health agencies bill patients but never even show up. He said there’s one case in Rochester where there was $70,000 in over billing.
“It’s a double fraud,” Cuomo said. “It’s victimizing elderly people, disabled people who are home bound for the most part, and you rip off the taxpayers.”
He said the subpoenas will seek records and information from home-health care companies about their billing practices and work with patients.
The home-health care industry is the latest target by Cuomo, who earlier this week expanded his probe into whether local governments and schools are bilking taxpayers by putting consultants on the payroll in order to receive state benefits, such as health care and pensions.
Friday, April 11, 2008
Health Care Fraud kickback scheme.
About time this 'puppet' does something useful. But I really want to know weher is the money? Is he smart enought to get that?
U.S. Department of Justice
U.S. Attorney’s Office
Western District of Texas
Johnny Sutton, U.S. Attorney
--------------------------------------------------------------------------------
April 9, 2008
Shana Jones, Special Assistant
Daryl Fields, Public Information Officer
(210) 384-7440 May 18, 2007
SAN ANTONIO BUSINESS OWNER SENTENCED TO FEDERAL PRISON
AND ORDERED TO PAY OVER $4 MILLION RESTITUTION
United States Attorney Johnny Sutton announced that in San Antonio this afternoon, Mary Lou Hernandez, owner of Angel Care Medical Supply, was sentenced to 24 months in federal prison and ordered to pay $4,409,518 in restitution for her role in a Health Care Fraud kickback scheme.
In addition to the prison term, United States District Judge W. Royal Furgeson ordered that Hernandez be placed under supervised release for a period of three years after completing her prison term. Today, Hernandez forfeited nearly $428,000 in assets toward satisfying the agreed $4 million monetary judgement ordered by the Court on April 12, 2007.
On November 16, 2006, Hernandez pleaded guilty to a 3-count Information charging her with conspiracy to commit Health Care Fraud, Health Care Fraud and violation of the Anti-kickback statute.
A Certificate of Medical Necessity (CMN) documents a beneficiary’s physician’s conclusion that durable medical equipment (DME) such as wheel chairs, hospital beds, ventilators and oxygen equipment is medically necessary and reasonable for the treatment of an illness or injury. Hernandez admitted that beginning in 2000, she paid between $800 and $1,000 in kickbacks to five San Antonio area physicians for each CMN. Hernandez also admitted to submitting false Medicare and Medicaid reimbursement claims for DME. The factual basis alleges that from January 13, 2001, to September 30, 2004, ACMS was overpaid $3,032,404.94 by Medicare and $1,377,114 by Medicaid.
The defendant’s fraudulent scheme was revealed during an investigation conducted by the Federal Bureau of Investigation. Assistant United States Attorney Tom McHugh prosecuted this case on behalf of the Government.
U.S. Department of Justice
U.S. Attorney’s Office
Western District of Texas
Johnny Sutton, U.S. Attorney
--------------------------------------------------------------------------------
April 9, 2008
Shana Jones, Special Assistant
Daryl Fields, Public Information Officer
(210) 384-7440 May 18, 2007
SAN ANTONIO BUSINESS OWNER SENTENCED TO FEDERAL PRISON
AND ORDERED TO PAY OVER $4 MILLION RESTITUTION
United States Attorney Johnny Sutton announced that in San Antonio this afternoon, Mary Lou Hernandez, owner of Angel Care Medical Supply, was sentenced to 24 months in federal prison and ordered to pay $4,409,518 in restitution for her role in a Health Care Fraud kickback scheme.
In addition to the prison term, United States District Judge W. Royal Furgeson ordered that Hernandez be placed under supervised release for a period of three years after completing her prison term. Today, Hernandez forfeited nearly $428,000 in assets toward satisfying the agreed $4 million monetary judgement ordered by the Court on April 12, 2007.
On November 16, 2006, Hernandez pleaded guilty to a 3-count Information charging her with conspiracy to commit Health Care Fraud, Health Care Fraud and violation of the Anti-kickback statute.
A Certificate of Medical Necessity (CMN) documents a beneficiary’s physician’s conclusion that durable medical equipment (DME) such as wheel chairs, hospital beds, ventilators and oxygen equipment is medically necessary and reasonable for the treatment of an illness or injury. Hernandez admitted that beginning in 2000, she paid between $800 and $1,000 in kickbacks to five San Antonio area physicians for each CMN. Hernandez also admitted to submitting false Medicare and Medicaid reimbursement claims for DME. The factual basis alleges that from January 13, 2001, to September 30, 2004, ACMS was overpaid $3,032,404.94 by Medicare and $1,377,114 by Medicaid.
