Tuesday, April 2, 2013
Wednesday, March 27, 2013
Health Care Fraud Indictments
Tariq Hafeez, Esq.
Thirteen individuals from the metro Detroit area have been
charged in a large-scale health care fraud and drug distribution scheme, United
States Attorney Barbara L. McQuade announced today.
The superseding indictment, adds 13 new defendants and new
charges to a 2011 indictment, which charged Canton Pharmacist Babubhai ‘Bob”
Patel with overseeing a massive health care fraud and drug distribution ring at
more than 20 pharmacies that he owned and controlled in metro Detroit.
The 21-count superseding indictment
charges with prescription fraud involving 26 Michigan pharmacies. The
indictment alleges that the defendants participated in a scheme whereby the
owners/controllers of the pharmacies provided kickbacks, bribes, and other
illegal benefits to physicians to induce those physicians to write
prescriptions for patients with Medicare,
Medicaid, and private insurance. The prescriptions be presented to one of the
defendants’ pharmacies for billing. In exchange for their kickbacks and
inducements, the physicians would write prescriptions for the patients and bill
the relevant insurers for services supposedly provided to the patients without
regard to the medical necessity of those prescriptions and services. The
physicians would direct the patients to fill their prescriptions at one of the
defendant owned pharmacies, where defendants would bill insurers, including
Medicare, Medicaid, and private
insurers, for dispensing the medications, despite the fact that the medications
were medically unnecessary and, in many cases, never provided. Patients were
recruited into the scheme by patient recruiters or “marketers,” who would pay
kickbacks and bribes to patients in exchange for the patients’ permitting the
defendants’ pharmacies and the defendant physicians to bill their insurance for
medications and services that were medically unnecessary and/or never provided.
The indictment further alleges a
conspiracy to distribute controlled substances at the defendants’ pharmacies to facilitate the submission of
false and fraudulent claims to Medicare, Medicaid, and private insurers.
According to the indictment, defendants paid physicians kickbacks for
prescriptions for controlled substances for their patients and directed those
patients to fill the prescriptions at defendants owned/controlled pharmacies.
The controlled substances included the Schedule II drug oxycodone (Oxycontin),
the Schedule III drug hydrocodone (Vicodin, Lortab), the Schedule IV drug
alprazolam (Xanax), and the Schedule V drug cough syrup with codeine. According
to the indictment, prescriptions for these drugs were written outside the
course of legitimate medical practice.
This most recent indictment falls in line with the federal
government’s increased investigation and prosecution of health care fraud
across the country. In May 2009, the
Department of Health and Human Services (HHS)
and the Department of Justice (DOJ)
created the Health Care Fraud Prevention and Enforcement Action Team (HEAT),
making the fight against health care fraud a Cabinet-level position. The Heat
task force is focused on nine cities including Detroit.
If you have questions about health care fraud or other legal issues,
please contact Mark Mandell or Tariq Hafeez at 248.380.0000 or online at www.MichiganFraudLawyer.com.
Friday, March 22, 2013
Penalties Severe for Pharmacy and Medicare Fraud
In Detroit on Wednesday, 43 individuals were indicted by the
Federal government on allegations of a widespread conspiracy of pharmacy and
Medicare fraud. The indictment alleges
that conspiring doctors, pharmacists, and health care workers wrote fraudulent
prescriptions for pills such as OxyContin, Vicodin, and Xanax. These pills were then sold on the streets of
Detroit and elsewhere at a significant profit.
This conspiracy is believed to have defrauded Medicare for
more than $21.5 million.
Defendants were charged with a variety of crimes, the main
charges including Conspiracy to Distribute and Possess with Intent to Distribute
Controlled Substances; and Health Care Fraud Conspiracy. Also charged were various unlawful monetary
transactions and weapons-related offenses.
If convicted of conspiracy to distribute a Schedule II controlled
substance, such as OxyContin, Defendants are looking at up to 20 years in
prison and more if death or injury resulted from the use of the controlled
substances. This is on top of fines up
to $1 million for individual defendants.
If a convicted Defendant has any prior felony drug convictions, the
minimum term of imprisonment and fines are increased.
If convicted of a Health Care Fraud Conspiracy, Defendants
are looking at up to 10 years in prison, more if injury or death occurs as a
result of the fraud.
These fines and imprisonment are in addition to restitution
that Defendants may be required to pay to the Medicare System for the fraud.
With the Federal government’s crackdown on all types of
health care fraud, these indictments are becoming more and more common. If you are caught up in fraud or other
criminal charges, having experienced and knowledgeable defense attorneys isn’t
just helpful – it’s imperative. Mark
Mandell and the fraud team at Fausone Bohn, LLP, have years of experience and
are especially suited to negotiate charges with prosecutors and, if necessary,
take these cases to trial.
If you need a top-notch legal defense, contact Mark Mandell
at 248-380-0000 or online at www.MichiganFraudLawyer.com.
43 Indicted in Michigan on Federal Prescription Drug Fraud Charges
Yesterday, the Federal government indicted 43 people on
charges of running a massive prescription drug scheme. Those charged include doctors, pharmacists,
and home health care workers.
According to the indictment, five of the doctors charged
prescribed more than half a million doses of OxyContin – pills with a street
value of $10 million. In addition, those
doctors are alleged to have prescribed 2 million doses of Vicodin, 2 million doses
of Xanax, and more than 1,000 liters of cough syrup. All of this occurred over a 21-month period,
the indictment said.
