Wednesday, May 18, 2011

MEDICAL DEVICE COMPANY OWNER GETS PRISON TIME FOR MEDICARE FRAUD

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.

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.”

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."

Thursday, May 12, 2011

REFUSE COMPANY PRESIDENT IN ILLIONOIS SENTENCED FOR MAIL AND WIRE FRAUD

Everyone in America knows that local governments and private contractors conspire to steal from the people on a regular basis. We all know it but seldom do these crimes see the light of day. The following case which is quoted from the Department of Justice web site shows in a very concrete way how such crimes are committed:

“WASHINGTON — A former president of an Illinois refuse disposal container repair company was sentenced today for his role in a conspiracy to commit mail and wire fraud in connection with bids on a contract for the repair of refuse carts for the city of Chicago, the Department of Justice announced today.
Douglas E. Ritter, an Illinois resident, was sentenced by U.S. District Court Judge Ruben Castillo to serve 16 months in prison and to pay $35,303 in restitution for his participation in a conspiracy to defraud the city of Chicago on a contract for the repair of refuse carts from as early as November 2004 to as late as September 2008. Ritter, along with his business partner Steven Fenzl, was charged in an indictment filed on April 21, 2009, in U.S. District Court in Chicago. Ritter pleaded guilty to the conspiracy on June 3, 2010. Fenzl, a California resident, was found guilty by a jury on Sept. 28, 2010, of one count of conspiracy to commit mail and wire fraud, two counts of mail fraud and one count of wire fraud. Fenzl is scheduled to be sentenced on June 15, 2011.
According to the indictment, Ritter, Fenzl and their co-conspirator conspired to deceive city of Chicago officials about the number of legitimate, competitive bids submitted for the contract. Specifically, Ritter and his co-conspirators fraudulently induced other companies to submit bids for the contract at prices determined by Ritter and his co-conspirators and greater than the price for which Ritter's company had submitted a bid. The department said that included in these bids were fraudulent documents indicating that, if awarded the contract, the bidder would enter into subcontracts to purchase goods or services for a specified percentage of the contract from a minority-owned business and a women-owned business, as required by the city of Chicago. According to the indictment, Ritter and his co-conspirators also fraudulently certified to the city on Ritter's company's bid that it had not entered an agreement with any other bidder relating to the price named in any other bid submitted to the city for the contract.
Today's sentencing resulted from an ongoing investigation of the refuse cart repair industry being conducted by the Antitrust Division's Chicago Field Office and the city of Chicago's Office of Inspector General.”

Anyone who believes that contracting out public services to private companies leads to free enterprise capitalism full of integrity and a devotion to looking out for the greater good, is not quite right in the head. Business is all about maximizing the profit of the individual no matter what he/she has to do or who he/she has to steal from. I was told when I was a young naive manager at a large retailer that in the world of business there is only one thing to know and that is "Everyone steals if they think they can get away with it".

Sunday, May 8, 2011

DRUGS AND KICKBACKS: BIG PHARMA COMPANY GETS CAUGHT

The Securities and Exchange Commission has a giant pharmaceutical company with bribing doctors in Europe and paying kickbacks to Iraq. There was a lot of cooperation between various governments and agencies.  The following is an excerpt  from the SEC web site:


“Washington, D.C., April 7, 2011
The SEC alleges that since at least 1998, subsidiaries of the New Brunswick, N.J.-based pharmaceutical, consumer product, and medical device company paid bribes to public doctors in Greece who selected J&J surgical implants, public doctors and hospital administrators in Poland who awarded contracts to J&J, and public doctors in Romania to prescribe J&J pharmaceutical products. J&J subsidiaries also paid kickbacks to Iraq to obtain 19 contracts under the United Nations Oil for Food Program.
J&J agreed to settle the SEC’s charges by paying more than $48.6 million in disgorgement and prejudgment interest. J&J also agreed to pay a $21.4 million fine to settle parallel criminal charges announced by the U.S. Department of Justice (DOJ) today. A resolution of a related investigation by the United Kingdom Serious Fraud Office is anticipated.
“The message in this and the SEC’s other FCPA cases is plain – any competitive advantage gained through corruption is a mirage,” said Robert Khuzami, Director of the SEC's Division of Enforcement. “J&J chose profit margins over compliance with the law by acquiring a private company for the purpose of paying bribes, and using sham contracts, off-shore companies, and slush funds to cover its tracks.”
Cheryl J. Scarboro, Chief of the SEC Enforcement Division’s Foreign Corrupt Practices Act Unit, added, “Bribes to public doctors can have a detrimental effect on the public health care systems that potentially pay more for products procured through greed and corruption.”
According to the SEC’s complaint filed in federal court in the District of Columbia, public doctors and administrators in Greece, Poland, and Romania who ordered or prescribed J&J products were rewarded in a variety of ways, including with cash and inappropriate travel. J&J subsidiaries, employees and agents used slush funds, sham civil contracts with doctors, and off-shore companies in the Isle of Man to carry out the bribery.
Without admitting or denying the SEC’s allegations, J&J has consented to the entry of a court order permanently enjoining it from future violations of Sections 30A, 13(b)(2)(A), and 13(b)(2)(B) of the Securities Exchange Act of 1934; ordering it to pay $38,227,826 in disgorgement and $10,438,490 in prejudgment interest; and ordering it to comply with certain undertakings regarding its FCPA compliance program. J&J voluntarily disclosed some of the violations by its employees and conducted a thorough internal investigation to determine the scope of the bribery and other violations, including proactive investigations in more than a dozen countries by both its internal auditors and outside counsel. J&J’s internal investigation and its ongoing compliance programs were essential in gathering facts regarding the full extent of J&J’s FCPA violations.
. The SEC acknowledges the assistance of the U.S. Department of Justice, Fraud Section; Federal Bureau of Investigation; Serious Fraud Office in the United Kingdom; and 5th Investigation Department of the Regional Prosecutor’s Office in Radom, Poland. The SEC's investigation is continuing.”

