Medical Fraud

Published on: June 14, 2010

Southern California Medical Insurance Fraud Experts Closely Watching Desai Case in Nevada

On Friday June 4th, a grand jury indicted Dr. Dipak Desai on 28 criminal counts – from racketeering to insurance fraud – prompting those who follow stories of Southern California medical insurance fraud to vigorous debate the potential fallout.

Dr. Desai – who was charged along with two of his former employees, Ronald Lakeman and Keith Mathahs – allegedly accidently infected over 100 patients with Hepatitis C at his Endoscopy Center of Southern Nevada from March 2004 through January 2008. Patients at his center allegedly got infected because nurses reused syringes. An astounding 50,000 patients in total might have been exposed to HIV and Hepatitis B in addition to Hepatitis C.

Felony counts against Desai include criminal neglect of patients, medical insurance fraud, obtaining money under false pretences, and racketeering. Desai is in the midst of a filing for Chapter 11 bankruptcy, and representatives for plaintiffs have whalloped the embattled physician (former physician actually, since his license was stripped earlier this year) with a slate of malpractice suits. Attorneys said that the insurance coverage “will be grossly and totally inadequate to satisfy the damage claims of plaintiffs.”

Published on: May 24, 2010

Businessman Ordered to Pay $1.3 Million in Southern California Insurance Fraud Case

by Michael Kraut

On May 7th, an L.A. Superior Court Judge ordered local businessman Joseph Baiden to pay over $1.3 million in restitution for committing Southern California insurance fraud. According to a KPCC news story, Baiden had illegally underreported his workers comp pay roll in conjunction with a company called Nurse Connection Inc. He also failed to pay insurance premiums for workers comp. Initially, Baiden had been ordered to spend five years in prison, but Judge Horowitz agreed to allow the 57-year-old Diamond Bar resident to have five years supervised probation, including 90-days of electronic monitoring. In addition, Baiden will have to pay over $100,000 in investigative fees to the California Department of Insurance.

Moving forward, as a result of pleading guilty to Southern California workers comp fraud, Baiden must submit his tax returns to both the DA’s office and the Department of Insurance and offer clear proof both that he has workers comp insurance and that he is in complete compliance with his payment obligations. Baiden will return to court on November 8th to submit a progress report.

Los Angeles insurance fraud charges can be complicated to understand and difficult to fight. Different laws cover different kinds of Southern California insurance fraud. For instance, Penal Code Section S550(a)(5) defines medical insurance fraud; whereas California Insurance code Section 1872.8 spells out the definition of Auto Insurance fraud.

If you or a loved one is being investigated for any kind of Southern California fraud – from life insurance to medical insurance to auto fraud – odds are that you need a reliable, trustworthy, and trial-proven attorney to see you through the difficult legal proceedings ahead.

Published on: May 17, 2010

Southern California Healthcare Fraud Experts Scratch Heads over Double-Edged Decision in Pennsylvania Case

by Michael Kraut

Last Wednesday, a Federal Judge gave a Pennsylvania doctor, John Kristofic, a year and a day in prison pursuant to a healthcare scam that lasted from 2003 to 2008. Southern California healthcare fraud experts have been poring over Judge Ambrose’s decision to determine whether and how the decision might be impact local cases. dr-John%20Kristofic.jpg

The perplexing saga of Dr. Kristofic
The 62-year-old Dr. Kristofic (of Shadyside, PA) has a long and tumultuous history with the law. Back in the 1980s, he was brought up on charges under the Racketeer Influence and Corrupt Organizations Act of stealing more than a $1 million by billing for non-medically necessary tests. He allegedly invested the proceeds of this scam into private commercial real estate. The doctor settled that case for $0.75 million. He was later arrested and convicted of driving under the influence, AND he got probation for lying about his asset portfolio in 1991.

His latest arrest pertains to similar charges. From 2003 to 2008, Dr. Kristofic allegedly unfairly billed Medicare and other private insurers for services he never provided to his patients. Many Southern California healthcare fraud experts — at this point reading about Dr. Kristofic’s bio –would feel pretty confident that his repeated chronic violations of the law should merit a harsh sentence.

But… the story thickens.

It turns out that Dr. Kristofic has another side — an altruistic and giving one. Among other things, he provided free medical care for organizations like Operations Safety Net, Alcoholics Anonymous, and Catholic Charities. In a 2006 trip to Haiti, he gave out free care to the sick, an act which a local Reverend said “exuded a sense of compassion… it was extraordinary.” And Judge Ambrose received 60+ letters from various people and organizations commending Dr. Kristofic for his charity and extraordinary givingness.