The indictment alleges that the defendants held “patient
parties” and hired recruiters to obtain new beneficiaries for the scheme.
It is believed that the fraud bilked Medicare for more than
$21.5 million. Also included in the
indictment are charges for bribery, money laundering, kickbacks, and weapons-related
offenses.
If you have questions regarding fraud or any other legal
issues, contact Mark Mandell at 248.380.0000 or online at www.MichiganFraudLawyer.com.
To read the original Free Press article detailing the
indictment, please visit: http://www.freep.com/apps/pbcs.dll/article?AID=2013303210180
Monday, March 11, 2013
Worry over Healthcare Leaves Elderly Vulnerable to Medicare Scam
Mark Mandell, Esq.
Scammers are now targeting the
elderly, a population who are increasingly concerned over their health care,
especially in light of the Affordable
Care Act’s ensuing changes. A Medicare-card related scam has left a trail
of elderly victims across at least 15 states, including Michigan ,
West Virginia , Tennessee ,
Illinois , New Jersey
and California
Individuals fall prey to such a
scam after receiving a phone call informing them of the need to verify
information in order to receive a new Medicare
card. Despite being warned to never give out personal information over the
phone, when the caller on the other end of the line seems legitimate, it is
hard to pick out a fraudulent call.
"Medicare is my lifeline,”
says Bessie Bell, 72, just one of many senior citizens who has received a
fraudulent call within the last year.
When fraudulent callers pick up
on these worries and focus on current issues such as Medicare changes and the
cost of prescription drugs, it is easy for concerned individuals to believe the
newest pitch. Lately, Medicare beneficiaries are being told they must verify
their account information by giving out their bank account or Social Security
numbers in order to receive a new Medicare card. Others have been lured into
believing in a new, “Preferred Medicare” card that would somehow be used alongside
the current card.
The public is concerned with how
to spot the scammers as they grow more convincing. Before giving out any
personal information, individuals are warned to stop and think: would the
government call each individual if changes were made to the Medicare program?
Senior citizens have been advised to first call their doctor, the drugstore, or
the AARP before taking any action. While a
call may seem legitimate, it is important to remember that bank routing numbers
are public information, and while a caller’s knowledge of such information may
make the call seem more legitimate, it is better to be safe than sorry.
While this Medicare-card related
scam may be one of the newer fraudulent schemes occurring across the nation,
these scammers are not alone. Just last year, millions were called to verify
their personal information in order to receive diabetic test strips; fraudulent
online pharmacies lure in many each year by offering prescription drugs at prices
too good to be true.
If you have questions about
criminal matters, fraud or other legal issues, please contact Mark Mandell or
Tariq Hafeez at 248.380.0000 or online at www.MichiganFraudLawyer.com.
To learn more and visit the
original article, please visit: http://www.livingstondaily.com/article/20130210/OPINION01/302100310/Susan-Tompor-Scammers-target-seniors-fake-Medicare-card
Friday, March 8, 2013
Debate Over Penalties Facing Fraudulent Bottle Returners
Mark Mandell, Esq.
The House Regulatory
Reform Committee debated bills relating to the fraudulent return of
out-of-state cans and bottles for refunds in Michigan
Angela Madden of Michigan Beer and Wine Wholesalers emphasized
how this practice hurts businesses. Many Michigan
The committee has yet to vote on
the legislation, and while only a dime per returned container does not seem
like much, thousands of these returns could be costing the state a pretty
penny.
If you have questions about
criminal matters, fraud or other legal issues, please contact Mark Mandell or
Tariq Hafeez at 248.380.0000 or online at www.MichiganFraudLawyer.com
To learn more and read the
original article, please visit: http://www.myfoxdetroit.com/story/21243521/michigan-lawmakers-debate-bottle-return-fraud-penalties
Wednesday, March 6, 2013
Auto Industry Looking to Create Insurance Fraud Authority
Mark Mandell, Esq
Michigan’s auto insurance
industry is looking to tackle the issue of fake medical claims relating to auto
accidents and scams that involve the billing of insurance companies for procedures
more expensive than those actually performed. There has been a recent increase
in such questionable claims, and Michigan
now ranks third in the nation in such claims. Even Gov. Rick Snyder is onboard,
addressing both the issue of auto insurance fraud and no-fault insurance in
general during his State of the State address last month.
The robust no-fault insurance provision
can be a “magnet for unscrupulous and fraudulent claims activity,” says Meghan
Cass, an Allstate Insurance spokeswoman.
Under Michigan
The proposed Fraud Authority
would involve the ferreting out of what scams are taking place while providing
financial support to law enforcement, prosecutors, and insurance associations.
While insurers may have to dedicate up to $15 million per year towards such an
authority; it would save millions more. It is estimated that 10% of all claims
in Michigan
The high fraud rate in Michigan
If the issue of a fraud authority
does not get too tied up in the more controversial debate over no-fault
insurance in general, some say the creation of such an authority may stand a chance
this year.
If you have questions about
criminal matters, fraud or other legal issues, please contact Mark Mandell or
Tariq Hafeez at 248.380.0000 or online at www.MichiganFraudLawyer.com.
To learn more and read the
original article, please visit: http://www.freep.com/apps/pbcs.dll/article?AID=2013302170152
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