$223 Million Medicare Fraud Bust

Matthew Worley, Esq.

The Medicare Fraud Strike Force has struck again.  The Federal government recently indicted 89 individuals on suspicion of committing Medicare fraud.

The schemes are believed to have resulted in approximately $223 million in false billings submitted to the government.

The 89 individuals charged include doctors, nurses, and other licensed medical professionals.  The defendants reside in eight different cities; 18 of whom (including 2 doctors) are from Detroit.  They are accused of a variety of health care fraud-related crimes, including conspiracy, violations of anti-kickback statutes, money laundering, and submitting claims for medically unnecessary treatments.

These indictments are the latest step forward in the Federal government’s comprehensive efforts combatting healthcare fraud and abuse.  The Medicare Fraud Strike Force team is a division of the Health Care Fraud Prevention & Enforcement Action Team (also known as HEAT).  Since 2007, the Strike Force team has charged more than 1,500 defendants who collectively have falsely billed the Medicare program more than $5 billion.

With the Federal government’s recent crackdown on Medicare fraud, knowledgeable legal counsel is essential to effectively defend these charges.  If you or someone you know needs sound advice regarding fraud, contact the experienced team at Fausone Bohn, LLP at (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

To read the Department of Health & Human Services press release, please visit: http://www.hhs.gov/news/press/2013pres/05/20130514a.html.

The Evolution of Drunk Driving

Mark J. Mandell, Esq.

Recently, a principle of one of Michigan’s elementary schools was arrested with charges of Super Drunk Driving. Passed in 2010, the new ‘Super Drunk’ law has created harsher penalties for those driving with a BAC of .17% or higher.

In comparison to a regular drunk driving charge, those convicted of being “super drunk drivers” can face up to 180 days in jail, are required to complete an alcohol treatment program, pay up to $700 in fines and are not allowed to drive for 45 days following the incident. On top of all of that, their driving is further restricted for 320 days with the implementation of an ignition interlock device that prevents the vehicle from starting if alcohol is detected on the breath.

While these penalties may seem harsh, alcohol-related traffic accidents account for nearly one-third of all traffic-related deaths in the United States. Each year, tens of thousands of people are killed in such crashes – despite their preventability.

In recent years, Michigan has seen a fall in the rates of alcohol-related arrests; however, it is hard to say whether this trend is a direct result of the new laws and associated penalties or the police force’s loss in manpower due to budget cuts. The Michigan Office of Highway Safety Planning has stated that by advertising and warning the public about the dangers and costs of drunk driving, people are thinking twice before getting behind the wheel while drunk.

To learn more about Michigan’s drunk driving laws, or if you yourself have been charged, please visit: www.michiganfraudlawyer.com or contact Mark Mandell at (248) 380-9976.

Detroit Man Pleads Guilty to $29.1 Fraudulent Medicare Fraud Scheme

Mark J. Mandell, Esq.

For five years, Sachin Sharma of Detroit, 37, oversaw and directed the operations of a broad network of home health, psychotherapy, and medical clinics. As the ringleader of the operation, Sharma – with the help of many – fraudulently billed Medicare for $29.1 million in medically unnecessary claims. Now, Sharma has pleaded guilty to one count of conspiracy to commit health care fraud and one count of tax evasion this month.

Apart from the fraudulent kickbacks, Sharma also trained others in techniques used to both defraud the system as well as conceal the fraud. By directing employees to fabricate and alter medical documents, the broad network of home health, psychotherapy, and medical clinics involved gave the impression that medical services were provided.

As a result of the scheme, Sharma admitted to receiving substantial proceeds of the fraud from these companies, however, he failed to report these proceeds on his individual federal income tax returns. Moreover, Sharma failed to file tax returns from 2007 to 2011.

               

At sentencing, Sharma faces up to 10 years in prison and a $250,000 fine. Several of Sharma’s co-defendants have already pleaded guilty to conspiracy to commit health care fraud for their roles in the scheme, and one remains a fugitive.

To learn more about Michigan’s drunk driving laws, or if you yourself have been charged, please visit: www.michiganfraudlawyer.com or contact Mark Mandell or Tariq Hafeez at (248) 380-9976.

To read the original article, please visit: http://www.fbi.gov/detroit/press-releases/2013/leader-of-29.1-million-medicare-fraud-scheme-pleads-guilty-in-detroit

Award under Michigan Whistleblower Act Reversed

Matthew Worley, Esq.

The Michigan Court of Appeals has reversed a jury verdict awarding more than $147,000 to a woman who claimed she was fired for reporting illegal activity.

Barbara Hays was a home care worker for Lutheran Social Services of Michigan.  One of her clients smoked marijuana in his house, including when she was present.  Ms. Hays informed her supervisor and, at one point, contacted the Bay Area Narcotics Enforcement Team (BAYANET) to find out if there were any legal consequences to her.  At the end of the phone call, she was asked if she wanted to take any further action but she declined.

When her supervisor later found out that she disclosed this patient information to an outside party, which was a violation of her confidentiality agreement, Ms. Hays was terminated.

Ms. Hays then filed a lawsuit under Michigan’s Whistleblower Act which provides a remedy to people who are fired for reporting a violation of law.

In order to provide relief, the Act requires the person to make a “report” of illegal activity; however, the Act does not actually define what constitutes a “report.” 

The Court of Appeals determined that Ms. Hays did not make a “report” of the incident to anyone because when she called law enforcement, she didn’t give any names, locations, or even the type of drug used.  She was merely seeking information and advice.  To provide her relief, the court said, would not further the purpose of the Whistleblower Act which is protecting the public by encouraging the reporting of illegal activity.

Because she failed to meet the requirements under the Act, the Court of Appeals reversed her jury award and dismissed her case.

If you have been retaliated against for reporting illegal activity, or have questions about this or other legal topics, contact the experienced legal team at Fausone Bohn, LLP at (248) 380-0000 or online at www.fb-firm.com.