As you can see, cases of Southern California insurance fraud can be a lot more complicated than they first appear in the headlines.

If you or a family member has been charged with healthcare fraud or any other white collar crime in Southern California, consider protecting yourself by retaining high quality legal counsel.

Published on: November 12, 2009

20 Suspects Arrested for Los Angeles Health Care Fraud: Allegedly Bilked Medicare of $26 million

by Michael Kraut

According to the AP, Los Angeles authorities have arrested and indicted 20 people for Los Angeles health care fraud over the past two weeks. The suspects allegedly scammed the Medicare program out of $26 million. The strike force that conducted the operation has been working since 2007 to combat criminal organizations that steal literally billions of dollars every year from the coffers of Medicare and Medicaid. All told, 331 people have been indicted in a series of 4 separate sweeps since 2007.

A Los Angeles white collar crime attorney will likely be assigned to help the defendants develop a strategy. A Justice Department official said the accused may have been active members in a criminal gang. One defendant, 30-year-old Michael Martinez, allegedly recruited friends and relatives to help with the scheme, which involved purchasing wheelchairs for people who didn’t exist or who had already died. They also billed for hospital beds that no one needed or used.

If you’re convicted of health care fraud or white collar crime in Los Angeles, penalties can be swift and can include a jail sentence, forced restitution to victims, and other fines. Many suspects make ill-advised statements to authorities that can compromise or even cripple their chances at an adequate defense. To develop a solid strategy often requires combing through reams of paperwork and potentially challenging the government investigation on technical points. In cases of Medicaid fraud in Southern California, defendants may not have much margin for error. Presidential Obama’s Justice Department and Attorney General Holder have both publicly committed to reining in Medicare and Medicaid fraud and making examples out of those arrested to deter gang members and other organized criminal elements from further defrauding government entitlement programs.

Published on: July 22, 2009

Michael Jackson’s Doctor Has Office Raided After LAPD Asks For Los Angeles Search Warrant

by Michael Kraut

The Los Angeles Police Department is spearheading the investigation into the pop star’s death. Recent leaks in the investigation have pointed into the direction of repeated overdosing of Michael Jackson by his many close physicians. However, the focus of the investigation seems to be pointing to Jackson’s personal physician, Dr. Conrad Murry.

On Wednesday, July 21, 2009, The Drug Enforcement Administration raided Dr. Murry’s Houston office. Armed with a search warrant, they entered the office and took numerous items. Accompanying the DEA were Los Angeles Police Department detectives assigned to the Jackson Investigation. Murry was with the singer at the time of his death.

Because of the scope and extensiveness of the Los Angeles investigation, it would be wise for Dr. Murry, or any other medical professional to immediately contact a Los Angeles Pre-filing criminal Defense Attorney. The skills of a former Los Angeles criminal prosecutor can be very helpful to anyone under investigation. Los Angeles criminal defense attorneys who are former prosecutors often have conducted similar investigations and know how best to protect the suspect from further harm.

Published on: July 5, 2009

Medical Fraud Investigation in Los Angeles Continuing in Michael Jackson Case

by Michael Kraut

The Federal authorities and Los Angeles law enforcement are combing through vast amounts of evidence to ascertain whether there was Los Angeles Medical Fraud and Holmby Hills white-collar fraud in the death of singer Michael Jackson. Investigators have been looking at a total of five doctors who were writing prescriptions for the famous singer, some under fake names. Los Angeles pre-filing defense attorneys are making great headway in protecting their physician clients from potentially devastating results. It is very important if a professional is under investigation to immediately hire a top notch Los Angeles investigation defense attorney to manage the investigation in a parallel manner to law enforcement. Thereby, providing key evidence and witnesses who can either clear the professional from further harm to their reputation, or worse, a criminal filing and lose of license.

Dozens of prescription bottles have been found in the Los Angeles home rented for the singer since his death last week. The investigators have let slip that many of the bottles have no labels, other have names other then the singers true names. It has been reported that Jackson had been suffering from an addition to prescription pain pills for many years. In fact, the singers family has publicly come forward and blamed his many doctors for enabling the singer with these powerful drugs. One of the drugs of most concern to law enforcement is the drug Diprivan. The drug is one of the most power sedatives on the market. Usually only used in operating rooms by anesthesiologists in surgery. Some of the bottles in Jackson’s home were full of the drug, while others were completely empty.