Two Timing

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Waynesboro Woman Pleads Guilty to Medicaid Fraud,” written by Becky Metrick and published by PublicOpinionOnline.com on May 30, 2015.

CHAMBERSBURG – A Waynesboro woman pleaded guilty and was sentenced for felony Medicaid fraud during a hearing on Wednesday at Franklin County Courthouse.

Sandra D. Grisson, 49, was charged in early April by the Attorney General’s Office, for falsely recording hours that she spent as a caretaker for at least one person, including duplicate hours being reported to two companies.

High Priority

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Carson Woman Sentenced to Prison for $8.3 Medicare Fraud Scheme,” published by the Daily Breeze on May 11, 2015.

A registered nurse from Carson who owned a medical supply company was sentenced Wednesday to four years in federal prison for her role in an $8.3 million Medicare fraud scheme.

In addition to the prison term, U.S. District Judge Christina A. Snyder ordered Olufunke Fadojutimi to pay nearly $4.3 million in restitution, according to the U.S. Department of Justice.

Trail of Evidence

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “North Jersey Man’s Plea Deal in MRI Fraud has Incentive Clause,” written by Lindy Washburn and posted on NorthJersey.com on May 11, 2015.

The owner of a string of imaging centers that bribed doctors with cash and luxury goods for patient referrals agreed in court on Monday to help fraud prosecutors investigate others in the scheme — a deal that will reduce his prison time the more doctors he turns in.

Rehan “Ray” Zuberi described in state Superior Court in Morristown how he and others in his organization paid “anywhere from $50 to $150” per MRI or CT scan to physicians and chiropractors who referred their patients to his centers. Authorities said his organization paid several million dollars in kickbacks over six years.

Smoke Screen

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Counselor’s Medicaid Fraud Sentencing Cancelled,” published by The Argus Leader on April 29, 2015.

A man who’d once admitted to Medicaid fraud will take his case to trial after a judge rejected his plea agreement at sentencing.

Shawl Nills, 41, was set to be sentenced Wednesday in Madison for making false claims to Medicaid, but Judge Vince Foley decided not to proceed.

Losing Control

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled “Owner of N.J. Healthcare Agency Admits to $7 Million Fraud, Bribery, and Tax Evasion” posted on NJ.com on April 20, 2015.

NEWARK — The owner of a Linden home health care agency pleaded guilty to carrying out a multimillion dollar Medicaid fraud, bribery and other offenses that could lead to decades in prison, the office of U.S. Attorney for New Jersey Paul Fishman announced Monday.

Irina Krutoyarsky, 61, of Springfield, owner of HHCH Health Care, is scheduled to be sentenced in September after admitting she told the state’s Board of Nursing that the aides she employed had completed required training and testing when in reality she charged the aides hundreds each for obtaining fraudulent credentials.

The Sobering Effect of Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Brookline Doctor Sentenced to Jail, Fined for Medicaid Fraud,” written by Jack Newsham and published by The Boston Globe on April 7, 2015.

A Brookline doctor has been sentenced to 11 months in jail and ordered to pay $9.3 million for running a Medicaid fraud scheme.

Dr. Punyamurtula Kishore and his statewide chain, Preventive Medical Associates, Inc., were found guilty of fraudulently billing MassHealth for unnecessary drug tests. According to the state, Kishore collected urine samples from drug treatment centers across the state and billed the Medicaid provider for testing them, even though the people who provided the samples weren’t being treated by his clinics and the tests weren’t medically necessary.

What Goes On Behind Closed Doors

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Former NSU Vice Rector Sentenced for $1.4 Million Fraud,” written by Scott Daugherty and published by The Virginian-Pilot on January 9, 2015.

Prosecutors wanted W. Wayne Perry Jr. to serve more than 21 years in federal prison.

Last year a jury convicted the former owner of a Norfolk-based home health care company and his wife of perpetrating a $1.4 million Medicaid fraud. Federal guidelines recommended a lengthy sentence, and Assistant U.S. Attorney Melissa O’Boyle argued Perry deserved every day. She blasted the former vice rector of Norfolk State University for showing no remorse and blaming others for his wrongdoing.

Keeping Stories Straight

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled “Anchorage Physician Pleads Guilty to Medicaid Fraud,” written by Jerzy Shedlock and published by Alaska Dispatch News on December 1, 2014.

Dr. Shubhranjan Ghosh, an Anchorage physician charged with Medicaid fraud totaling more than $1 million, pleaded guilty Monday to two charges as part of a plea agreement.

Ghosh entered guilty pleas for single counts of medical assistance fraud and evidence tampering, both felonies, according to the state’s plea agreement.

Home Alone

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Man Commits Medicaid Fraud from Illinois Jail, Court Says,” written by Blythe Bernhard and published by the St. Louis Post-Dispatch on September 5, 2014.

A man submitted claims for working in an Illinois health care program while he was incarcerated in an Illinois jail, federal prosecutors announced today.

U.S. Attorney Stephen Wigginton of the Southern District of Illinois said Christopher Spivey, 30, pleaded guilty to submitting bills to the state Medicaid agency for caring for a patient in a program aimed at keeping people in their own homes instead of nursing facilities. Spivey was incarcerated at the Richland County Jail in Olney, Ill. at the time he claimed to be taking care of the patient. A sentencing date was not announced.

Crossing the Line

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “11 Charged in Medicare/Medicaid Fraud Scheme,” posted on NBCMiami.com on November 19, 2014.

Federal agents raided Florida Healthcare Plus in Coral Gables Wednesday for allegedly running a more than $25 million Medicare, Medicaid, and wire fraud scheme.

Authorities said eleven people were involved in the schemed to defraud the government. According to the federal indictment, Florida Healthcare Plus (FHCP) was authorized by Medicare and Medicaid to offer plans to the beneficiaries, which was then allegedly taken advantage of by the defendants.

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