Detroit Health Care Fraud

Matt Worley, Esq.

Despite regular indictments and convictions of home health care agency owners, Medicare and Medicaid fraud remains prevalent in metro Detroit, according to a new report by the Office of the Inspector General (OIG).

The US Department of Health and Human Services (HHS) found high fraud, waste, and abuse in Detroit.  Other cities found to have high fraud include Chicago, Miami, Tampa, Los Angeles, Dallas, Houston, and Baton Rouge.

Fraud is a major problem in the Medicare system.  Most experts believe that up to ten percent of the annual $1 trillion cost of Medicare and Medicaid can be attributed to fraud, waste, and abuse.  In 2009 HHS created HEAT – a task force whose aim is to reduce fraud in these programs.

According to this report, as much as 22 percent of claims inspected were filed in error because the services were unnecessary or were coded inaccurately.  This resulted in $432 million in unnecessary payments to home health agencies.  Part of the problem lies in poor record-keeping by the agencies.

The OIG report made three recommendations to home health agencies to reduce fraud.  These providers should (1) increase Medicare contractor standards to identify high risk providers; (2) track license revocation recommendations; and (3) take measures to prevent inappropriate payments to agencies with suspended or revoked licenses.

In response to the report, the Centers for Medicare and Medicaid Services (CMS) said it would implement all three of these recommendations.

To read the original article in Crain’s Detroit Business, please visit: http://www.crainsdetroit.com/article/20121220/BLOG010/121229986/report-home-health-agencies-still-target-of-fraud-investigators-in

If you have questions about Medicare or Medicaid fraud, or other legal issues, please contact Mark Mandell or Tariq Hafeez at 248.380.0000 or online at www.MichiganFraudLawyer.com.

Man Pleads Guilty to Mail Fraud Totaling $2.6 million

Mark Mandell, Esq

While we may not often think of inmates as vulnerable, it is upon these individuals that John Wilson preyed, conning both the inmates and their families out of $2.6 million.

It has been two years since Wilson was accused, but he has finally pled guilty to fraud. Wilson worked with Lari Zeka, a Macomb Township man, running three businesses that sent mailings to inmates across the nation. The mailings, which targeted both the inmates and their families, presented an offer of legal services on the inmate’s behalf. The catch, however, was the necessity of payment upfront, money that would supposedly be used for legal research and lawyer retainer fees. The research would help toward the inmate’s appeal, while the retainer fee would be put toward the case. Once fees were paid, however, the money disappeared. No research was conducted and no attorney was ever assigned to work on the inmate’s appeal.

Wilson seemed to target both black and Hispanic inmates specifically; however, the nature of the scheme was universal in nature. The mailings preyed upon the desperate desire of family members to help their loved ones behind bars.

As a result of an investigation by the Internal Revenue Service and the U.S. Postal Inspection Service, Wilson was indicted on 66 counts of mail fraud in October 2010 and finally pleaded guilty in January. For now, he awaits sentencing.

To learn more and read the original article, please visit: http://www.detroitnews.com/article/20121211/METRO/212110435/1409/rss36

Michigan Working to Make Courts More Efficient

Matt Worley, Esq.

Michigan Trial Courts may soon be working smarter and more efficient, thanks to an initiative by the State Court Administrative Office (SCAO).  With a program entitled “Courts Working Smarter for a Better Michigan,” the SCAO will be measuring the performance of Michigan trial courts.

The plan allows the courts to identify performance issues, set goals, and improve performance.

For example, the plan analyzes how long it takes for a case to be heard by a judge.  Courts can then see where the problems lie and work to correct them in order to shorten the time cases sit in limbo.

Additionally, courts will measure what percentage of jurors called to duty actually serve on a trial.  Customer satisfaction surveys will also be provided to people using the courthouse as a way to improve customer service. Lastly, the courts will also be able to review the reliability and integrity of case files – having accurate court records is indispensable for an effective appeal.

Perhaps best of all, these measures will be provided to members of the bar and the public, providing for greater transparency of the courts to Michigan citizens.

To read the Michigan Bar Journal article about the steps being taken by the SCAO to improve the efficiency of the courts, please visit:  http://www.michbar.org/journal/pdf/pdf4article2113.pdf.

If you have legal questions, contact the experienced team of attorneys at Fausone Bohn, LLP at (248) 380-0000 or www.fb-firm.com.

Judge to Hear Motion to Dismiss for Congressman McCotter Staffer

Mark Mandell, Esq.

Attorney General Bill Schuette deemed the acts of Paul Seewald and Don Yowchuang a “disgraceful violation of the public trust” on Tuesday. The two, who worked for former congressman Thaddeus McCotter and were involved in McCotter’s petition scandal, entered pleas to all but one of the criminal charges brought against them. Seewald and Yowchuang, along with other members of McCotter’s Michigan staff, were involved in the fraudulent copying and altering of petitions that led to McCotter’s qualification for the 2012 Michigan ballot.Yowchuang pleaded no contest to ten counts of forgery – a felony – and six counts of falsely signing a nominating petition – a misdemeanor. Seewald, on the other hand, pleaded guilty to nine counts of falsely signing a nominating petition as circulator.

One charge remains, however. Conspiracy to Commit a Legal Act in an Illegal Manner is still pending against both Seewald and Yowchuang. Judge Marie Braxton is expected to hear an argument on January 9, 2013 from Mr. Seewald’s attorney, Mark Mandell, to have this remaining felony charge dismissed. Mandell, a partner at the law firm Fausone Bohn, LLP, will face opposition from the Attorney General’s office when they oppose the motion in court.

A handful of other McCotter staffers have previously made pleas in regards to the petition scandal. Members include Lorianne O’Brady, a former scheduler for the congressman, who pleaded no contest to five counts of falsely signing a nominating petition as circulator. She has been sentenced to 20 days in jail or in a work program. Further, O’Brady will serve probation for 18 months following the sentence, and she has been ordered to pay over $2,000 in fines.

One member of McCotter’s staff still faces criminal charges. Mary Melissa Turnbull, who is scheduled to appear for a Pre-Trial hearing on January 8, 2013, has been charged with one count of Conspiracy to Commit a Legal Act in an Illegal Manner and one count of falsely signing a nominating petition as circulator.

These convictions have come as a result of Attorney General Schuette’s creation of the Public Integrity Unit in 2011. Since its creation, the unit has filed over 200 charges in various cases involving corruption at both the state and local levels. The unit continues to pursue convictions in such fraud and corruption cases.

If you have questions regarding fraud or other legal issues, please contact Mark Mandell at 248.380.0000 or www.MichiganFraudLawyer.com.

To learn more and read the original articles, please visit:

http://www.detroitnews.com/article/20121127/METRO01/211270373/1361/McCotter-staffers-enter-pleas-in-petition-fraud-case and http://www.michigan.gov/ag/0,4534,7-164-46849_47203-290480--,00.html