The defendant’s fraudulent scheme was revealed during an investigation conducted by the Federal Bureau of Investigation. Assistant United States Attorney Tom McHugh prosecuted this case on behalf of the Government.
Monday, February 18, 2008
$3 billion fraud through a business that bought accounts receivables from health-care providers
The fraud trial of executives at what was once the nation's largest health-care finance company opened Thursday in Columbus with competing claims of what caused the company's multibillion-dollar collapse.
U.S. District Court Judge Algenon L. Marbley began the National Century Financial Enterprises Inc. trial by instructing the 15 seated jurors how they should decide the fates of the five former company executives.
The government is alleging the five executives and two others who will be tried later, including National Century CEO Lance Poulsen, masterminded a $3 billion fraud through a business that bought accounts receivables from health-care providers at a discount and packaged the accounts as bond funds, which were sold to raise money to buy more accounts. The government has accused the executives of diverting $2.84 billion for their benefit.
The Dublin company collapsed into bankruptcy in 2002. The executives were later indicted on conspiracy, securities, fraud and money laundering charges. Poulsen also faces claims he tried to bribe a government witness.
"This case is about promises made, promises broken and a massive cover-up," said Assistant U.S. Attorney Douglas W. Squires, who began the day's opening arguments.
Over the course of 25 minutes, Squires told the jury how National Century's business plan was supposed to work, then he alluded to payments the company allegedly made to health-care providers in which National Century's owners and founders - Poulsen, Donald H. Ayers and Rebecca S. Parrett - had financial interests.
In the end, Squires said the case is a simple one of fraud and cover-up.
Defense lawyers, meanwhile, disputed the government's claims, stressing the complexity of everything surrounding National Century.
Brian Dickerson, attorney for the 71-year-old Ayers, said he expects the government will give jurors just a fraction of the story during the trial.
Dickerson told jurors that evidence will show Ayers, the company's chief operating officer, sunk $2 million of his money into National Century, a company he said helped hospitals and health-care facilities stay in business.
U.S. District Court Judge Algenon L. Marbley began the National Century Financial Enterprises Inc. trial by instructing the 15 seated jurors how they should decide the fates of the five former company executives.
The government is alleging the five executives and two others who will be tried later, including National Century CEO Lance Poulsen, masterminded a $3 billion fraud through a business that bought accounts receivables from health-care providers at a discount and packaged the accounts as bond funds, which were sold to raise money to buy more accounts. The government has accused the executives of diverting $2.84 billion for their benefit.
The Dublin company collapsed into bankruptcy in 2002. The executives were later indicted on conspiracy, securities, fraud and money laundering charges. Poulsen also faces claims he tried to bribe a government witness.
"This case is about promises made, promises broken and a massive cover-up," said Assistant U.S. Attorney Douglas W. Squires, who began the day's opening arguments.
Over the course of 25 minutes, Squires told the jury how National Century's business plan was supposed to work, then he alluded to payments the company allegedly made to health-care providers in which National Century's owners and founders - Poulsen, Donald H. Ayers and Rebecca S. Parrett - had financial interests.
In the end, Squires said the case is a simple one of fraud and cover-up.
Defense lawyers, meanwhile, disputed the government's claims, stressing the complexity of everything surrounding National Century.
Brian Dickerson, attorney for the 71-year-old Ayers, said he expects the government will give jurors just a fraction of the story during the trial.
Dickerson told jurors that evidence will show Ayers, the company's chief operating officer, sunk $2 million of his money into National Century, a company he said helped hospitals and health-care facilities stay in business.
James Happ is scheduled for trial in October because he wasn't charged in connection with the company's failure until last May.
National Century's indicted Poulsen hires new lawyers
The founder and former chief executive of National Century Financial Enterprises Inc. has hired lawyers from Charlotte, N.C., to represent him in criminal trials stemming from the Dublin health-care finance company's collapse in 2002.
Anderson Terpening PLLC, a white-collar criminal defense law firm that specializes in fraud cases, said Lance K. Poulsen retained its lawyers for an obstruction trial scheduled for March and a securities fraud trial scheduled for August. Poulsen needed new lawyers because his former defense attorneys pulled out of the case last year.
