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October 22, 2012

Grand Jury Indicts New Defendants and Brings Additional Charges Against L.A.-Based OxyContin Ring that Allegedly Bilked Medicare

Filed under: Los Angeles Criminal attorney — Tags: , , — fayarfa @ 5:28 pm

Indictment Alleges that Medicare and Medi-Cal Were Fraudulently Billed for More Than $8.9 Million for the Addictive Painkiller and Unneeded Medical Services

LOS ANGELES – A federal grand jury has returned a superseding indictment that charges 16 defendants with being part of a drug trafficking organization that illegally obtained and distributed more than 900,000 OxyContin pills obtained in part through fraud against public insurance programs such as Medicare.

One of the defendants – Theodore Yoon, 68, of Arcadia – was arraigned on the new indictment this afternoon in United States District Court in Los Angeles. Nine of the defendants were arraigned yesterday. Five other defendants were arraigned October 5. The 15 defendants who have been arraigned have all pleaded not guilty and were ordered to stand trial next month. One defendant is a fugitive.

The first superseding indictment replaces charges filed a year ago, adding new charges of money laundering and structuring of cash transactions. The superseding indictment adds new defendants, including four pharmacists. The indictment alleges a conspiracy to distribute controlled substances, a conspiracy to commit health care fraud, structuring financial transactions and money laundering. The indictment also seeks the forfeiture of proceeds related to the criminal offenses.
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February 15, 2012

CO-OWNER OF TWO LOS ANGELES-AREA HEALTH CARE COMPANIES SENTENCED TO 96 MONTHS IN PRISON FOR HEALTH CARE FRAUD

WASHINGTON – The co-owner of two Los Angeles-area health care companies was sentenced today to 96 months in prison for his conviction stemming from a nine-year scheme to defraud Medicare, announced the Departments of Justice and Health and Human Services (HHS).

U.S. District Judge Stephen V. Wilson also ordered Evans Oniha, 49, to pay $7 million in restitution and to serve three years of supervised release following his prison term.  A federal jury in the Central District of California found Oniha guilty on July 7, 2011, of one count of conspiracy to commit health care fraud, four counts of health care fraud and one count of false statements relating to health care matters.

According to court documents, in 2002, Oniha and co-defendant Camillus Ehigie founded and began operating Prosperity Home Health Services Inc., a home health agency, and Caravan Medical Supplies Inc., a durable medical equipment (DME) company.  According to testimony presented at trial, from October 2002 to February 2011, Oniha conspired with Ehigie and others to defraud Medicare by paying “marketers” for Medicare beneficiary information, fraudulent prescriptions and other documents for DME and home health services.  Testimony at trial showed that the marketers were individuals who acquired patient Medicare numbers and doctors’ prescriptions and sold them to Oniha.  Oniha used these fraudulent documents to submit and cause the submission of false claims to Medicare for DME and home health services that were not medically necessary and that often were not provided to Medicare beneficiaries.  According to court documents, Oniha caused Prosperity to submit approximately $8 million in fraudulent claims to Medicare for home health services purportedly provided by Prosperity.  Oniha caused Caravan to submit approximately $5.8 million in fraudulent claims to Medicare for DME purportedly provided by Caravan.

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February 9, 2012

Los Angeles Man Sentenced to 77 Months in Prison for Medicare Fraud Scheme Resulting in More Than $18.9 Million in Fraudulent Claims to Medicare

Filed under: Los Angeles Criminal attorney — Tags: , , — fayarfa @ 4:35 am

WASHINGTON—A Los Angeles-area man was sentenced yesterday to 77 months in prison for organizing and leading a medical clinic fraud scheme that used the stolen identities of physicians to submit more than $18.9 million in fraudulent claims to Medicare, the Department of Justice, the FBI and the Department of Health and Human Services (HHS) announced.

Eduard Aslanyan, 38, of Sherman Oaks, Calif., was sentenced by U.S. District Judge Consuelo B. Marshall in the Central District of California. In addition to his prison term, Aslanyan was sentenced to three years of supervised release and was ordered to pay $10.8 million in restitution.

Aslanyan pleaded guilty in April 2011. He admitted that between March 2007 and September 2008, he established a series of fraudulent medical clinics in and around Los Angeles to defraud Medicare. Carolyn Vasquez, who previously pleaded guilty to conspiring with Aslanyan to defraud Medicare, recruited physicians to serve as the medical directors of Aslanyan’s fraudulent medical clinics. The physicians did not perform services at the clinics and were rarely present at the clinics. Physician assistants were hired by Aslanyan and Vasquez and were complicit in the fraud scheme at the clinics.

