Michigan to Receive $42 Million in Nationwide Healthcare Fraud Settlement

Matthew Worley, Esq.

 

Johnson & Johnson and its subsidiaries have agreed to pay more than $2.2 billion to the federal government and 45 states in one of the largest health care fraud settlements in history.

 

The payment is made to settle criminal fines and civil suits alleging the entities offered kickbacks to doctors and pharmacies to promote certain drugs for uses not approved by the FDA – a practice prohibited under U.S. law.

Allegedly, the health care giant promoted the use of schizophrenia drugs for use in elderly dementia patients and for children with AD/HD, autism, and other disorders.  These drugs were not approved for these uses, making it illegal for the manufacturer of the drug to market them.

Michigan’s share of the settlement, which is approximately $42 million, will primarily go to the state’s Medicaid program which initially paid for most of these prescriptions.  According to Michigan Attorney General Bill Schuette, this major settlement makes a statement that the hardworking taxpayers of Michigan deserve better than to be duped into paying more than they should have.

Under a “Corporate Integrity Agreement,” the federal government will be closely monitoring the company’s marketing practices going forward.

If you have questions about health care fraud, or are afraid that you may have been the victim of a fraud, contact the experienced attorneys at Fausone Bohn, LLP, by calling (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

To read the original article detailing this health care fraud settlement, visit: http://www.mlive.com/business/index.ssf/2013/11/michigan_johnson_johnson_drug.html

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

$40 million Detroit-area Medicare Fraud Scheme

Tariq Hafeez, Esq.

A Detroit-area doctor, Hicham Elhorr, has been charged in federal court for his alleged leading role in a $40 million Medicare fraud scheme.

Dr. Elhorr was the owner and operator of House Calls Physicians (HCP), a physician home visiting service.  Elhorr allegedly submitted claims through HCP for physician home visits for patients that were never seen or visits conducted by doctors who were not licensed.  The complaint further alleges that Elhorr submitted claims to Medicare when he was out of the country, when beneficiaries were hospitalized, or even when the beneficiary was dead.

Additionally, Elhorr is charged with accepting kickbacks from home health agencies in exchange for referring patients to those agencies.  According to court documents, HCP has billed Medicare for approximately $9.2 million since January 2008.  In that same time period, the company has allegedly referred Medicare beneficiaries for home health services that resulted in approximately $30.8 million of reimbursements from Medicare.

 

Of course, these charges mean that Dr. Elhorr is suspected of committing these crimes but is considered innocent until proven guilty beyond a reasonable doubt in a court of law.

 

Medicare and Medicaid fraud are serious offenses that are harshly prosecuted and carry severe penalties and jail time.  Having quality legal advice is imperative when defending against such allegations.

The experienced fraud team at Fausone Bohn, LLP – Mark Mandell, Tariq Hafeez, and Breeda O’Leary – can provide a top-notch legal defense for those involved in a government investigation or prosecution.  The team can also provide counsel for “whistleblowers” looking to expose the fraud of their employers (or ex-employers).  Whistleblowers may be eligible to receive money from a settlement or verdict and this knowledgeable team has the expertise to obtain these positive results.

To learn more or read the original article, please visit:

http://www.examiner.com/article/michigan-doctor-charged-40m-medicare-fraud-scheme