Medical Fraud

Published on: April 10, 2013

After Your Los Angeles Medicare Fraud Arrest: Are You on the Flywheel or the “Doom Loop”?

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.

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.

Published on: March 29, 2013

Very Weird Case Out of New York — Will Your Los Angeles Medicare Fraud Case Be As Bizarre?

by Michael Kraut

Even “straightforward” Los Angeles Medicare fraud schemes often become surprisingly dynamic.

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.

Published on: March 6, 2013

Fighting Medicare Fraud in Los Angeles Pays Off, Big Time, for Federal Government

by Michael Kraut

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

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.

Published on: March 4, 2013

Physician Collects $4 Million for Whistleblowing Medicare Fraud. Los Angeles Defendants, Take Note!

by Michael Kraut

As a defendant (or soon-to-be defendant) in a Los Angeles Medicare fraud case, you’re deeply confused and concerned about how your situation will play out.

Maybe the government will overwhelm you with powerful evidence and testimonies. Or maybe surprising witnesses will come forward to “blow the whistle” on your activities.

Sometimes, blowing the whistle can pay off significantly. Consider a case out of Tampa, Florida, where a local physician, Dr. Alan Freedman, just collected $4 million for his part in blowing the whistle on an illicit kickback arrangement between Florida Pathology Laboratory and a dermatologist. The scheme apparently ran for over 15 years. Dr. Steven Wasserman, the dermatologist implicated, settled his case by paying over $26 million.

Published on: February 20, 2013

What You Must Do Before You Build a Defense to Los Angeles Medicare Fraud Charges

by Michael Kraut

Whether you’ve been charged with Medicare or Medi-Cal fraud in Los Angeles — or any other fraud or white collar crime in Southern California — you’re at high risk of making a vital mistake that could complicate your case before you begin.

That mistake is this: You might fail to identify, with crystalline clarity, exactly what you and your associates did before, during and after the federal or state investigation.

That sounds like a bit strange.

Published on: January 28, 2013

Disgusting Los Angeles Medicare Fraud News — in More Ways than One!

by Michael Kraut

As a doctor, chiropractor, dentist, or other health provider who has come under investigation for Los Angeles Medicare Fraud, you may be embarrassed by what you did… or by what authorities allege that you did.

But you also likely resent being classified as a criminal. For instance, you probably don’t want to be thought of in the same company as 55-year-old Richard Alan Behnan, a Michigan area podiatrist recently sentenced to 55 months behind bars.

Behnan recently pled guilty in U.S. District Court to masterminding and executing a $1.6 million scam to fraudulently bill Blue Cross Blue Shield and Medicare.

Published on: January 8, 2013

After You’ve Been Arrested/Investigated for Medicare Fraud in Los Angeles: Like Waking from a Dream

by Michael Kraut

Getting charged with Los Angeles Medicare fraud can change your life — and not in a good way (but not necessarily in a totally bad way, either!)

Defendants often go through a period of epiphany or powerful reflection after being accused. This can be disconcerting. If you’ve recently been arrested — or if you know or care about someone who has been charged — you probably recognize symptoms, such as:

• Sudden dismay and regret regarding years of actions;

Published on: January 1, 2013

$11 Million Guilty Verdict in Major Los Angeles Medicare Fraud Case

by Michael Kraut

Last Monday, Charles Agbu, a 58-year pastor based in Carson, pled guilty to an $11 million Los Angeles Medicare fraud scam.

The Department of Justice accused Agbu of masterminding the reimbursement fraud. Agbu faces the specter of a 20-year prison sentence on top of a fine of $500,000. He will be sentenced in May.

Agbu’s company, Bonfee Inc., marketed itself as a medical equipment supply business. In reality, Bonfee paid people to offer beneficiaries power wheelchairs in exchange for their Medicare information. Once Agbu and his crew had this info, they billed Medicare for the wheelchairs but never delivered them to clients. Bonfee and Agbu also falsified prescriptions and other documents to bill Medicare illegally. Agbu paid his co-conspirators, including Dr. Juan Tomas Van Putten, hundreds of dollars for batch orders of these fake prescriptions.

Published on: December 24, 2012

Can New Antifraud Computer System Stop Medicare Fraud in Los Angeles and Beyond?

by Michael Kraut

The Federal Government, under the Obama administration, has made a huge push to crack down on Medicare fraud in Los Angeles and beyond.

We’ve covered many relevant stories over the past few years, citing probably dozens of examples of big time busts. We’ve also discussed some of the scary consequences for the perpetrators of these alleged offenses. The typical way the government goes after fraud is known as “pay and chase.” Investigators try to identify fraudulent payments from the system, track down the pilfered money, and then punish perpetrators and force restitution, if possible.

This way of preventing fraud is somewhat wasteful, and it is certainly very punitive.

Published on: December 17, 2012

Biggest Case of Medicare Fraud in the History of the World?

by Michael Kraut

Blockbuster charges face DaVita Inc., one of the largest dialysis companies in United States, including charges of Medicare fraud in Los Angeles and beyond.

DaVita is a $7 billion company that operates 2,000 dialysis clinics in the United States. The CEO alone receives $15 million annually, much of that paid for ultimately by taxpayers. The Denver-based company may have engaged in a massively complex, hugely scaled scam to steal money from Medicare and Medicaid. One of the whistleblowers, Dr. Alon Vainer of Georgia, said “We are talking in the hundreds of millions, easily …the profit this company made from those two [Medicare and Medicaid] schemes… was hundreds of millions of dollars.”

Dr. Vainer and a nurse, Daniel Barbir, allege that DaVita engaged in a massive fraud scheme from 2003 through 2010, leveraging tens of thousands of patients to fraudulently boost their revenue from the Federal Government’s programs.