Life Care Centers of America denies massive Medicare fraud charges; judge criticizes feds in secret whistleblower case

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Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481Medicare reimbursed $4.2 billion to Life Care Centers between 2006 and 2011, the newspaper reported. While skilled nursing facilities averaged 35% of treatments for rehab patients at the ultra-high level nationwide in 2008, Life Care Centers had 68% of therapies at the ultra-high level, court records say. Rehab therapy claims have come under increased scrutiny in recent years, with other nursing home chains also have faced accusations of upcoding. 

Video: Medicare Fraud is costing us millions of dollars!

60 Minutes Reports on Medicare Fraud Investigation

Several whiste blowers have come forward to uncover this fraud, and most of them has suffered the consequence of a lost job.  However, its important to know that federal law provides protection to whistle blowers from wrongful termination, as well as a portion of damages recovered by the U.S. Government under certain circumstances.

Medicare fraud: 'Much more needs to be done'

•    Neville Pattinson, senior vice president of government affairs, standards and business development, Gemalto, on behalf of the Secure ID Coalition; •    Dan Olson, director of fraud prevention, Health Information Designs; •    Alanna Lavelle, director investigations, East Region/Special Investigations Unit, Wellpoint; •    Michael Terzich, senior vice president, global sales and marketing, Zebra Technologies; and •    Louis Saccocccio, CEO, National Health Care Anti-Fraud Association

Doctor Pleads Guilty to Medicare Fraud Scheme

Some of the recruiters also worked for durable medical equipment (DME) suppliers operated by Charles Agbu and his daughter, Obiageli Agbu. Dr. Van Putten admitted that the Agbus paid him cash kickbacks to write prescriptions for expensive power wheelchairs and other DME that he knew the patients did not need. In the written orders, he exaggerated the patients’ conditions and diagnoses so that they would appear to meet Medicare’s requirements for coverage, with knowledge that the orders would be submitted to Medicare for payment. Van Putten and his co-defendants allegedly billed Medicare for $11,094,918 and received payments of about $5,789,000.

Do Hospital Systems Commit Medicare Fraud When They Set Patient Admission Goals?

Recently, 60 Minutes ran a segment looking into the questionable inpatient admission practices of hospitals owned by Health Management Associates (HMA). According to 60 Minutes, HMA is under federal investigation for pressuring its associated physicians into admitting patients, regardless of medical necessity. For added pressure, HMA supposedly set lofty patient admission goals for each hospital. Moreover, when some providers and senior-level employees raised health care fraud concerns, they were allegedly alienated, isolated and terminated by the company. Hospital systems potentially commit Medicare fraud when they set high patient admission goals for their hospitals. Indeed, when hospitals admit Medicare beneficiaries based on monetary greed, as opposed to medical need, the admissions run afoul of the law, triggering liability under the federal False Claims Act. More information for whistleblowers is located at the Nolan Auerbach website.  

Former Optometrist Sentenced in Medicaid Fraud Case

Seventh Circuit Court Judge Janine M. Kern suspended the execution of sentence on several conditions. Judge Kern ordered Feldman to serve 180 days in jail and ordered him to pay a total of $363,049.90 in restitution to Medicaid and Medicare. Feldman turned over a coin collection with an estimated value of $157,000, and paid an additional $80,000 to the government, so his remaining restitution balance is $126,049.90. Feldman was also ordered to serve 300 hours of community service, pay costs of $712.20 to the State and court costs of $208. Feldman allowed the South Dakota Board of Optometry to revoke his license in October.

Clinic Workers Plead Guilty To Role In Medicare Fraud Ring

(TM and Copyright 2012 CBS Radio Inc. and its relevant subsidiaries. CBS RADIO and EYE Logo TM and Copyright 2012 CBS Broadcasting Inc. Used under license. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)

Attention Seniors: Help Stop Medicare Fraud

The Wisconsin Council of Churches is partnering with the Coalition of Wisconsin Aging Groups (CWAG) to help seniors in our congregations control rising health care costs by helping to fight Medicare fraud. The Wisconsin Senior Medicare Patrol (SMP), overseen by CWAG, provides resources to Medicare beneficiaries, caregivers, and the professionals who serve them throughout the state to prevent, detect, and report healthcare fraud, waste, and abuse.  For more information, click here.

How to Prevent Medicare Fraud

December 3, 2012….Fairfield, Connecticut…Ms. Trish Simmons, MSW and a certified Medicare Fraud Prevention Specialist, will give a lecture at the Fairfield Senior Center on Wednesday, December 12, 2012 starting at 10:30 a.m.  The topic will be “Medicare Fraud Prevention.” 


A US law enforcement agent has publicly disclosed, during an interview, that there are eighty-six Federal fugitives, all believed to be in the South Florida area, who are wanted on charges of Medicare Fraud. Some of these individuals are also accused of money laundering. This is of relevant interest to compliance officers at South Florida financial institutions, and broker-dealers, because many of there fugitives have defrauded the United States out of millions of dollars in Medicare payments, and therefore have substantial assets. You are advised to look carefully at new customers who fit the following profile: (1) High net worth individuals or closely-held corporations with larger amounts of cash to deposit. (2) Dominican or Cuban nationality, or Cuban-Americans who are resident in Florida. (3) Little or no prior credit agency history. (4) Present or prior health care industry connections or involvement. (5) Medical supply store owner or operator. (6) Individuals who have been resident in the United States for a short period of time. Many medicare fraudsters import front men from the Dominican Republic, or the Republic of Cuba,  and return them to their native countries after the fraud has been successfully perpetrated. Is he totally monolingual, with no English-speaking ability ? If so, he may be a recent arrival. Does he exhibit regional slang in his Spanish that may indicate he is not a long-time resident of Florida ? (7) Request to deposit US Government cheques in large amounts.

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