Whistleblowers Earn Millions Turning in Medicare/Medicaid Scammers

What a coincidence!  Two stories came my way yesterday, one from Tennessee and the other from Pennsylvania, where whistleblowers filed cases against large companies they said were scamming the US taxpayers and were handsomely rewarded for their good work on our behalf.

The first story at the National Law Review is this one from Tennessee:

Tennessee-Based Health Services Company Settles FCA Case Alleging Medicaid Fraud For $9.5 Million

The Department of Justice (“DOJ”) announced another False Claims Act (“FCA”) settlement centered around a health services company’s practice of providing unnecessary therapy services to patients in order to receive the maximum amount of reimbursement under Medicare. The $9.5 million settlement is with Diversicare Health Services Inc, a Tennessee-based company that provides nursing and rehabilitation services at 74 locations throughout the country. Diversicare’s alleged violations are similar to those in a medicaid fraud case settled by the DOJ for $15.4 million two weeks earlier concerning fraudulent Medicare reimbursements for unnecessary rehabilitation services.

The settlement resolves two separate qui tam FCA lawsuits filed by whistleblowers Mary Haggard and Bryant Fitzmorris, both former Diversicare employees. Ms. Haggard will receive a whistleblower award of roughly $1.4 million, and Mr. Fitzmorris will receive $145,350. The FCA allows private citizens who possess inside information of fraudulently billing against the United States Government to initiate a lawsuit on the Government’s behalf to recover those funds. The citizens, known as qui tam relators, are then entitled to receive a share of any damages that the Government ultimately recovers from the litigation.

More details here.

Then from Whistleblower News Review (cool, a newsletter for whistleblowers) comes this story from Pennsylvania:

Guardian Elder Care Will Pay $15.4 Million to Resolve Allegations of Medicare Fraud – Whistleblowers Will Receive $2.8 Million

Guardian Elder Care Holdings Inc. and a list of related entities, including Guardian LTC Management and Guardian Rehabilitation Services (collectively, Guardian), have agreed to pay $15.4 million to settle a False Claims Act lawsuit. According to the complaint, Guardian billed government healthcare programs for medically unnecessary services. The company allegedly defrauded both Medicare and the Federal Employees Health Benefits Program.

Guardian is headquartered in PA. https://www.phillyvoice.com/guardian-elder-care-nursing-home-unnecessary-rehab-therapy-settlement/

Pennsylvania-headquartered Guardian operates over 50 nursing facilities in Pennsylvania, Ohio, and West Virginia. According to the whistleblower lawsuit filed by two rehab managers who worked at a Guardian facility in Carlisle, Guardian caused some of its facilities in all three states to bill the government for medically unnecessary services, at the highest level of Medicare reimbursement, solely to maximize profits.

The whistleblower complaint resolved by the $15.4 million settlement was filed under the False Claims Act (“FCA”). Under the FCA, whistleblowers with original information about a fraud can come forward and become eligible for an award ranging between 10 and 30 percent of any resulting recovery. The two whistleblowers in this case, Philippa Krauss and Julie White, will share a $2.8 million award.

More here.

How many more companies are ripping off US taxpayers via Medicare and Medicaid fraud?  I bet a lot.  So if you work for one and suspect fraud, check into becoming a whistleblower—it is the patriotic thing to do!

I have a bunch of posts about other successful whistleblowers, see here.


Feds Streamline Immigration Fraud Reporting Procedure

NumbersUSA alerted its members last week to a new system at the USCIS for citizens to report fraud.  Thanks to reader Michael for telling me about it.

USCIS Launches New Online Form for Reporting Fraud


U.S. Citizenship and Immigration Services has launched a new online tip form to help the public provide the agency with information about immigration fraud. The new online form, available on the USCIS public website, prompts the user for the information that the USCIS’ fraud investigators need to investigate allegations of immigration benefit fraud or abuse.

See that USCIS had previously provided e-mail addresses to report fraud, but will be phasing those out.

The new online tip form collects information related to the relevant fraud, identifies the type of benefit in question and provides space for the user to describe the alleged fraud or abuse in additional detail.

This online form streamlines fraud reporting by replacing three email boxes USCIS now uses for fraud and abuse reporting. The tip form will make the tip process more effective and efficient. Every day, well-intentioned people try to report immigration fraud or abuse to USCIS, but our USCIS’s internal procedures did not allow for a consistent and timely way to respond.

More here.

Marriage fraud, such as I reported in my previous post today, would be something you could report through this new system.  See USCIS list.

New Jersey: Woman Sentenced to Prison for Enslaving Foreign National for a Decade

The woman sentenced to nearly six years behind bars is from Jordan—another ‘new American’ who comes from a culture where this sort of treatment of people of lesser stature is accepted?

From the Philadelphia Inquirer (h/t Judy):

N.J. woman who forced Sri Lankan woman to work as nanny, housekeeper for no pay is sentenced to nearly 6 years in prison

A federal judge in Camden on Tuesday sentenced a North Jersey woman to 5 years and 10 months in federal prison for forcing a Sri Lankan woman to work as a nanny and housekeeper in her homes for almost a decade without pay.

