Los Angeles Criminal Defense Attorney Blog

A 70-year old cardiologist, Dr. Walter Janke, and his wife, Lalita Janke, have agreed to pay $22.6 million to resolve Medicare fraud allegations – a stunning move that has analysts who follow events in the world of Los Angeles Medicare fraud talking.

The Jankes had owned two large organizations – Medicare Advantage and America’s Health Choice Medical Plans – and allegedly overstated patient diagnoses to garner extra money from the federal government. Lawyers for the U.S. in District Court argued that Jankes’ acts violated the False Claims Act. The U.S. has frozen $20 million of the Jankes’ assets. The settlement will be paid out of those assets as well as out of their personal funds.

The Centers for Medicaid and Medicare Services (CMS) has been engaged in a long and heated battle with the Jankes, according to an article in South Florida Business Journal. The cardiologist’s attorney lamented the situation: ”there has been a long history of clear animosity directed at the Janke’s from CMS.” The attorney argued that the Medicare audit done to determine the settlement amount was unfair – essentially, by extrapolating based on a fraction of a percentage of patient cases, CMS might have erred by as much as 30%.

But without wading too deep into the technicalities of the case, let’s bring it back and speak more generally about Southern California insurance fraud, white color crimes, and Medicare fraud. If you do as the Jankes allegedly did -- bill for chiropractic, dental, or medical care that you didn’t provide -- you can be charged with a crime. Other types of healthcare fraud include:

• Making up false medical records
• Billing twice for work
• Prescribing medications or therapies that are clinically unnecessary
• Billing non-emergency services at an emergency rate
• Requesting meaningless or unnecessary tests
• Otherwise violating laws, such as Insurance Code Section 1871.4, Penal Code Section 118, or Penal Code Section 550

If you are convicted of defrauding Medicare or an insurance company or Medi-Cal, you can face jail time, serious court costs and fines, loss of your medical license, and forced restitution to victims, including insurance carriers and the state.

If you or a loved has been hit with a charge of Southern California white collar crime, look to Los Angeles criminal defense attorney Michael Kraut for solid, reliable advice. Attorney Kraut was a prosecutor for many years – and he also has a Harvard Law School education. He can discuss your matter in confidence today and provide high caliber strategic advice about how to protect your reputation, assets, and license to practice.

Last week, Southern California DUI bloggers took a look at two breaking minor celebrity arrests out of Florida. Although a vast majority of DUI in Pasadena, DUI in Burbank, DUI in Glendale, and DUI in Los Angeles cases involve “non-celebrities,” DUI bloggers nonetheless spend the lion’s share of their attention on the plights of the popular. Last week, that meant probing the arrests of a professional wrestler’s sidekick and a failed mayoral candidate.

The website TMZ.com reported on Thursday that Kevin Kiley -- a.k.a “Alex Riley” -- had been arrested in Tampa after driving under the influence. Riley is a star of the World Wrestling Circuit – he serves as a sidekick to another wrestler named The Miz. The 29-year old Riley was released after posting a $500 bond.

Meanwhile, in Fort Myers, Florida, a former mayoral candidate, the 27-year old Gena Persons, flipped her car over a parking barrier near the intersection of Shoemaker and Palm Beach, while driving nearly 65 miles per hour. Officers who responded to the rollover tested Persons for DUI and gave her a breathalyzer test. She blew a 0.191% and 0.187% – both significantly over both Florida and California’s legal limit of 0.08%.

Now, when most people read stories of celebrities (or non-celebrities) like Persons blowing breathalyzer results of 0.191% or so, they quickly “convict in their minds.” But this rush to judgment is often unfounded. Indeed, breathalyzer results are far less accurate than popular culture makes them to be. Many factors can throw off breathalyzer test results – way off. These include but are not limited to:

• Whether you are a diabetic (diabetics produce chemicals on their breath that can skew breathalyzer tests towards “false positives”)
• Whether you are a man or a woman – men and women process alcohol at very different rates
• How deeply you blow into the machine – the deeper you blow, the higher your BAC level will read
• Issues with the test itself – poor calibration, administration, and record keeping on the part of police can lead people to get arrested/convicted for DUI unfairly

So what should you do if you or someone close to you has been recently arrested for driving under the influence in Southern California? Can you fight the breathalyzer test results? Should you? What if the blood tests show that you were DUI?

To get these and other crucial questions answered, you should almost certainly retain an experienced Los Angeles DUI attorney, like Los Angeles Criminal Defense Attorney Michael Kraut.

Continue reading " Los Angeles DUI Bloggers Intrigued by Two Minor Celebrity Arrests " »

Southern California medical care fraud analysts have been wrapped up debating the massive October bust of a Medicare fraud ring allegedly tied to the Armenian mafia. But a breaking story out of Kansas has siphoned off a lot of media attention.

Wayne W. Williamson, 67, an Olathe Kansas ex-physician, was sentenced last Monday to a three year federal jail sentence for distributing prescription drugs illegally and committing healthcare fraud. Williamson pled guilty in July to medical fraud and to harassing a Kansas medical investigator. White collar crime prosecutors said that Williamson used to go into apartment complex parking lots and sell drugs out of his car – drugs like Percocet, Xanax, and OxyContin. One “client” allegedly paid the doctor for $150 for prescriptions of Oxycodone. The client then resold those pills on the black market for $30 each to make a profit. The man testified to making several transactions with the former doctor over two years. Williamson also billed Medicare and Medicaid for non-existing services. The court ordered him to pay restitution of nearly $3,000. Williamson also surrendered his medical license and agreed to never practice medicine in the U.S. again.