Poulsen, 64, faces 13 counts of securities fraud, concealment of money laundering, conspiracy, wire fraud and money laundering conspiracy in connection with company's financial collapse. The federal government later indicted the former CEO and an associate, alleging they attempted to bribe a government witness.
Five other National Century executives are being tried in a criminal case that began this week in U.S. District Court in Columbus. The government has alleged those five executives, along with Poulsen and another executive were behind a $3 billion fraud at the company.
Poulsen's lawyers, Thomas and James Tyack of Tyack Blackmore & Liston Co. LPA, pulled out of the case last November, telling a judge that Poulsen's Oct. 23 indictment on conspiracy charges created a conflict of interest. According to the indictment, Poulsen and associate Karl A. Demmler allegedly hatched a scheme to give $500,000 to an ex-National Century executive if she would develop "amnesia" when testifying as a government witness about the firm's collapse. A revised indictment in January added a count each of witness tampering and witness tampering by influencing testimony to the conspiracy charges.
Poulsen and Demmler in January pleaded not guilty to the charges.
Anderson Terpening said its attorneys have argued for Poulsen's release from the Ross County Jail in Chillicothe, where he was transferred in January from the Franklin County Jail, saying having him out from behind bars is necessary to allow "direct and daily interaction" with his lawyers and complex documents.
Poulsen isn't the only National Century executive scheduled for a trial apart from the five now in court. James Happ is scheduled for trial in October because he wasn't charged in connection with the company's failure until last May.
The founder and former chief executive of National Century Financial Enterprises Inc. has hired lawyers from Charlotte, N.C., to represent him in criminal trials stemming from the Dublin health-care finance company's collapse in 2002.
Anderson Terpening PLLC, a white-collar criminal defense law firm that specializes in fraud cases, said Lance K. Poulsen retained its lawyers for an obstruction trial scheduled for March and a securities fraud trial scheduled for August. Poulsen needed new lawyers because his former defense attorneys pulled out of the case last year.
Poulsen, 64, faces 13 counts of securities fraud, concealment of money laundering, conspiracy, wire fraud and money laundering conspiracy in connection with company's financial collapse. The federal government later indicted the former CEO and an associate, alleging they attempted to bribe a government witness.
Five other National Century executives are being tried in a criminal case that began this week in U.S. District Court in Columbus. The government has alleged those five executives, along with Poulsen and another executive were behind a $3 billion fraud at the company.
Poulsen's lawyers, Thomas and James Tyack of Tyack Blackmore & Liston Co. LPA, pulled out of the case last November, telling a judge that Poulsen's Oct. 23 indictment on conspiracy charges created a conflict of interest. According to the indictment, Poulsen and associate Karl A. Demmler allegedly hatched a scheme to give $500,000 to an ex-National Century executive if she would develop "amnesia" when testifying as a government witness about the firm's collapse. A revised indictment in January added a count each of witness tampering and witness tampering by influencing testimony to the conspiracy charges.
Poulsen and Demmler in January pleaded not guilty to the charges.
Anderson Terpening said its attorneys have argued for Poulsen's release from the Ross County Jail in Chillicothe, where he was transferred in January from the Franklin County Jail, saying having him out from behind bars is necessary to allow "direct and daily interaction" with his lawyers and complex documents.
Poulsen isn't the only National Century executive scheduled for a trial apart from the five now in court. James Happ is scheduled for trial in October because he wasn't charged in connection with the company's failure until last May.
NCFE...financially unstable were evident six years before it collapsed.
There is so much more to this story that has yet to be told......and who is really behind this so called Financial Institute related to HEALTHCARE
Feb 08, 2008 (The Columbus Dispatch - McClatchy-Tribune Information Services via COMTEX) -- CYFL | news | PowerRating | PR Charts -- Signs that the National Century Financial Enterprises company was financially unstable were evident six years before it collapsed, the government's first witness in a fraud trial for its top executives testified.
William Parizek served as National Century's director of corporate financing from October 1996 until he resigned in January 1997. He said he moved his family from Kansas to Dublin already knowing a lot about the company.
His former employer, Koch Industries, had asked him to investigate National Century before the oil and gas company agreed to invest in the Dublin-based health-care financing company.
But less than a month after starting to work at National Century, Parizek said he realized investors, including his former company, had been duped.
"I felt (National Century) would be unable to survive for more than two or three months" because they were so shaky financially, Parizek testified.