As is often the case with stories like this, I couldn’t find a photo of the perp, but found this organization that works to expose and stop such slavery in the US. http://www.endslaverynow.org/learn/slavery-today/forced-labor

Alia Imad Faleh Al Hunaity, a.k.a. Alia Al Qaternah, 44, a naturalized U.S. citizen from Jordan, had brought the victim, a Sri Lankan national, to the United States on a temporary visa in 2009 to perform domestic work. Hunaity caused the victim to overstay her visa and remain in the United States illegally for more than nine years, federal prosecutors have said.

Hunaity, a cancer research scientist, was convicted by a federal jury in Camden in May on charges of forced labor, alien harboring for financial gain, and marriage fraud. She had forced the victim to cook and clean her homes in Woodland Park and Secaucus and to care for her three children, all without pay, prosecutors have said.

In 2018, Hunaity forced the woman — who was not identified in court — to marry her so that the woman could obtain legal residence and continue to work for her, authorities have said.

Hunaity also “forced the victim into a sham marriage” with Hunaity that brought the victim shame, Kugler said.

Hunaity, who worked in New York, has not been in custody. She was ordered to surrender at a date to be determined by the Bureau of Prisons and to pay the woman $1.2 million in restitution. In addition, the judge sentenced Hunaity to three years’ supervised release after the prison term.

There is more of the sick tale here.

You might want to check the UK Daily Mail in a day or two about this story.  It is right up their alley and they usually find good pics.

Guess I will have to make a category for ‘slavery’ here at ‘Frauds and Crooks.’

Plastic Surgeon Charged with Drugging/Raping Women on Camera

I don’t know if you can call him an Ohio man (or a Michigan man either), looks like another ‘New American’ doctor taking advantage of women and America!

This sicko is in big trouble!  Complaint filed with the medical board said he “had been drugging and raping women for years.”

Is he one of those immigrant entrepreneurs that Michael Bloomberg’s New American Economy is always raving about?

Here (below) is the sanitized Fox News version of the story involving Dr. Manish Gupta and the charges against him. (I am assuming he is of Indian origin.)

And if you want the R-rated story (this comes with a warning) see it at ClickonDetroit.


From Fox News:

Ohio plastic surgeon charged with drugging, raping women on camera

A plastic surgeon primarily based in Ohio was arrested Friday by the FBI for allegedly drugging multiple women to the point of unconsciousness and raping them on camera.

Dr. Manish Gupta, 49, is charged with illegally dispensing controlled substances, aggravated sexual abuse and sex trafficking, Toledo’s WTVG reported. He was booked into Lucas County Corrections Center in Toledo Friday afternoon after a federal search warrant on his phone, residence, personal vehicle and two offices in Lucas County uncovered sex toys, camera equipment, SD cards and vials of Diazepam and Ketamine, which are controlled substances not used in his medical practice, according to WTVG.

While visiting Los Angeles in 2016 to attend a plastic surgery convention, Gupta allegedly arranged for sex with a high-end escort, drugged her to the point of unconsciousness and raped her, according to a court filing in the U.S. District Court in Toledo.

The woman did not file a police report at the time. She took an at-home drug test that showed she had signs of benzodiazepine, a type of medication known as a tranquilizer, in her system, Toledo’s WTOL reported, citing the court filing. She later visited the Rape Treatment Center at the UCLA Medical Center, Santa Monica, where she had a rape kit exam performed, WTVG reported.

The woman researched Gupta in an online database used by sex workers to make others aware of possibly dangerous individuals, according to the filing. She said she found multiple other women had reported a man either matching Gupta’s name or description, claiming he drugged, raped and possibly recorded them without their consent, WTOL reported.

Gupta is a board-certified plastic surgeon and medical doctor licensed in both Ohio and Michigan. He owns Artisan Cosmetic Surgery, which has two offices in Ohio and one in Michigan, WTVG reported.

The FBI launched an investigation into the claims against Gupta in January 2019. The investigation revealed that in 2014, an employee working for Gupta found multiple SDs with videos showing the plastic surgeon performing sex acts on motionless women who appeared to be unconscious. In February of this year, the State of Ohio Medical Board received a complaint claiming Gupta had been drugging and raping women for years.

BTW, I found a photo on line of Gupta and his female staffers although his social media accounts have been removed from on-line.  I was going to post the photo, but chose not to because when you read more about the case you will see that some of his staff participated in bringing him to justice. I wouldn’t want there to be any reprisals against them.

Lewiston, ME: The Back Story on the Election of a CAIR-candidate for City Council

I have dozens and dozens of posts at Refugee Resettlement Watch about the transformation of Lewiston, Maine that has occurred over a few decades as Somali refugees have ‘found their way’ to the Maine city.

