Medicare fraud

A Miami Beach doctor will stay in a federal detention center while he awaits trial for Medicare fraud, the Miami Herald reports. Dr. Christopher Gregory Wayne, known for his punk rock style and nicknamed the “Rock Doc” by patients, is charged with a dozen counts of Medicare fraud totaling $230. But the indictment alleges systematic abuse: he’s accused of billing for, on average, 500 physical therapy sessions a day in 2008. 

Dr. Christopher Gregory Wayne, called the “Rock Doc" and known by a signature punk-rock hairstyle, has been charged with 12 counts of Medicare fraud, The Miami Herald reports (paywall alert).

 

The former CEO of Hollywood Pavilion psychiatric facility who was found guilty of $67-million Medicare fraud in June had asked that she be sentenced to house arrest in her waterfront mansion. Instead,  Karen Kallen-Zury, 60, was sentenced to 25 years in prison and ordered to repay the $40 million she stole, according to the Miami Herald (paywall alert)

In response to a billion-dollar whistleblower suit that alleges Halifax Health violated federal laws prohibiting kickbacks to doctors, hospital officials say they were merely serving the public by making sure they paid enough to keep good doctors. The bonuses they paid to certain physicians were needed to ensure they would stay at the safety-net hospital, the Daytona Beach News-Journal reports.

Three of Universal Health Care's top executives -- including president and CEO Dr. A.K. Desai -- required that vendors provide the men with lucrative personal deals on the side before signing contracts, an attorney for the U.S. Bankruptcy Court trustee told the  judge at a hearing covered by the Tampa Bay Times.

Pinellas County Sheriff's Office

Rather than run separate summaries on the various misdeeds, here’s a roundup:

Florida, one of the nation's hotspots for Medicare and Medicaid fraud, is at particular risk as budget changes in Washington combine to force the layoff this year of 400 employees of the Inspector General's office at the Department of Health and Human Services.

While Roberto F. Marrero made a name for himself as an actor, federal prosecutors depict him as a con man. They say Marrero and his wife owned a home healthcare agency that bilked Medicare of $15 million.

Because the couple have family ties in Cuba and have traveled there a lot, prosecutors plan to ask a federal judge to detain the couple without bail, according to The Miami Herald.

A company started by Florida Senate President Don Gaetz, but which he later sold, is in hot water with the federal government.  In a suit filed against Chemed, the U.S. Department of Justice accused it of Medicare fraud.  Gaetz was vice chairman during part of the time in question, according to the Tampa Bay Times

Two medical supply companies, including one based in Boca Raton, may be subpoenaed to testify before Congress to explain why a review of their claims showed that two-thirds or more were improper, McClatchy Newspapers reports.

Ellen Weinstein / Broward Palm Beach New Times

Some of the Medicare fraud stories that come out of South Florida are pretty unbelievable, as the Broward Palm Beach New Times reports. There are plenty of people who exploit the Medicare system for quick, easy cash. Prosecutors are overwhelmed, and many guilty of Medicare fraud get little more than a slap on the wrist.  

 

A federal judge has sentenced Gary Kushner, a 72-year-old Plantation physician, to 12 years in prison for Medicare fraud, according to a press release from the U.S. Department of Justice. 

A jury last August found Kushner guilty after a two-month trial based on evidence that he and co-conspirators submitted $50 million in fraudulent billings through Biscayne Milieu, a Miami-based mental-health clinic. Kushner had been medical director of the clinic.

Florida Hospital repaid almost $3 million to Medicare following an audit, which the attorney for a whistleblower says is evidence their lawsuit has legs, the Orlando Sentinel reports.  The hospital says the audit was routine and that the amount repaid is far less than 1 percent of revenue, a minor matter.  

WellCare

Opening arguments were scheduled today in what could turn out to be a three-month trial for four former WellCare executives accused of defrauding state Medicaid programs and Florida KidCare, the Tampa Tribune reports. The company has already settled criminal and civil charges for breaking the law in the years leading up to an FBI raid on the Tampa headquarters in 2007.

Usually it’s the clinic owners and their minions who are sent to prison for Medicare fraud. This time, it’s three Medicare beneficiaries who accepted kickbacks for allowing a home healthcare agency to use their cards to submit fraudulent claims, the Miami Herald reports.

Miami Herald

It may seem as though it’s always health-care-fraud week in Miami, but this week’s a lollapalooza. And all the alleged crimes involved mental-health clinics.

As the Miami Herald reports, the FBI captured Kathryn Abbate, who used to run the Miami Beach Community Health Center until auditors found $6.8 million in taxpayers’ money had been siphoned off.

Nearly a decade ago Dr. Alan Freedman of Tampa reported a kickback scheme involving a Venice dermatologist and a Tampa pathology lab; now his payday has come. As the U.S. Department of Justice says in a press release, Freedman’s share of the recovery adds up to $4 million.

The dermatologist, Steven J. Wasserman, settled the case with federal authorities by agreeing to pay more than $26 million.

Medicare Fraud Focus of Raid on Eye Doctor’s Clinic

Jan 31, 2013

On top of accusations that he provided free trips and possibly underage prostitutes for Senator Bob Menendez, South Florida eye surgeon Salomon Melgen is now being investigated for Medicare fraud, the Miami Herald reports.

Orlando Sentinel

 

Lazaro Delgado, a native of Cuba. was sentenced to 10 years -- more than the guidelines -- for a $1.8 Medicare fraud, according to the Miami Herald.  Before turning to the federal health-care program, Delgado was convicted of trafficking in guns and cocaine and accused of trying to have an informant killed, not to mention mortgage fraud. In the Medicare fraud case, prosecutors said he took over two home-health agencies and used straw owners to avoid detection.

Keilan Fife and two other young adults were arrested on charges of defrauding Medicare of over $26 million by paying kickbacks and bribes to patients and others.

Two high-ranking employees who worked for a Fort Lauderdale clinic were convicted in the the country’s biggest case of Medicare fraud at a mental health facility.

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