National Century loaned more to small hospitals, clinics and nursing homes than they could repay, he said.
Parizek said he disagreed with National Century's practices so strongly that he quit without having another job. That meant giving up a $75,000 annual salary and a potential $3 million bonus if he raised $50 million in equity capital for the company.
Former National Century executives Rebecca S. Parrett, Donald H. Ayers, James E. Dierker, Roger S. Faulkenberry and Randolph H. Speer are on trial on charges of fraud, securities fraud, wire fraud and money laundering in connection with the company's collapse, which eventually led to the loss of nearly $2 billion by investors.
Parizek's testimony was cut short yesterday afternoon after questioning by defense attorney Brian Dickerson revealed that Parizek still had handwritten notes of his warning company executives about the financial problems.
Prosecutors had not given defense attorneys copies of the notes.
Federal Judge Algenon L. Marbley had the court make copies of Parizek's 34 pages of notes and gave them to defense attorneys.
Marbley said he expects copies of such documents to be given out at least a day in advance and warned prosecutors not to let it happen again.
The testimony came after a morning in which defense and prosecuting attorneys painted vastly different pictures in opening statements as to the reasons behind the company's demise.
"This is a case about promises made, promises broken and a massive coverup," assistant U.S. attorney Doug Squires said.
The company's financial problems stemmed in large part from loaning hundreds of millions more to health-care providers than what the companies qualified for, Squires said.
Dickerson said National Century had problems with communication among its divisions, but that there were always rating agencies, auditors, banks and investors watching everything they did.
"If it's a coverup, there's a lot of people covering up a lot of things," he said.
Other defense attorneys also said the downfall wasn't the result of criminal activity.
"There is a vast difference between bad business decisions and criminal activity," James Ervin Jr. said. "This case is about business decisions, not illegal conduct."
National Century started in 1991 with fewer than 10 employees and grew to 357. It loaned money to more than 2,000 health-care providers, helping them to stay in business.
"You cannot be the backbone to so many health-care providers across the country if you are not making good decisions," defense attorney Javier Armengau said.
Before the trial started yesterday, one juror asked to be dismissed.
Marbley said he excused a man because of work and family conflicts. The jury is now made up of eight women and four men, with three women serving as alternates.
jandes@dispatch.com
Feb 08, 2008 (The Columbus Dispatch - McClatchy-Tribune Information Services via COMTEX) -- CYFL | news | PowerRating | PR Charts -- Signs that the National Century Financial Enterprises company was financially unstable were evident six years before it collapsed, the government's first witness in a fraud trial for its top executives testified.
William Parizek served as National Century's director of corporate financing from October 1996 until he resigned in January 1997. He said he moved his family from Kansas to Dublin already knowing a lot about the company.
His former employer, Koch Industries, had asked him to investigate National Century before the oil and gas company agreed to invest in the Dublin-based health-care financing company.
But less than a month after starting to work at National Century, Parizek said he realized investors, including his former company, had been duped.
"I felt (National Century) would be unable to survive for more than two or three months" because they were so shaky financially, Parizek testified.
National Century loaned more to small hospitals, clinics and nursing homes than they could repay, he said.
Parizek said he disagreed with National Century's practices so strongly that he quit without having another job. That meant giving up a $75,000 annual salary and a potential $3 million bonus if he raised $50 million in equity capital for the company.
Former National Century executives Rebecca S. Parrett, Donald H. Ayers, James E. Dierker, Roger S. Faulkenberry and Randolph H. Speer are on trial on charges of fraud, securities fraud, wire fraud and money laundering in connection with the company's collapse, which eventually led to the loss of nearly $2 billion by investors.
Parizek's testimony was cut short yesterday afternoon after questioning by defense attorney Brian Dickerson revealed that Parizek still had handwritten notes of his warning company executives about the financial problems.
Prosecutors had not given defense attorneys copies of the notes.
Federal Judge Algenon L. Marbley had the court make copies of Parizek's 34 pages of notes and gave them to defense attorneys.
Marbley said he expects copies of such documents to be given out at least a day in advance and warned prosecutors not to let it happen again.
The testimony came after a morning in which defense and prosecuting attorneys painted vastly different pictures in opening statements as to the reasons behind the company's demise.
"This is a case about promises made, promises broken and a massive coverup," assistant U.S. attorney Doug Squires said.
The company's financial problems stemmed in large part from loaning hundreds of millions more to health-care providers than what the companies qualified for, Squires said.