MN Rep. Ilhan Omar congratulates newly elected Safiya Khalid. I told readers at RRW about CAIR crowing over her victory here: https://refugeeresettlementwatch.org/2019/11/08/cair-crows-muslims-are-winning-big-in-local-elections/

I also have a couple of posts there that mention Safiya Khalid who won a seat on the Lewiston city council last fall to cheers from the Council on American Islamic Relations.

But, I missed the back story on how the twenty-something Somali won that seat as the darling of the local Democrat party, that is until I had an e-mail from a resident of the city who told me this horrifying tale.

This could happen to your town too!

Here is a bit of the e-mail to me from Mainer Maura Murphy:

As a resident of Lewiston, Maine who lived abroad for almost 30 years then came back to my hometown, I was horrified to see the decline and degradation. Part of it was post-industrial malaise and consequent multi-generational poverty for sure; part of it was the thriving drug trade started by dealers from other states who found central Maine’s drug capital to be an easy place to do what they could no longer get away with to the same degree in NY, MA, PA, D.C., etc.; and part of it was the abysmal way the addition of thousands of refugees and asylum seekers has been handled.

After returning to Lewiston several years ago, I was shocked to hear firsthand account after firsthand account of violence, theft, destruction of property, etc. committed by roving gangs of immigrant boys, gang bullying episodes–swept under the carpet by administrations–in all pubic schools to the point that parents have taken their kids out of schools, and much more.

I would not have believed it had I not heard directly from people who had experienced these episodes, including teacher friends who *quit* due to the double standard of permissiveness for immigrant students and other friends who have had rocks or chunks of ice thrown at their cars when driving through downtown.

See my most recent post on the killing of Donald Giusti. African Emmanuel Nkurunziza charged in his death. https://fraudscrookscriminals.com/2020/03/04/african-teen-charged-in-death-of-maine-man-wants-special-favors/

Donald Guisti’s murder by a gang of refugee/asylum seeker youth–and the unbelievable way the investigation was mishandled–was not only the culmination of simmering violence committed by immigrants, but opened the way for a new wave of immigrant entitlement and bitter resentment of the community they supposedly came to to escape the brutality of their home countries.

You may have read about a Somali immigrant, Safiya Khalid, running for city council in Lewiston? While numerous media reports celebrated her victory, they declined to mention that her campaign had ruthlessly bullied her opponent under cover of darkness at his own home, in an effort to intimidate him into withdrawing from the race.

Even though there are *audio tapes* of the harassment, Khalid’s campaign *got away with it*, thanks to extensive media manipulation and a smear campaign to try to transform outcry against the bullying into an act of “racism”.

The bullies, and Safiya herself, were and still are the top officers of the Lewiston Democratic Party, as well as local elected officials. When I found out about this bullying, my first action was to ask the victim–who was then in the hospital–if it was true. He told me it was, and gave me the recordings. When I raised the alarm to my fellow local Democrats and Khalid herself–giving them the benefit of the doubt that they didn’t know–they personally attacked *me* for telling them. This is when I knew there was a wider campaign to be sure Khalid was elected at any cost, and a friend and I did our own investigation.

I wrote the article below initially to let people know that Walter “Ed” Hill was indeed running for Ward One Representative, and to alert them to what had happened.

From Medium.com:

“I Was Afraid They Were Going to Break Down My Door.” (Walter Hill)

On the evening of August 28th, 2019, longtime community volunteer and public servant Walter Hill made his way back to his suburban Lewiston home after having had hip surgery. A few blocks away from his house, he noted the familiar figures of Lewiston Democratic Party Chair, Kiernan Majerus-Collins, and his opponent in the upcoming election for Ward One City Council, Safiya Khalid, who served as party Vice Chair. Because Hill’s close-knit neighborhood was isolated — not a place where people usually spent time unless they lived there — their frequent presence canvassing there had been noticeable for some time.


Members of the Lewiston Democratic Party: Alicia Rea, Christopher Hodgkins, Owen Cardwell-Copenhefer, Jared Golden, Kiernan Majerus-Collins, Safiya Khalid and Jim Lysen


As much as Hill was looking forward to campaigning himself, he was completely spent from his medical procedure, and just wanted to get back to the place he had called home for more than 25 years. “I really wanted to get out there and let people know I was running and have conversations about Lewiston, but I literally couldn’t move,” said Hill. “The timing just couldn’t have been worse.”

As a new wave of pain swept over Hill upon arrival at home, he took his medication, settled in as comfortably as possible on the couch and fell asleep. About 20 minutes after returning, he was jolted out of a deep sleep by the sound of pounding at his door. It got louder. He realized there was more than one person on his property. The banging and kicking got louder, and was coming from multiple directions. Both doorbells were ringing. Under cover of darkness, Hill’s house had been surrounded and was being relentlessly pummeled.

From his position on the couch and in a daze, Hill recognized the voices of two people, both officials in the Democratic Party holding multiple local and county leadership positions, Kiernan Majerus-Collins and Owen Cardwell-Copenhefer.

Go read it all!  See what happens next and consider that this is happening in America!

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