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.

Abusing Trust

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Pair Allegedly Took Advantage of Cobb Children for Medicaid Fraud,” written by Justin Ove and published by The Ackworth Patch on November 11, 2014.

A grand jury in Cobb County has charged two people with Medicaid fraud, identity fraud, and conspiracy to defraud the state for a scheme which allegedly stole the Medicaid numbers of local children and used them to receive hundreds of thousands of dollars of bogus billing payments from the state.

Matthew David Harrell owned Revive Athletics, Inc. in Henry County, and Andrea Lillie Barrett was the owner of Lillie Cares Health Services, LLC in Glynn and Chatham counties. Both defendants’ companies were enrolled as service providers for Georgians on Medicaid.

Falling on Hard Times

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Father, Son Sentenced in Medicaid Fraud Case,” written by Karen Blackledge and published in The Daily Item on October 7, 2014.

DANVILLE — An elderly father was placed in a special program to expunge a charge of Medicaid fraud while his son will spend at least two months in jail.

Montour County Judge Gary Norton allowed David L. Albertson, 75, of 24 Montour St., to participate in the Accelerated Rehabilitative Disposition Program for one year where successful participation will result in the elimination of charges.

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.

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