Dickerson said National Century had problems with communication among its divisions, but that there were always rating agencies, auditors, banks and investors watching everything they did.
"If it's a coverup, there's a lot of people covering up a lot of things," he said.
Other defense attorneys also said the downfall wasn't the result of criminal activity.
"There is a vast difference between bad business decisions and criminal activity," James Ervin Jr. said. "This case is about business decisions, not illegal conduct."
National Century started in 1991 with fewer than 10 employees and grew to 357. It loaned money to more than 2,000 health-care providers, helping them to stay in business.
"You cannot be the backbone to so many health-care providers across the country if you are not making good decisions," defense attorney Javier Armengau said.
Before the trial started yesterday, one juror asked to be dismissed.
Marbley said he excused a man because of work and family conflicts. The jury is now made up of eight women and four men, with three women serving as alternates.
jandes@dispatch.com
In a surprise, NCFE trial kickoff draws in the publicOhio media pays attention to arcane fraud case that's likely to drag on for quite a while
By: Cinda Becker
Story posted: February 13, 2008 - 1:34 pm EDT
One might think that the embarrassing if not ignoble collapse of what was once described as “the country’s largest provider of healthcare accounts-receivable financing” would only be of interest to some affected healthcare providers, accounting nerds and burned Wall Street investors. But the criminal trial of five former executives of National Century Financial Enterprises is actually front-page news in Columbus, Ohio, where the trial got under way last week in a U.S. District courtroom.
In fact, based on a story that ran on the front page of the Columbus Dispatch the Sunday before the trial, defense attorneys motioned last week to conduct individualized and comprehensive voir dire of the dozens if not hundreds of prospective jurors. Without one-on-one questioning to determine otherwise, the attorneys said they were concerned that the prominent media coverage might have contaminated the pool.
For those of you who did not work for one of the 275 healthcare providers that supposedly went bankrupt after NCFE’s collapse, or are not accountants, burned investors or Columbus-area residents, here’s the back story: NCFE purchased medical accounts receivable from providers typically in dire financial straits, raising capital by selling AAA-rated asset-backed bonds or notes to investors. Prosecutors are alleging that it was all a sham that eventually led to the November 2002 collapse of NCFE days after FBI agents raided its Dublin, Ohio, headquarters. They claim that the fraud cost investors more than $1.9 billion.
Fortunately for the court calendar, Judge Algenon Marbley, a folksy man both pragmatic and aware of the legal rules, found a way around the voir dire motion that was amenable to both sides. Even with that, jury selection took three full days, putting the trial, which is expected to last four to six weeks, behind by a full day before it even got started.
The irony here is that jury selection traditionally gives lawyers an opportunity to taint the jury pool by their line of questioning, and this was very much apparent on the third day of questioning. The pool had already been whittled down to a mere courtroom-size group with prospective jurors sitting in every available seat, including the jury box. Marbley started things off that day by asking if a six-week trial would be a hardship for anyone. Several people raised their hands, including a waitress who said she would not get any pay and a young man who informed the judge that he worked for his family’s plumbing business.
“I was informed yesterday by my father that he would not pay me,” the young man said, lightening the mood in the courtroom.
Defense attorneys’ questions to the prospective jurors grew progressively rhetorical in nature after the jurors were first screened on direct questions like whether they had been victims of bankruptcy or whether they had ever been involved in any whistle-blower complaints. (One prospective juror had been employed by WorldCom and another by the now defunct Dublin Securities.)
Questions then seemed to get broader and more tangential as the pool was quizzed on their knowledge of financial concepts; auditors, specifically Deloitte & Touche; credit-rating agencies; trustees; and whether anyone had ever bothered to read their credit-card agreements. They also were asked how they felt about executive compensation—is $500,000 a year too much?—and whether they knew what a “144A offering” was. The pool was casually surveyed as to how many of them held job titles that had anything to do with what they actually did for a living and whether anyone had ever heard of the term “healthcare securitizations.” (No one had, or at least no one admitted they had.) During the course of this line of questioning, one woman in the back of the courtroom revealed that she is a personal friend of the chief executive officer of Deloitte and her husband had been at one time chief financial officer of Ford and Battelle. She was not selected.
