The rising costs of medial procedures are not helped when health care providers file fraudulent claims with either private insurers or government entities like Medicare. In the case below the owner of medical equipment company was sentenced to do some serious prison time. The following excerpt is from the
Department of Justice web site:
“Wednesday, May 18, 2011
Houston Medical Equipment Company Owner Sentenced to 84 Months in Prison for Health Care Fraud Scheme Involving More Than $2 Million in False Billings
WASHINGTON – The owner of a Houston-area durable medical equipment (DME) company was sentenced to 84 months in prison for her role in a Medicare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced.
Doris Vinitski, a Houston-area resident, was sentenced yesterday by U.S. District Court Judge Nancy F. Atlas in the Southern District of Texas. Vinitski pleaded guilty in April 2010 to one count of conspiracy to commit health care fraud.
According to court documents, Vinitski, 46, was the owner of Onward Medical Supply, a Houston-area DME company. Onward began billing Medicare for fraudulent DME in 2003. In pleading guilty, Vinitski admitted she paid kickbacks, sometimes $1,000 per patient, to recruiters who brought patients to Onward. Vinitski and her co-conspirator and estranged husband, John Lachman, then billed Medicare for DME that these patients either did not need or never received, including power wheelchairs and orthotic devices. Lachman also pleaded guilty in April 2010 to one count of conspiracy to commit health care fraud and was sentenced to 26 months in prison. According to court documents, the fraud scheme at Onward resulted in more than $2 million in fraudulent billing to Medicare.
Nine additional defendants involved in the Onward fraud scheme are currently serving prison sentences. One remaining defendant is awaiting sentencing in the Eastern District of Texas.
The sentence was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney José Angel Moreno of the Southern District of Texas; Russell D. Robinson, Acting Special Agent-in-Charge of the FBI’s Houston Office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of the HHS Office of Inspector General (OIG), Office of Investigations; and Texas Attorney General Greg Abbott on behalf of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).
The cases were prosecuted by Trial Attorney Jennifer L. Saulino and Acting Assistant Chief O. Benton Curtis III of the Criminal Division’s Fraud Section. The cases were investigated by the FBI, HHS-OIG and MFCU.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section. Since March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,000 defendants who collectively have billed the Medicare program for more than $2.3 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG are taking steps to increase accountability and decrease the presence of fraudulent providers.”
Recruiting people to commit Medicare fraud seems beyond belief. What is also hard to believe is that more than 1,000 people have been charged with Medicare or Medicade fraud.
Wednesday, May 18, 2011
Monday, May 16, 2011
JUDGE FINDS FRAUD IN SECURITIES CASE
The following is an excerpt from the SEC Web site:
" Securities and Exchange Commission v. North American Clearing, Inc., et al., Civil Action No. 06-08-cv-829-Orl-35KRS (M.D. Fla.)
On April 27, 2011, Judge Mary Scriven found Richard L. Goble liable for committing fraud and aiding and abetting his clearing firm’s violations of the Customer Protection Rule and books and records provisions of the Securities Exchange Act of 1934 in SEC v. North American Clearing, Inc., et al., Case No. 6:08-cv-829-Orl-35KRS (M.D. Fla., May 28, 2008). North American Clearing, Inc., was a broker-dealer that acted as the clearing firm for approximately 40 correspondent firms and more than 10,000 customer accounts. Goble, a former FINRA board member, was the founder, sole owner, and a director of North American.
Following a five-day bench trial, the judge found “it clear from the evidence of record, that North American had financial problems and Defendant Goble and North American’s executives made a substantial effort to conceal it.” Specifically, the judge found Goble acted with the “highest degree of scienter” in directing North American to falsely record a $5 million money market purchase, which artificially lowered the firm’s reserve requirement under the Customer Protection Rule and allowed North American to improperly withdraw more than $3 million from its Exclusive Benefit of Customers (EBOC) Account. The Court further found this “sham” transaction constituted fraud on the market.
As a result, the Court permanently enjoined Goble from violating Sections 10(b), 15(c)(3), and 17(a) of the Exchange Act and Rules 10b-5, 15c3-3, and 17a-3 thereunder. Additionally, on its own initiative, the Court enjoined Goble from attempting to secure any securities licenses or otherwise attempting to engage in the securities business. The Court also ordered him to pay a reduced civil penalty amount of $7,500 based, in part, on her consideration that Goble’s firm had been liquidated in a Securities Investor Protection Corporation bankruptcy proceeding.
