Can’t You Hear the Whistle Blow

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Organon to Pay $31 Million Over FCA Medicaid Allegations,” written by Erica Teichert and posted on Law360.com on October 15, 2014.

Drug manufacturer Organon USA Inc. has agreed to pay $31 million to settle allegations from the federal government and several states, including New York and Kentucky, that it underpaid rebates to state Medicaid programs, several state attorneys general said Wednesday.

Organon faced two separate lawsuits in Texas and Massachusetts federal court, claiming the company underpaid Medicaid rebates, offered improper financial incentives to nursing home pharmacy companies, misrepresented drug prices and promoted drugs for off-label uses, according to the state attorneys general.

Money Talks

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Ex-mental Health Official Sentenced to Prison for Fraud,” written by Tony Leys and published by The Des Moines Register on September 19, 2014.

The former leader of a Centerville counseling center has been sentenced to a year and a day in prison for defrauding public and private insurers out of more than $1 million.

Angela Shae Ellison admitted that she billed Medicaid and private insurers for visits with physicians even though they never treated her clients. She admitted that one of the physicians lived in Pakistan, state records have shown.

Fraudulent Friends

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Two Guilty of Health Care Fraud,” published by the Suffolk News-Herald on September 17, 2014.

A Medicaid provider and his wife, formerly of Suffolk, have been found guilty of health care fraud — to the tune of $1.3 million — and other charges after a three-week trial.

W. Wayne Perry Jr., 55, and Angela Perry, 52, were convicted Tuesday afternoon by a federal jury of one count of conspiracy to commit health care fraud, four counts of health care fraud, eight counts of false statements relating to health care matters, one count of alteration of records and four counts of aggravated identity theft.

Head Check

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Counseling Service Owner Pleads Guilty to Medicaid Fraud,” published by the News & Observer on September 3, 2014.

GREENSBORO — A Person County resident who operated a counseling service with offices in Durham and Fayetteville has been convicted in federal district court of a scam that cost the Medicaid system about $1 million, officials said.

Tracie Yvette Clay, 46, who lives in Timberlake, pleaded guilty to health-care fraud and money laundering, U.S. Attorney Ripley Rand said in a statement Tuesday.

No Contest

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Retired Doctor Pleads No Contest in Medicaid Fraud Case,” published by the Leavenworth Times on September 3, 2014.

A retired Leavenworth physician has pleaded no contest to six felony charges in a Medicaid fraud case.

Dr. Adnan A. Ashkar, 71, entered his plea Wednesday in Leavenworth County District Court.

Hungry for Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Federal Trial Set in Frozen Meals Medicaid Fraud Case,” written by Alison Gene Smith and published by MagicValley.com on July 17, 2014.

KIMBERLY – A Kimberly frozen-meal delivery company accused of bilking Medicaid out of nearly $900,000 has a federal trial set for 2015.

Prosecutors say Homestyle Direct illegally billed Medicaid $888,152, delivered meals to deceased clients, lied to clients about Medicaid requirements and continued to deliver meals to Medicaid clients’ homes even when they were hospitalized.

Image is Everything

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled “Michael Mendoza Guilty in $205 million Medicare fraud scheme by recruiting patients for kickbacks” published on WPTV.com on June 20, 2014.

MIAMI – A South Florida man has pleaded guilty to recruiting patients in exchange for illegal kickbacks as part a $205 million Medicare fraud scheme.

Former Network Resource Consultant Inc. chief Michael Mendoza pleaded guilty to health fraud conspiracy Thursday in Miami federal court.

The Fraudster Next Door

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Judge Orders Probation in Medicaid Fraud Case; Other Issues Pending,” written by Michelle Friedrich and published by the Southeaster Missourian on June 12, 2014.

A federal judge has placed a former Ellsinore, Missouri, man on probation for his role in a Medicaid scheme.

Gary Wayne Bender, aka “Goober,” who pleaded guilty in March to one felony count of health-care fraud, was sentenced Monday to time served by U.S. District Judge Stephen Limbaugh Jr.

Lagging Behind

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Georgia Woman Convicted of Medicaid Fraud Sentenced,” written by Francine Frazier and published by News4Jax.com on June 9, 2014.

BRUNSWICK – A Brunswick, Georgia, woman who was convicted by a federal jury on 58 counts of conspiracy, health care fraud, aggravated identity theft and money laundering, was sentenced last month to 16 years in prison.

Schella Logan Hope, 47, was convicted in November 2013 for her role in a multi-million dollar Medicaid fraud conspiracy.

Double Billing

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on a press release titled, “Owner of Baton Rouge Pharmacy Pleads Guilty for Directing $2.2 Million Health Care Fraud Scheme,” released by the Department of Justice on April 24, 2014.

The owner of a Louisiana pharmacy pleaded guilty today for directing a $2.2 million Medicare fraud scheme to repackage and redistribute prescription medications.

Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, Interim U.S. Attorney J. Walter Green of the Middle District of Louisiana, Special Agent in Charge Mike Fields of the Dallas Region of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), Special Agent in Charge Michael Anderson of the FBI’s New Orleans Division and Louisiana State Attorney General James Buddy Caldwell made the announcement.

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