Another prospective juror who was not selected was a man who works for Cardinal Health, also headquartered in Dublin, who said he reported directly to a vice president. On the other hand, one of the few people who raised their hands when asked if they actually wanted to serve on this jury was selected. When asked why he wanted to serve, he replied, “I think it’s a duty, and if anyone didn’t know anything (about this case) when they came in, I was him.”
No one connected with the trial has any inflated hopes of swift justice. Each of the five defendants had at least two defense lawyers sitting with him, and there were four lawyers sitting at the U.S. attorney’s table so that whenever there was a request for a sidebar—and there were many—there was a sea of dark suits huddling to the side of the courtroom while Musak played over the courtroom speakers. Yet for all of the dissension in the reams of motions and trial briefs that are accumulating with the case, the prosecutors and defense attorneys actually seemed to get along very well.
But missing from the defense side of the courtroom is perhaps the most contentious principal involved with NCFE: Lance Poulsen, one of NCFE’s founders and its former president, chairman and chief executive officer. Poulsen’s case was severed from the trial earlier this year; he will be tried in August. In the meantime, considered a flight risk, he is sitting in jail outside Columbus, facing separate charges of witness tampering at a trial expected to take place this spring.
Poulsen has fallen far. NCFE and Poulsen were once held in high enough regard in the Columbus area that the Dispatch profiled him in its business section in May 2000. Poulsen noted in the profile that marketing had been his primary focus over the previous 32 years of his career. His first professional position was with Hamm’s Brewery in St. Paul, Minn., according to the profile. He also said that as a result of his first job as a teenager working as a box wrapper and part-time salesman at the Robert Hall clothing store, he had learned, “Selling and marketing is more lucrative than packaging.”
As for his biggest mistake (up until that point in time), he recalled a boating accident that, in hindsight, might have been prophetic. He said: “Once while cruising in the coastal waters of Florida, I inadvertently turned the chart upside down and ran my vessel hard aground at a high speed.” How did he resolve the mistake? “I now make sure I always have the chart right-side up. Much like life, some things appear different than they actually are, and we must take time to examine the facts.
By: Cinda Becker
Story posted: February 13, 2008 - 1:34 pm EDT
One might think that the embarrassing if not ignoble collapse of what was once described as “the country’s largest provider of healthcare accounts-receivable financing” would only be of interest to some affected healthcare providers, accounting nerds and burned Wall Street investors. But the criminal trial of five former executives of National Century Financial Enterprises is actually front-page news in Columbus, Ohio, where the trial got under way last week in a U.S. District courtroom.
In fact, based on a story that ran on the front page of the Columbus Dispatch the Sunday before the trial, defense attorneys motioned last week to conduct individualized and comprehensive voir dire of the dozens if not hundreds of prospective jurors. Without one-on-one questioning to determine otherwise, the attorneys said they were concerned that the prominent media coverage might have contaminated the pool.
For those of you who did not work for one of the 275 healthcare providers that supposedly went bankrupt after NCFE’s collapse, or are not accountants, burned investors or Columbus-area residents, here’s the back story: NCFE purchased medical accounts receivable from providers typically in dire financial straits, raising capital by selling AAA-rated asset-backed bonds or notes to investors. Prosecutors are alleging that it was all a sham that eventually led to the November 2002 collapse of NCFE days after FBI agents raided its Dublin, Ohio, headquarters. They claim that the fraud cost investors more than $1.9 billion.
Fortunately for the court calendar, Judge Algenon Marbley, a folksy man both pragmatic and aware of the legal rules, found a way around the voir dire motion that was amenable to both sides. Even with that, jury selection took three full days, putting the trial, which is expected to last four to six weeks, behind by a full day before it even got started.
The irony here is that jury selection traditionally gives lawyers an opportunity to taint the jury pool by their line of questioning, and this was very much apparent on the third day of questioning. The pool had already been whittled down to a mere courtroom-size group with prospective jurors sitting in every available seat, including the jury box. Marbley started things off that day by asking if a six-week trial would be a hardship for anyone. Several people raised their hands, including a waitress who said she would not get any pay and a young man who informed the judge that he worked for his family’s plumbing business.
“I was informed yesterday by my father that he would not pay me,” the young man said, lightening the mood in the courtroom.
Defense attorneys’ questions to the prospective jurors grew progressively rhetorical in nature after the jurors were first screened on direct questions like whether they had been victims of bankruptcy or whether they had ever been involved in any whistle-blower complaints. (One prospective juror had been employed by WorldCom and another by the now defunct Dublin Securities.)