The Commission commenced this action by filing its complaint on May 27, 2008, against North American Clearing, Inc., Goble, its president Bruce Blatman and its former financial and operations principal Timothy Ward. The other defendants previously settled the Commission’s charges against them by consenting, without admitting or denying the Commission’s allegations, to permanent injunctions. Pursuant to his
settlement, the Court previously ordered Blatman to pay a civil penalty. A civil penalty amount against Ward is still to be decided.”
" Securities and Exchange Commission v. North American Clearing, Inc., et al., Civil Action No. 06-08-cv-829-Orl-35KRS (M.D. Fla.)
On April 27, 2011, Judge Mary Scriven found Richard L. Goble liable for committing fraud and aiding and abetting his clearing firm’s violations of the Customer Protection Rule and books and records provisions of the Securities Exchange Act of 1934 in SEC v. North American Clearing, Inc., et al., Case No. 6:08-cv-829-Orl-35KRS (M.D. Fla., May 28, 2008). North American Clearing, Inc., was a broker-dealer that acted as the clearing firm for approximately 40 correspondent firms and more than 10,000 customer accounts. Goble, a former FINRA board member, was the founder, sole owner, and a director of North American.
Following a five-day bench trial, the judge found “it clear from the evidence of record, that North American had financial problems and Defendant Goble and North American’s executives made a substantial effort to conceal it.” Specifically, the judge found Goble acted with the “highest degree of scienter” in directing North American to falsely record a $5 million money market purchase, which artificially lowered the firm’s reserve requirement under the Customer Protection Rule and allowed North American to improperly withdraw more than $3 million from its Exclusive Benefit of Customers (EBOC) Account. The Court further found this “sham” transaction constituted fraud on the market.
As a result, the Court permanently enjoined Goble from violating Sections 10(b), 15(c)(3), and 17(a) of the Exchange Act and Rules 10b-5, 15c3-3, and 17a-3 thereunder. Additionally, on its own initiative, the Court enjoined Goble from attempting to secure any securities licenses or otherwise attempting to engage in the securities business. The Court also ordered him to pay a reduced civil penalty amount of $7,500 based, in part, on her consideration that Goble’s firm had been liquidated in a Securities Investor Protection Corporation bankruptcy proceeding.
The Commission commenced this action by filing its complaint on May 27, 2008, against North American Clearing, Inc., Goble, its president Bruce Blatman and its former financial and operations principal Timothy Ward. The other defendants previously settled the Commission’s charges against them by consenting, without admitting or denying the Commission’s allegations, to permanent injunctions. Pursuant to his
settlement, the Court previously ordered Blatman to pay a civil penalty. A civil penalty amount against Ward is still to be decided.”
Sunday, May 15, 2011
FORMER AIR FRANCE EXECUTIVES INDICTED FOR CONSPIRACY
Price fixing is an activity that undermines a free and fair economy. The following case involves price fixing in the air cargo business. The following is from the Department of Justice web site:
" WASHINGTON — A Chicago grand jury returned an indictment today against two former executives of Paris-based Société Air France (Air France), for participating in a conspiracy to fix and coordinate surcharges on air cargo shipments to and from the United States and elsewhere and air cargo service rates to certain locations in the United States and elsewhere, the Department of Justice announced today. The indictment further alleges that the former executives along with co-conspirators also agreed to refuse to pay their customers commissions on surcharges for air cargo shipments to and from the United States and elsewhere.
The indictment, returned today in U.S. District Court in Chicago, charges Marc Boudier, former executive vice president of the cargo division of Air France, and Jean Charles Foucault, former vice president of the cargo division of sales and marketing of Air France, with conspiring with other air cargo carriers and their officials to suppress and restrain competition for international air cargo services. The department said that Boudier and Foucault carried out a conspiracy by fixing and coordinatingrates on air cargo shipments to certain U.S. locations and elsewhere and surcharges on air cargo shipments to and from the United States and elsewhere, and refusing to pay their customers commissions on surcharges for air cargo shipments to and from the United States and elsewhere. According to the indictment, Boudier and Foucault participated in the conspiracy from at least as early as August 2004 until at least February 2006.
