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.

A Need for Respite

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Suffolk Woman Gets 33 Months for Medicaid Fraud,” published by the Richmond Times-Dispatch on June 14, 2014.

NORFOLK — A Suffolk home health care services provider who pleaded guilty to defrauding Medicaid has been sentenced to nearly three years in prison.

Fifty-eight-year-old Angie L. Gilchrist was sentenced Thursday in federal court in Norfolk to two years and nine months for health care fraud.

More Than Just a Toothache

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Pasco Dentist Charged with Medicaid Fraud,” written by Jon Silman and published by the Tampa Bay Times on May 23, 2014.

SPRING HILL — The 35-year-old patient had perfect teeth, but her jaw hurt. She went to see dentist Miranda Smith, who told her the only way to fix her problem was to pull her teeth — all of them — and get fitted for dentures. The patient was understandably reluctant, as she didn’t have a single cavity.

After her teeth were gone, her jaw pain persisted. The dentures didn’t fit right. Smith’s response, according to a criminal complaint: Medicaid won’t pay for more procedures. If the woman wanted more dental work, she’d have to pay out of pocket.

Abuse of Position

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Robstown Physician Ordered to Federal Prison for Health Care Fraud Following Probe,” published in the Examiner on May 17, 2014.

Dr. Roque Joel Ramirez, 48, of Robstown, has been ordered to federal prison following his conviction of mail fraud in connection with his scheme to defraud Medicare and Medicaid through fraudulent billings, announced United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott. Ramirez pleaded guilty Feb. 18, 2014.

Today, Senior U.S. District Judge Hayden Head, who accepted the guilty plea, handed Ramirez a sentence of 37 months in federal prison. He was also ordered to pay a $10,000 fine and $370,638.28 in restitution to Medicare and Medicaid and will be required to serve three years of supervised release following completion of the prison term. In handing down the sentence, Judge Head noted how Ramirez had abused his position of trust within the health care community.

Hiding Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “LI Pharmacy Owner Sentenced in $16M Medicaid Fraud,” written by Gary Dymski and published in Newsday on May 5, 2014.

A Dix Hills man who admitted his part in a scheme to defraud the state’s Medicaid program of more than $16 million was sentenced Monday to 1 to 3 years in prison, state prosecutors said.

Raheel Pervez, 41, was sentenced in Bronx Supreme Court before Justice Steven Barrett, state Attorney General Eric T. Schneiderman’s office said in a news release.

Check and Recheck

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Man Ordered to Pay $74,000 in Medicaid Fraud Case,” written by Dave Kolpack and published in The Bismarck Tribune on April 28, 2014.

FARGO — A North Dakota man accused of lying about his mother’s finances so she would qualify for Medicaid benefits was ordered Monday to reimburse the government for her expenses and pay a civil fine.

Authorities say Donald Hochhalter, 65, of New Leipzig, understated the value of his mother’s assets so she would qualify for government payments when she moved into a nursing home. He pleaded guilty to a misdemeanor charge of making false statements.

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