Articles Posted in Medical Fraud

Brace yourself for a slew of high profile Southern California medicare fraud arrests.

According to a July 10 article in Los Angeles Times, “Medicare Anti-fraud Detection System Launched,” federal officials have set up a powerful new predictive modeling system to identify Medicare fraud and punish syndicates and individuals who bill for false claims and engage in other types of fraud.

The LAT describes the computer predictive modeling system – which was honed in South Florida over a few years – as working “much like credit card systems that raise alerts about suspicious purchases – such as 20 pairs of shoes or unusually large sales – to help block criminals from using stolen cards or IDs.”

A quiet but disturbing Los Angeles Medicare fraud case resolved last Monday, when 45-year-old Petros Odachyan was sentenced to 51 months in prison in a Los Angeles Federal Court pursuant to charges that his company, RL Medical Supply, defrauded Medicare out of $600,000 (after billing the program for more than $1 million).

Prosecutors charged Odachyan with forging prescriptions for items like medical equipment, electric wheelchairs, and hospital bills – most of which RL Medical Supply never gave to patients. Odachyan pled guilty last June to committing healthcare fraud; he now will apparently face more than four years behind bars, unless he appeals the decision and manages to get some reprieve.

Odachyan’s sad saga is unfortunately all too common these days. And anyone who has been recently accused of Southern California medical fraud, Los Angeles insurance fraud, or any other Southern California white collar crime could potentially face similarly serious sentences – many years behind bars, possibly, and a total devastation of your business reputation.

Last week, while most of the blogosphere zeroed in on the salacious accusations against International Monetary Fund’s chief, the news on the Southern California Medicare fraud front was not exactly silent.

Indeed, a May 14th article in the Wall Street Journal (“Medicare Fraud Nets Guilty Plea”) has had a lot of pundits and analysts debating the implications. A Brooklyn physical therapist, Alexander Kharkover, plead guilty the Friday before last in Federal Court to five counts of submitting false/fraudulent claims to Medicare. For a five-year period (from January 2005 to July 2010), Kharkover allegedly overbilled Medicare to the tune of nearly $12 million, and Medicare paid $7.3 million worth of those claims.

Mr. Kharkover pled guilty without trying to arrange a plea deal. He has yet to be sentenced. Here is an interesting quote from the WSJ about the matter: “According to a person familiar with the case, in one instance, Mr. Kharkover allegedly submitted a bill for a service he performed personally, but on a date when he was on vacation cruise.”

As this blog has been reporting for months now, federal investigators have been really cracking down on crimes like Southern California Medicare and Medical fraud. A breaking story out of Miami highlights how much the government means “business.”

According to an April 14th story in the Miami Herald, Lawrence Duran and his wife, Marianella Valera, pled guilty to stealing $200 million from Medicare as part of a massive conspiracy. The couple could face 20 years in prison – for running what the Herald describes as “The nation’s largest mental health racket.”

The couple, who owned seven different mental health clinics, got indicted last October on charges of defrauding 22 defendants, including psychiatrists, recruiters, and even senior employers in their companies. The Assistant Attorney General of the Justice Department’s Criminal Division, Lanny Breuer, did not mince words: “they reaped millions in illegal profits by operating a sham mental healthcare company that provided unnecessary and illegitimate treatments to patients, many of whom were recruited through bribes and kickbacks, and then they laundered the proceeds.”