Articles Posted in Medical Fraud

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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.Healthcare_Fraud_los-angeles.jpg

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.

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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. clarity-in-los-angeles-medicare-fraud-case.jpg

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.

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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.los-angeles-california-medicare-fraud.jpg

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.

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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!) los-angeles-medicare-fraud-defense-overwhelmed.jpg

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;

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

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.

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

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.

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Blockbuster charges face DaVita Inc., one of the largest dialysis companies in United States, including charges of Medicare fraud in Los Angeles and beyond. los-angeles-medicare-fraud-davita-.jpg

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.

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Odds are that your Los Angeles Medicare fraud charges are slightly “less intense” than 50-year old Yuri Khandrius’ charges. The Brooklyn resident just pled guilty to a massive fraud scheme — a plan to pilfer over $71 million from Medicare’s coffers.

Last Monday, Khandrius pled guilty before U.S. District Judge Nina Gershon to a slate of charges, including conspiracy to pay kickbacks, healthcare fraud, and conspiracy to commit healthcare fraud. Khandrius and others billed the federal government’s Medicare program for an array of never-provided services, tests, therapies, and office visits. They paid co-conspirators in a place that was literally called the “Kickback Room” – offering up more than 1,000 kickbacks totaling over a half a million dollars, between April and June, 2010. When Khandrius gets sentenced on March 11th, he could face up to 25 years behind bars. If the 50-year old serves his full sentence, that means he would not be released again until the age of 75.

Khandrius did not operate this “Bay Medical” scheme himself. The 15 other defendants include five money launderers, two doctors, and nine employees/owners operators of clinics. Judge Gershon will try five more defendants in January.

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As someone who was recently charged with Southern California Medicare fraud, you feel alone and isolated. Odds are that you did not participate in a nine-figure con game — the kind of crime you read about in the Los Angeles Times and other big papers. two-women-punished-medicare-fraud.jpg

You might have been making a living (and then some) from what you were doing. But your dental, medical, or chiropractic fraud was relatively minor in the grand scheme of things.

Nevertheless, you may still face charges that could land you in jail for years or decades, destroy your reputation professionally and personally, and create all sorts of incidental, indirect havoc in your life.

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Many people believe that most Los Angeles Medicare and medical fraud defendants “knew what they were doing.”

In other words, when you crack open the Los Angeles Times and read about some executive or ambulance administrator who allegedly “bilked” the federal benefits program out of millions of dollars, you might assume that the suspect had organized an intricate operation – had behaved, in sense, like a criminal mastermind.

Indeed, there are individuals who fit this description, more or less. However, they are in the minority. In fact, a lot of Southern California white collar crime, insurance fraud and healthcare fraud cases are far more ambiguous. Indeed, perfectly innocent mistakes can get you into serious legal hot water.

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