According to court documents, Aslanyan hired patient recruiters to find Medicare beneficiaries who were willing to provide the recruiters with their Medicare billing information in exchange for expensive, high-end power wheelchairs and other medical equipment which the patient recruiters told the beneficiaries they could receive for free. Often, the Medicare beneficiaries did not have a legitimate medical need for the power wheelchairs and equipment. The patient recruiters then provided the beneficiaries’ Medicare billing information to Aslanyan or brought the beneficiaries to Aslanyan’s clinics. Aslanyan paid the patient recruiters cash kickbacks in exchange for recruiting the Medicare beneficiaries.

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November 4, 2011

Authorities Arrest 16 Linked to $18 Million Health Care Fraud Scheme Involving Bogus Prescriptions for Expensive Anti-Psychotic Drugs

Filed under: California Defense Attorney — Tags: , — fayarfa @ 1:08 am

LOS ANGELES – Sixteen people associated with a Glendale medical clinic, including a doctor and the owners of a San Marino pharmacy, were arrested this morning on criminal charges related to an $18 million scheme to defraud Medicare and Medi-Cal by, among other things, fraudulently prescribing expensive anti-psychotic medications, and then re-billing the government for those drugs over and over.

A federal criminal complaint unsealed this morning charges 17 defendants and alleges a scheme in which people associated with Manor Medical Imaging Clinic and pharmacies in and around the San Gabriel Valley participated in a “prescription harvesting” scheme that defrauded Medicare and Medi-Cal, causing at least $7.3 million in actual losses to the government health care programs. Fifteen of the 17 federal defendants were arrested this morning, and authorities arrested an additional defendant charged by the California Attorney General’s Office, for a total of 16 arrests today.  One federal defendant was arrested earlier this month in relation to another Medicare fraud case, one person named in the federal case remains a fugitive.

This is the first case in the nation alleging an organized scheme to defraud government health care programs through fraudulent claims for anti-psychotic medications, a type of scheme that investigators say is on the increase around the nation. Court documents outline a conspiracy in which Manor operated a bogus clinic authorized to make claims to Medicare, employed a doctor to write prescriptions, and had close relationships with pharmacies and a fraudulent drug wholesale company that was used to funnel prescription drugs back to the pharmacies participating in the scheme.

The affidavit in support of the criminal complaint alleges that Manor used “cappers” to recruit Medicare and Medi-Cal beneficiaries – including veterans, the homeless, low-income patients and the elderly – whose beneficiary information was used to bill Medicare and Medi-Cal for millions of dollars worth of illegitimate medical services and prescriptions for expensive anti-psychotic drugs. The drugs that were dispensed by the pharmacies allegedly did not go to the beneficiaries but, rather, were diverted to black market wholesalers and back to the pharmacies, where members of the conspiracy re-labeled, re-packaged and re-dispensed bottles of the medications so they could submit new bills to Medicare and/or Medi-Cal as though the drugs had never been dispensed.

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September 28, 2011

Former Police Detective Pleads in Fraud Case

Filed under: California Defense Attorney — Tags: , — fayarfa @ 9:57 pm

LOS ANGELES – A former Los Angeles police detective charged in connection with a workers’ compensation fraud investigation today pleaded no contest and resigned from the police department.

Deputy District Attorney Mario Coto-Lopez said John Xavier Vach Jr., 38, pleaded to two misdemeanor counts of insurance fraud. Vach is due back for sentencing on Nov. 7.

The charges stem from an investigation by the Los Angeles Police Department’s Workers’ Compensation Fraud Unit in cooperation with the District Attorney’s Healthcare Fraud Division.

Vach, a 15-year veteran of the LAPD, operated two private businesses while out on a disability claim for job-related stress. The defendant purportedly also sought a lifetime disability pension. The alleged offenses occurred between February and November 2008.

Under the terms of the negotiated settlement, the defendant was made to resign today from the police department. Additionally, Vach must pay $105,000 in restitution and will be placed on summary probation for three years.

July 30, 2011

Orange County Doctor Sentenced to 18 Months in Prison for Billing for Cancer Meds That Were Never Provided

Filed under: California Defense Attorney — Tags: , — fayarfa @ 3:21 am

SANTA ANA, CA—An Orange County cancer doctor was sentenced this morning to 18 months in federal prison for fraudulently submitting bills for approximately $1 million worth of injectable cancer medications that never were provided.

Dr. Glen R. Justice, 66, of Corona del Mar, was sentenced by United States District Judge Cormac J. Carney. Justice pleaded guilty in May 2010 to five counts of health care fraud.

