Articles Posted in Medical Fraud

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The Los Angeles Weekly recently ran a fantastic, compelling, and extremely disturbing story on Medicare fraud in Los Angeles and beyond. Entitled: “How Medicare fraud became the nation’s most lucrative crime,” the story blisteringly attacks a system of corruption that’s so deep and so diverse, it’s almost unbelievable. LA-weekly-health-care-fraud.jpg

It’s no secret that healthcare fraud in Southern California and beyond costs taxpayers $100 billion a year (some say that figure is as high as $300 billion). The Obama administration has clearly made it a priority to crack down on fraud, and the new awareness of the problem has undoubtedly led to improved policing.


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Your Los Angeles healthcare fraud charges are pretty severe. You could wind up paying massive fines and restitution as well as serving a big stint behind

But how does your case stack up against this one?

48-year-old Sandra Little (of Reno) and 65-year-old Susan Hill (of Las Vegas) recently pled guilty to defrauding Nevada’s Medicaid program out of about $1 million. Hill pled guilty to one count of money laundering and one count of healthcare fraud. Little pled guilty to 10 money laundering counts and 28 healthcare fraud counts. The U.S. Attorney for Nevada, Daniel Bogden, emphasized that the federal government “will vigorously prosecute persons who cheat and steal from federally funded programs … everyone suffers when programs designed to help persons in need are defrauded.”

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On April 24, 2013, the Obama Administration announced a spectacular new “Senior Reward” program, which could spur many new additional Southern California Medicare fraud cases. senior-los-angeles-medicare-fraud.jpg

The so-called Senior Medicare Patrol would offer whistleblowers up to $10 million for exposing fraud. The whistleblower would get 15% of the recovered funds. This is a huge change to the current HHS model, which offers a 10% reward of up to $1,000. The revised program is modeled after an IRS program, which has helped that agency collect nearly $2 billion in fraud over the past 10 years.

Since 1997, the Senior Medicare Patrol has generated 7,000 plus referrals to the Office of the Inspector General and the CMS. In just the last three years alone, the Obama Administration has cracked down hard and managed to re-collect nearly $15 billion stolen from Medicare’s coffers. Kathleen Sebelius, the Secretary of Health and Human Services, stated the President’s intentions in clear language: “President Obama has made the elimination of fraud, waste and abuse, particularly in healthcare, a top priority for the administration.”

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Maybe you concocted a sophisticated Los Angeles Medicare fraud scheme that raided the Federal Government’s coffers to the tune of several hundred thousand dollars. Or maybe you’re being investigated for failing to meet a Byzantine health care requirement. do-dont-los-angeles-medicare-fraud.jpg

Before taking action, read this list of five “don’ts,” so you can avoid making further mistakes that could imperil your case and lead to unnecessarily long jail sentences, the stripping of your professional license, humiliation, massive fines, and worse.

5 “Don’ts”

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Many Los Angeles Medicare and Medicaid fraud cases end in disaster for all stakeholders. For a tragic “rags to riches to rags” story, take a look at the disaster that befell the Scooter Store. scooter-store-los-angeles-medicare-fraud.jpg

If you’ve ever watched daytime TV, you’ve no doubt seen commercials for the Scooter Store. The vendor of power wheelchairs (based in New Braunfels, Texas) sold its products to consumers by pummeling the airwaves with advertisements. But a blockbuster CBS News investigative piece about the company led to a federal government investigation and ultimately an FBI raid. Doctors and salespeople alleged that the company followed a diabolical playbook. Salespeople would contact doctors’ offices and badger physicians to prescribe power wheelchairs and scooters to patients, even if patients did not need the products. They then relied on Medicare and Medicaid errors and bureaucratic snafus to approve the bad claims.

After the FBI raid, the company furloughed every employee and then laid off 1,000 workers.

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A 50-year-old Calabasas man, Dr. Pezhman Ebrahimzadeh, was sentenced to three and a half years behind bars for falsely billing Medicare for over $3 million. health-care-fraud-los-angeles.jpg

As penance for perpetrating healthcare fraud in Los Angeles, Dr. Ebrahimzadeh has been ordered to pay over $3 million in restitution, for his part in billing Medicare for medical services that he never performed. In many cases, these services involved patients who were no longer alive. Ebrahimzadeh – also known as Pez Abrahams – owns a cosmetic clinic called the Winnetka Medical Group, which provides liposuction and radiofrequency laser treatments.

Federal prosecutors say he collected information from beneficiaries to bill Medicare for never-performed procedures. He also collected information from 25 Medicare patients who were dead when they supposedly “got treated,” and then he changed medical records to conceal the Los Angeles Medicare fraud. He claimed he performed a bunch of pricey procedures, including radiotherapy catheter placement, bone tumor ablation, and revascularization, even though he lacked the equipment to do these procedures.

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Thirty-seven-year-old Tigran Aklyan recently pled guilty to Los Angeles Medicare fraud charges, say officials.power-wheelchair-los-angeles-medicare-fraud.jpg

Aklyan, the ex-owner of a San Gabriel medical equipment company, admitted that he conspired to defraud Medicare. He faces a maximum fine of $250,000 on top of a decade behind bars.

Aklyan owned Las Tunas Medical Equipment Inc., a company that sold medical equipment and power wheelchairs. From fall 2007 through spring 2009, Aklyan submitted false claims to Medicare for equipment and unneeded wheelchairs. He submitted over $910,000 in false claims and recouped over $650,000 from Medicare.

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Ever since authorities began investigating you for Medicare fraud in Southern California, you’ve been overwhelmed, uncertain, and scared for your reputation and your family’s future. DoomLoop-medicare-fraud-southern-california.jpg

Life, it seems, has taken an unexpected and decidedly unwelcome turn.

Given your hectic state of affairs, you might be laboring under some false assumptions about the trajectory of your life and welfare. In other words, all the legal chaos may bias you into believing that things are “getting worse” or “will get worse” for you.

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Even “straightforward” Los Angeles Medicare fraud schemes often become surprisingly dynamic.staged-accident-los-angeles-insurance-fraud.jpg

Perhaps you and an associate billed the state or federal government for wheelchairs that you never delivered to patients. Or maybe you constructed a scheme to collect Social Security numbers and patient data and then use that information to purchase pharmaceuticals to sell to a third market supplier.

Even the most carefully wrought, well-protected plans have a funny way of coming undone and leading to surprises not only for investigators but also for defendants themselves.

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A new study shows that the federal government’s vigorous campaign against Medicare fraud in Los Angeles and beyond is paying off — big time. medicare-fraud-los-angeles-dermotologist.jpg

Over the last three years, the government has returned $7.90 for every $1 invested into the anti-fraud mission. This marks the highest ever return for the Health Care Fraud and Abuse Control Program, a nearly two decade old program, and federal officials are crowing about the numbers. Kathleen Sebelius, the secretary of Health & Human Services, said “our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off. We are gaining the upper hand in our fight against healthcare fraud.”

The antifraud initiative is a collaboration between the Department of Justice and HHS. The Obama administration has lent lots of help to soup up this program and deliver more results. Over the past four years, federal officials recovered nearly $15 billion from scam artists, executives, doctors, pharmaceutical companies, vendors, and others who masterminded or acted complicit with fraudulent schemes. That’s nearly double the amount recovered over the previous four-year period.

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