Questions then seemed to get broader and more tangential as the pool was quizzed on their knowledge of financial concepts; auditors, specifically Deloitte & Touche; credit-rating agencies; trustees; and whether anyone had ever bothered to read their credit-card agreements. They also were asked how they felt about executive compensation—is $500,000 a year too much?—and whether they knew what a “144A offering” was. The pool was casually surveyed as to how many of them held job titles that had anything to do with what they actually did for a living and whether anyone had ever heard of the term “healthcare securitizations.” (No one had, or at least no one admitted they had.) During the course of this line of questioning, one woman in the back of the courtroom revealed that she is a personal friend of the chief executive officer of Deloitte and her husband had been at one time chief financial officer of Ford and Battelle. She was not selected.
Another prospective juror who was not selected was a man who works for Cardinal Health, also headquartered in Dublin, who said he reported directly to a vice president. On the other hand, one of the few people who raised their hands when asked if they actually wanted to serve on this jury was selected. When asked why he wanted to serve, he replied, “I think it’s a duty, and if anyone didn’t know anything (about this case) when they came in, I was him.”
No one connected with the trial has any inflated hopes of swift justice. Each of the five defendants had at least two defense lawyers sitting with him, and there were four lawyers sitting at the U.S. attorney’s table so that whenever there was a request for a sidebar—and there were many—there was a sea of dark suits huddling to the side of the courtroom while Musak played over the courtroom speakers. Yet for all of the dissension in the reams of motions and trial briefs that are accumulating with the case, the prosecutors and defense attorneys actually seemed to get along very well.
But missing from the defense side of the courtroom is perhaps the most contentious principal involved with NCFE: Lance Poulsen, one of NCFE’s founders and its former president, chairman and chief executive officer. Poulsen’s case was severed from the trial earlier this year; he will be tried in August. In the meantime, considered a flight risk, he is sitting in jail outside Columbus, facing separate charges of witness tampering at a trial expected to take place this spring.
Poulsen has fallen far. NCFE and Poulsen were once held in high enough regard in the Columbus area that the Dispatch profiled him in its business section in May 2000. Poulsen noted in the profile that marketing had been his primary focus over the previous 32 years of his career. His first professional position was with Hamm’s Brewery in St. Paul, Minn., according to the profile. He also said that as a result of his first job as a teenager working as a box wrapper and part-time salesman at the Robert Hall clothing store, he had learned, “Selling and marketing is more lucrative than packaging.”
As for his biggest mistake (up until that point in time), he recalled a boating accident that, in hindsight, might have been prophetic. He said: “Once while cruising in the coastal waters of Florida, I inadvertently turned the chart upside down and ran my vessel hard aground at a high speed.” How did he resolve the mistake? “I now make sure I always have the chart right-side up. Much like life, some things appear different than they actually are, and we must take time to examine the facts.
Multi Billion $$$ Fraud and a $250,000 fine
National Century exec says colleagues lied to investorsFebruary 11, 2008 5:37 PM ET
The final hours of testimony by former National Century Financial Enterprises Inc. executive Jon Beacham became heated Monday afternoon in U.S. District Court.
The former director of securitizations at Dublin-based National Century argued with a defense lawyer over whether he believed he had engaged in a criminal act. Leonard Yelsky, an attorney for defendant James Dierker, who is standing trial with four other former National Century executives on criminal charges, implied Beacham didn't have all the facts about the company to know whether anything illegal took place.
"Sir, I don't need all the facts. I have enough," Beacham said, adding he knew all the defendants made a material omission when providing information to investors, which he said was the same as lying.
Under questioning by government attorneys Friday, Beacham testified he and other executives at the company, then the nation's largest health-care financing company, lied to investors and ratings agencies when the business issued its NPF XII fund.
"There was definitely material omissions at (investor) presentations," Beacham told jurors Friday.
Beacham, 41, headed the department that sold asset-backed bonds to investors.
When defense attorneys got their chance to question Beacham Monday, they tried to show he was an unreliable witness because he changed his earlier not guilty plea after agreeing to be a government witness. Now a stay-at-home father in Gross Pointe, Mich., Beacham pleaded guilty in July to a count each of securities fraud and conspiracy to commit securities fraud and wire fraud. He also agreed to forfeit $330,000.
He faces up to five years in prison with three years of supervised release, plus a $250,000 fine. He has yet to be sentenced, and as of January the government had not recommended his sentence be reduced.