In this case the company cooperated in the investigation.   The defence in this case sounds like the "Enron Defence":  Blame lower level employees to save the top executives.   Of course in this case shareholders also loose out in taking a hit from both fines and ruining the reputation of the company.       
– The Securities and Exchange Commission today charged Johnson and Johnson (J&J) with violating the Foreign Corrupt Practices Act (FCPA) by bribing public doctors in several European countries and paying kickbacks to Iraq to illegally obtain business.

Sunday, May 1, 2011

TO GASOLINE FRAUDSTERS: THE GOVERNMENT WILL BE WATCHING YOU!

President Obama has said that speculation is one reason the price of oil is rising.   In the following   excerpt  from the Department of Justice Web site, The U.S. Attorney General indicates that he has a plan to fight fraud and price manipulation of the commodities of gasoline and oil:

" The following post appears courtesy of Attorney General Eric Holder
Over the past few years, American businesses and families across the country have suffered the effects of the worst financial crisis in generations. Today, although our economic recovery is gaining steam, it remains critically important that we continue to use every available tool and resource to safeguard consumers against additional – and unnecessary – financial burdens.
For many, rapidly rising gasoline prices pose a serious concern. And while some factors – like regional variations and other lawful reasons for increased prices – may be beyond our control, it is imperative that we take action to identify and address potential cases of fraud and manipulation that may harm families and businesses.
Yesterday, I announced the formation of an Oil and Gas Price Fraud Working Group to help identify civil or criminal violations in the oil and gasoline markets, and to ensure that American consumers are not harmed by unlawful conduct. Since last month, at President Obama’s request, I have been directing efforts to increase cooperation between the Department of Justice and other groups with relevant authority, including federal agencies and state attorneys general. I am proud to say that this Working Group will enable us to formalize these partnerships, share monitoring information, and exchange ideas about what works – and what doesn’t work – at the state and federal level.
It will foster increased cooperation between investigators and government officials, so we can vigorously enforce state and federal laws against collusion, manipulation and other forms of wrongdoing. It will also allow us to evaluate significant market developments, including the activities of speculators and index traders, so we can anticipate and aggressively pursue cases of suspected illegal activity.
We’ve already proven that this kind of approach can be effective. Our new Working Group will report to me through the Financial Fraud Enforcement Task Force (FFETF), a partnership formed in late 2009 between agencies, regulators, state attorneys general, and local law enforcement organizations, which has already brought a powerful array of tools to the fight against financial fraud. By building on this work, the Justice Department and its partners can help promote a competitive and fraud-free marketplace – and can do so both efficiently and effectively.
As we work to determine if any laws have been violated and, if so, to swiftly bring those wrongdoers to justice, I am confident that the new Oil and Gas Price Fraud Working Group will help protect American consumers from unnecessary pain at the pump due to illegal activity. My colleagues and I at the Justice Department and across the administration are committed to stopping criminals who would take advantage of others for personal gain."

It sounds like the Attorney General is doing something positive that might ferret out some really bad and illegal behaviors conducted by speculators and energy businessmen.
 

Saturday, April 30, 2011

WHITE HOUSE E-MAIL ON REDUCING OIL PRICES

The following is an e-mail sent out by the White House on April 29, 2011.  In it the White House outlined some steps being taken to end fraud, subsidies and energy dependence on foreign sources.  It is a short read and an excerpt from a longer e-mail which included a video:    

"A few weeks ago, I emailed you about rising gas prices, and I want to give you a quick update on three important steps:
  • Ending oil and gas subsidies. Oil companies are receiving $4 billion a year in taxpayer subsidies that don't make sense and that we can't afford. That's why President Obama has called on Democrats and Republicans in Congress to stop subsidizing the oil and gas industry so that we can afford to invest in the clean energy economy of tomorrow.
  • Stopping oil market fraud. Last week, Attorney General Eric Holder announced a working group focused on rooting out the cases of fraud in the oil markets that might affect gas prices (the President discussed this in his Weekly Address last Saturday).
  • Reducing our dependence on oil. Stepping back to look at the bigger picture, President Obama recently unveiled his Blueprint for a Secure Energy Future that set a goal of reducing our imports of foreign oil by a third in a little over a decade. To do this we have to increase our domestic energy production, reduce our demand for oil by building cleaner, more efficient vehicles, and fully utilize alternatives to oil in the transportation sector like natural gas and advanced biofuels.
These are difficult issues to tackle, and it's going to take all of us working together to move forward. For years, politicians in Washington have kicked this problem down the road, but we simply cannot afford the price of inaction any longer.
Sincerely,
David Plouffe
Senior Advisor to the President"