Southern California healthcare fraud is an immensely complicated crime. Depending on what you allegedly did, how you did it, and various other factors, you can face charges pursuant to many different laws. For instance, Labor Code Section 3700, Penal Code Section 118, Penal Code Section 550, and Insurance Code Section 1871.4 could be applicable. If convicted, you can face jail time, loss of your license, strict probation terms, major court costs and fines, and mandatory restitution to providers like Medi-Cal, Medicare, or insurance companies.

Law enforcement agents are familiar with myriad “varieties” of Southern California insurance fraud, white collar crime, and healthcare fraud. For instance, if you made up medical records, billed providers like Medi-Cal or Medicare for services that you never rendered, prescribed medicines that were not necessary, or “double billed” or offered excessive and unnecessary procedures, prosecutors can go after you.

Given how complicated these charges can be, it’s important to have a savvy and experienced Southern California medical care fraud attorney on your side, like Los Angeles Criminal Defense Attorney Michael Kraut.

Continue reading " Kansas Doctor Sentenced to Three Years in Federal Prison for Fraud; Los Angeles Medical Fraud Analysts Examine Case " »

A tragic Southern California DUI crash in Santa Barbara has resulted in the death of 73-year old Liesel Ryden as well as injuries to several other people. Local prosecutors are accusing a 54-year old local businesswoman, Priscilla Susman, of causing the complicated, multi-car accident on Highway 154 near Cold Spring Bridge.

If you’ve been recently arrested for DUI in Burbank, DUI in Pasadena, Los Angeles DUI, or Glendale DUI – whether you got involved in a big multi-car pileup or simply blew 0.08% or above on a breathalyzer test at a checkpoint – the story of the allegations against Susman may be quite instructive.

According to news reports, the restaurateur, who owns and runs the Paradise Store and Grill, lost control of her sport utility vehicle on September 15th at around 8:20 in the evening. She swung into oncoming traffic, precipitating a series of accidents involving vehicles travelling westbound. All told, four different vehicles got entangled. One woman (the aforementioned 73-year old Liesel Ryden) died. Three people, including Susman, suffered serious injuries. Prosecutors plan to arraign Susman on November 29th on an array of charges, including vehicular manslaughter while under the influence of alcohol, two DUI counts, and a special allegation of causing serious bodily injury to multiple people.

Let’s take a break here and review California’s vehicular manslaughter law -- a law that both Susman’s prosecutors and her defense attorneys will likely be scrutinizing in the upcoming weeks and months. California law makes numerous subtle distinctions in vehicular death cases that could have profound implications for any sentencing. For instance, if you caused someone’s death while driving with “gross negligence” while DUI, your penalties could be substantially elevated over what they would be for a standard vehicular manslaughter.

If you have been arrested and convicted of Los Angeles DUI in the past, prosecutors may even try to hit you with a charge of DUI murder – which is even more serious and could result in 15 years to life in jail.

To craft an effective defense against charges, you likely need a Southern California DUI attorney to review toxicology reports, police work, and other evidence from the scene of the accident and/or arrest. Without an aggressive counter response to prosecutorial charges, you could face major repercussions – such as longer than necessary jail sentences, high fines and court costs, and a variety of inconveniences, such as long-term loss of your driver’s license and mandatory installation of an interlock ignition device.

Continue reading " Southern California DUI Pileup Leads to One Death and Multiple Injuries " »

Analysts who study health, chiropractic, and dental fraud in Los Angeles have been heatedly discussing a case out of Kansas. A former doctor, John R. Toth, pled guilty last week to a variety of federal counts, including a count of reckless and voluntary manslaughter, stemming from a bizarre scheme to treat patients for a non-existent epidemic of Lyme disease.

The Weird Back Story

In 2001, the then Dr. Toth collaborated with a variety of businesspeople associated with the firm American Biologics to market drugs and a special microscope by ginning up fears of a Lyme disease epidemic. Apparently, Toth and his associates believed that Lyme disease was a primary cause of many illnesses. In any event, Toth prescribed various medications that the Food and Drug Administration had neither reviewed nor approved. One of those patients, Beverly Wunder, suffered serious renal failure as a result of the intravenous injection of a medication, and she fell into a coma and died. Toth was arrested and charged with a variety of crimes, including misbranding drugs for interstate commerce, using adulterated medical devices, committing mail fraud, and committing reckless and voluntary manslaughter.

If convicted of all recent counts, the 61 year-old could face 5 years in federal prison and a fine of $250,000. He already served 32 months in a state jail, after he pled no contest to the reckless and voluntary manslaughter charge back in November 2007.

If you or someone you care about has been arrested for Southern California healthcare fraud, Los Angeles insurance fraud, or white collar crimes in Southern California, you could face serious penalties. Prosecutors could charge you pursuant to Insurance Penal Code Section 550, Insurance Code Section 1871.4, Penal Code Section 118, or Labor Code Section 3700. Your charges and potential penalties obviously will depend on what you did and how prosecutors want to handle your case.

So how should you respond most effectively? A connected and experienced Southern California medical fraud attorney can help you piece together a smart, proactive defense.

Continue reading " Southern California Medical Fraud Experts Examine Kansas Doctor’s Sentence " »