Question: Dear Steve, After an auto accident was taken to a southwest Tennessee hospital. Hospital charged the other drivers insurance right. Ok. Somehow Medicare ended up paying for a portion of my care and is now demanding repayment. Also stating I can request a waiver (before 60 dys) and appeal their decision & calculated amount … Read more
“Dear Steve, I am currently 53 years old and single (never married). I am a licensed practical nurse. I was working full time until 2005 – when I went into kidney failure and had to go on dialysis. Because of my illness I had to stop working and go on Social Security Disability. I was … Read more
“Dear Steve, I have medicare & medicare gap coverage. Have filed for bankruptcy & discharged. If I were to mention to them I had filed, (just in case). Would that have an impact on my gap premium. In other words, how do they look at it. That you’re debt free & have extra money or … Read more
According to a criminal complaint unsealed today in U.S. District Court in Detroit, Dr. Hicham Elhorr, 45, masterminded a $ 40 million scheme involving the submission of fraudulent claims submitted to Medicare for services that were medically unnecessary and/or never provided through House Calls Physicians (HCP), a physician home visiting service he owned and operated. … Read more
Maryland consumers should be on the lookout for the latest scam that seeks to steal personal information over the phone by using the Patient Protection and Affordable Care Act (Federal Health Care Reform) as a ploy. “If someone claiming to be from the government calls and asks for your personal information, just hang up,” said … Read more
Stories like this scare me. Especially when I have family that utilizes these pharmacies and participates in the Medicare program. If you’re using Part D prescription drugs from CVS, read on…. It was announced late last week that the CVS Caremark Corporation has settled with the Federal Trade Commission (FTC) for deceptive pricing charges that … Read more
History repeats itself. Fact. George Santayana once stated, “those who cannot remember the past are condemned to repeat it.” This fact holds true with every aspect of one’s life, especially in one’s financial life. And especially in the world of scams. If you’re not up to date and familiar with the latest scams and schemes … Read more
A trucking company’s owners have been indicted on embezzlement, tax evasion and million dollar fraud charges related to the World Trade Center site clean-up. A thirty-one count indictment was unsealed in federal court in Brooklyn this month charging trucking company owners Gerardo P. Fusella and Vincent J. Fusella, Jr., with crimes including embezzlement, mail fraud … Read more
Earlier this month three people, Ovsanna Agopian (aka Joanna Ovsanna / Joanna Smbatyan / Ovsanna Agopian), Boghos Babadjanian and Tolulope Labeodan, were charged in a federal indictment with various offenses related to their involvement in the operation of Euless Healthcare Corporation. The 10-count indictment charges each defendant with one count of conspiracy to commit health … Read more
Another defendant in the Miami $25 million home health Medicare fraud scheme pled guilty for her participation in the scheme as a patient recruiter. Beatriz Torres-Cruz pleaded guilty to one count of conspiracy to commit health care fraud and one count of solicitation of health care kickbacks. Torres-Cruz was charged in a February 2011 indictment. … Read more
It was announced last week that the United States and the State of Tennessee will be receiving $2 million in a settlement of False Claims Act allegations from Vanguard and its wholly owned subsidiary, Vanguard Health Care Ancillary. The settlement resolves claims by the United States and the state of Tennessee that Vanguard wrongly billed … Read more
Married floridian fraudsters, Robert and Nikki Jenkins have each pleaded guilty to one count of conspiracy to solicit and receive health care kick backs after funneling patients through, American Therapeutic Corporation (ATC), a fraudulent mental health company. Then Jenkins’ managed and operated Life 4 Life Inc., which operated multiple halfway houses in Fort Lauderdale, Florida. … Read more
Two of America’s “Most Wanted” health care fraud fugitives were sentenced in Florida last week. Two sisters, Caridad Guilarte and Clara Guilarte, owned a fraudulent medical clinic near Detroit that lead to a $9.1 million Medicare fraud scheme. Each of the sisters face 14 years in prison. In August the sisters plead guilty to one … Read more
Houston, Texas doctor, Christina Joy Clardy, was sentenced to just over 11 years (135 months) in federal prison for a monumental health care fraud conspiracy the resulted in Medicare and Texas Medicaid programs to be billed $45,039,230 over a 30 month period. Clardy is the third defendant to be sentenced in this matter. Last week … Read more
I love the names investigators attach to investigations. For example, last week 16 arrests in conduction with Operation “Psyched Out” were made. Operation “Psyched Out”! Love the name, not the act. Apparently sixteen people affiliated with the Manor Medical Imaging Clinic and pharmacies in and around the San Gabriel Valley in California participated in “prescription … Read more