Justice, who ran the Pacific Coast Hematology/Oncology Medical Group in Fountain Valley, defrauded health insurance providers, including the Medicare program, by billing for injectable cancer medications when patients never received those medications. In some instances where patients did receive medications, Justice “upcoded” claims made to health insurance providers by falsely claiming that he administered more expensive injectable medications than were actually given to patients.

The medications involved in the scheme included Neulasta, Neupogen, Procrit/Epogen/Aranesp, and Neumega. Justice’s scheme ran from at least 2004 through October 2009, despite being advised by staff about the improper billing and the execution of a search warrant at his medical group in November 2006. In a plea agreement filed in court, Justice acknowledged that the public and private health insurance providers—including Medicare, Tricare, carriers contracted with the federal government through the Federal Employee Health Benefit Program, and Blue Cross and Blue Shield of California—suffered losses of between $400,000 and $1 million.

During today’s sentencing hearing, Justice did not contest government allegations that he had violated his plea agreement by continuing to submit fraudulent bills after he signed the agreement in March 2010.

In addition to the prison term, Judge Carney ordered Justice to pay $1,004,689 in restitution.

June 7, 2011

Doctor Pleads Guilty to Billing Medicare and Medicaid for Counseling Sessions with Dead Patients

Filed under: Federal Crimes Defense Attorney — Tags: , , — fayarfa @ 8:12 am

ATLANTA—ROBERT WILLIAMS, 72, of Atlanta, Georgia, pleaded guilty today in federal district court on two counts of health care fraud as part of a scheme to bill for group psychological therapy that WILLIAMS never provided.

United States Attorney Sally Quillian Yates said, “With so many elderly citizens and others who need specialized psychological care, this defendant ignored his duty as a doctor and became a billing machine who claimed to treat patients who were in fact dead. This blatant attempt to rip off the system took funds and care away from real live patients with real problems. Medicare and Medicaid need all the money they can get for legitimate patient care and this physician will get none of that money.”

“This case sends a strong message that Medicare and Medicaid fraud will not be tolerated in Georgia,” said Georgia Attorney General Sam Olens. “At a time when our state budget is heavily strained, every dollar intended for the needy must reach the recipient. We will continue to work with our partners, the U.S. Attorney’s Office, and the FBI, to weed out fraud in Georgia.”

Brian D. Lamkin, Special Agent in Charge, FBI Atlanta Field Office, said, “Dr. Williams had for years, enjoyed a position of trust within the medical and health provider industry. He chose to abandon that trust and instead displayed a level of greed that will not be tolerated. Medicare fraud should be promptly reported to the nearest FBI field office so that the much needed federal health care benefits will be there for those individuals who truly need them.”

According to United States Attorney Yates, the charges, and other information presented in court: WILLIAMS was a licensed physician, practicing in the Atlanta area. From approximately July 2007 through October 2009, he contracted with a medical services company to provide group psychological therapy to nursing home patients in a variety of nursing homes. Under his signature, thousands of claims were submitted to Medicare and Georgia Medicaid seeking reimbursement for group psychological therapy that WILLIAMS purportedly provided to beneficiaries at several nursing homes in the Atlanta area. In many instances, however, WILLIAMS did not actually provide the therapy.

Specifically, from July 2007 through October 2009, Medicare claims data indicated that over 55,000 claims were submitted using WILLIAMS’ provider number for group psychological therapy. Those claims sought reimbursement for over $2,000,000, and ultimately caused Medicare to reimburse WILLIAMS over $750,000. For the same time period, over 40,000 Medicaid claims were submitted by WILLIAMS for group psychological therapy, causing Georgia Medicaid to pay out over $225,000.

An investigation of WILLIAMS’ claims showed that, in many cases, he sought payment for services provided to beneficiaries who were deceased at the time he purportedly rendered the care. In two cases, the patient died over a year before he was allegedly seen by WILLIAMS in the nursing home. Numerous claims were submitted to Medicare and Medicaid for group psychological therapy when the beneficiary was hospitalized at the time of service and, consequently, could not have received care at the nursing home as represented.

WILLIAMS was indicted on February 22, 2011 on 10 counts of health care fraud. Today WILLIAMS pleaded guilty to two of those counts. He could receive a maximum sentence of 10 years in prison and a fine of up to $250,000 for each count. In determining the actual sentence, the court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.

Sentencing has been scheduled for August 23, 2011, at 11:30 a.m. before United States District Judge Richard W. Story.

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