Air cargo carriers transport a variety of cargo shipments, such as heavy equipment, perishable commodities and consumer goods, on scheduled international flights.
According to the indictment, Boudier, Foucault and co-conspirators carried out the conspiracy by participating in or directing the participation of subordinate employees in meetings, conversations and communications to discuss rates for air cargo shipments to certain U.S. locations and elsewhere and surcharges for air cargo shipments to and from the United States and elsewhere. The department said, in accordance with the agreement and understanding reached by Boudier, Foucault and co-conspirators, they issued announcements of increases on surcharges and rates.
Boudier and Foucault are charged with price fixing in violation of the Sherman Act, which carries a maximum penalty of 10 years in prison and a $1 million fine for individuals. The maximum fine may be increased to twice the gain derived from the crime or twice the loss suffered by the victims of the crime, if either of those amounts is greater than the statutory maximum fine.
A total of 21 airlines and 21 executives, including Boudier and Foucault, have been charged in the Justice Department’s ongoing investigation into price fixing in the air transportation industry. To date, more than $1.8 billion in criminal fines have been imposed and four executives have been sentenced to serve prison time. Charges are pending against the remaining 17 executives, including Boudier and Foucault.
Today’s charge is the result of a joint investigation into the air transportation industry being conducted by the Antitrust Division’s National Criminal Enforcement Section and Cleveland Field Office, the FBI’s Atlanta and Washington Field Offices, the Department of Transportation’s Office of Inspector General and the U.S. Postal Service’s Office of Inspector General."
" WASHINGTON — A Chicago grand jury returned an indictment today against two former executives of Paris-based Société Air France (Air France), for participating in a conspiracy to fix and coordinate surcharges on air cargo shipments to and from the United States and elsewhere and air cargo service rates to certain locations in the United States and elsewhere, the Department of Justice announced today. The indictment further alleges that the former executives along with co-conspirators also agreed to refuse to pay their customers commissions on surcharges for air cargo shipments to and from the United States and elsewhere.
The indictment, returned today in U.S. District Court in Chicago, charges Marc Boudier, former executive vice president of the cargo division of Air France, and Jean Charles Foucault, former vice president of the cargo division of sales and marketing of Air France, with conspiring with other air cargo carriers and their officials to suppress and restrain competition for international air cargo services. The department said that Boudier and Foucault carried out a conspiracy by fixing and coordinatingrates on air cargo shipments to certain U.S. locations and elsewhere and surcharges on air cargo shipments to and from the United States and elsewhere, and refusing to pay their customers commissions on surcharges for air cargo shipments to and from the United States and elsewhere. According to the indictment, Boudier and Foucault participated in the conspiracy from at least as early as August 2004 until at least February 2006.
Air cargo carriers transport a variety of cargo shipments, such as heavy equipment, perishable commodities and consumer goods, on scheduled international flights.
According to the indictment, Boudier, Foucault and co-conspirators carried out the conspiracy by participating in or directing the participation of subordinate employees in meetings, conversations and communications to discuss rates for air cargo shipments to certain U.S. locations and elsewhere and surcharges for air cargo shipments to and from the United States and elsewhere. The department said, in accordance with the agreement and understanding reached by Boudier, Foucault and co-conspirators, they issued announcements of increases on surcharges and rates.
Boudier and Foucault are charged with price fixing in violation of the Sherman Act, which carries a maximum penalty of 10 years in prison and a $1 million fine for individuals. The maximum fine may be increased to twice the gain derived from the crime or twice the loss suffered by the victims of the crime, if either of those amounts is greater than the statutory maximum fine.
A total of 21 airlines and 21 executives, including Boudier and Foucault, have been charged in the Justice Department’s ongoing investigation into price fixing in the air transportation industry. To date, more than $1.8 billion in criminal fines have been imposed and four executives have been sentenced to serve prison time. Charges are pending against the remaining 17 executives, including Boudier and Foucault.
Today’s charge is the result of a joint investigation into the air transportation industry being conducted by the Antitrust Division’s National Criminal Enforcement Section and Cleveland Field Office, the FBI’s Atlanta and Washington Field Offices, the Department of Transportation’s Office of Inspector General and the U.S. Postal Service’s Office of Inspector General."
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