Under later questioning by defense attorneys, Beacham testified he found out in October 2002 that National Century CEO Lance Poulsen had used all of NPF XII's reserve fund to buy additional accounts receivables. Beacham recounted how he alerted investors to the problem.
But Beacham qualified that even though the problem was disclosed in late 2002, he said there was still underlying conspiracy because no one told investors about potential problems earlier.
During Beacham's time on the witness stand Monday morning, defense lawyers spent their time asking him about his plea agreement with the government, implying he made a deal with the Justice Department not because he thought he was guilty, but because he wanted to reduce time away from his wife and four children.
Beacham was indicted in 2006 with the five executives now on trial -- National Century's chief operating officer, Donald Ayers, 71; the company's vice chairwoman, Rebecca Parrett, 58; Randolph Speer, 57, its chief financial officer; Roger Faulkenberry, 46, an executive vice president; and Dierker, 39, a vice president. The five are facing criminal charges they were behind a $3 billion fraud at the privately held company, which went bankrupt in 2002.
National Century financed health-care businesses by purchasing accounts receivables from medical providers at a discount and then packaging the accounts as bond funds. The government has accused the executives of diverting $2.84 billion for their benefit.
All have pleaded not guilty to charges that include conspiracy, securities, fraud and money laundering charges.
Poulsen, 64, is set for trial in August, five months after he is scheduled to be tried on allegations he and an associate attempted to bribe a government witness.
If found guilty, the defendants face 30 years to life in prison.
The final hours of testimony by former National Century Financial Enterprises Inc. executive Jon Beacham became heated Monday afternoon in U.S. District Court.
The former director of securitizations at Dublin-based National Century argued with a defense lawyer over whether he believed he had engaged in a criminal act. Leonard Yelsky, an attorney for defendant James Dierker, who is standing trial with four other former National Century executives on criminal charges, implied Beacham didn't have all the facts about the company to know whether anything illegal took place.
"Sir, I don't need all the facts. I have enough," Beacham said, adding he knew all the defendants made a material omission when providing information to investors, which he said was the same as lying.
Under questioning by government attorneys Friday, Beacham testified he and other executives at the company, then the nation's largest health-care financing company, lied to investors and ratings agencies when the business issued its NPF XII fund.
"There was definitely material omissions at (investor) presentations," Beacham told jurors Friday.
Beacham, 41, headed the department that sold asset-backed bonds to investors.
When defense attorneys got their chance to question Beacham Monday, they tried to show he was an unreliable witness because he changed his earlier not guilty plea after agreeing to be a government witness. Now a stay-at-home father in Gross Pointe, Mich., Beacham pleaded guilty in July to a count each of securities fraud and conspiracy to commit securities fraud and wire fraud. He also agreed to forfeit $330,000.
He faces up to five years in prison with three years of supervised release, plus a $250,000 fine. He has yet to be sentenced, and as of January the government had not recommended his sentence be reduced.
Under later questioning by defense attorneys, Beacham testified he found out in October 2002 that National Century CEO Lance Poulsen had used all of NPF XII's reserve fund to buy additional accounts receivables. Beacham recounted how he alerted investors to the problem.
But Beacham qualified that even though the problem was disclosed in late 2002, he said there was still underlying conspiracy because no one told investors about potential problems earlier.
During Beacham's time on the witness stand Monday morning, defense lawyers spent their time asking him about his plea agreement with the government, implying he made a deal with the Justice Department not because he thought he was guilty, but because he wanted to reduce time away from his wife and four children.
Beacham was indicted in 2006 with the five executives now on trial -- National Century's chief operating officer, Donald Ayers, 71; the company's vice chairwoman, Rebecca Parrett, 58; Randolph Speer, 57, its chief financial officer; Roger Faulkenberry, 46, an executive vice president; and Dierker, 39, a vice president. The five are facing criminal charges they were behind a $3 billion fraud at the privately held company, which went bankrupt in 2002.
National Century financed health-care businesses by purchasing accounts receivables from medical providers at a discount and then packaging the accounts as bond funds. The government has accused the executives of diverting $2.84 billion for their benefit.
All have pleaded not guilty to charges that include conspiracy, securities, fraud and money laundering charges.
Poulsen, 64, is set for trial in August, five months after he is scheduled to be tried on allegations he and an associate attempted to bribe a government witness.
If found guilty, the defendants face 30 years to life in prison.
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