Category: Medicare fraud

Michigan Doc Doing 45 Years Wants Out of Prison Due to COVID Fears

~ Ann Corcoran ~ 1 Comment
Farid Fata, 55

Lebanese doctor Farid Fata wants a “compassionate” release from prison because his health is so poor, he says, he might catch the Chinese virus and die in the slammer.  With a 45 year sentence that is likely anyway, COVID or no COVID.

I mentioned Fata last September in a list of Michigan docs involved in pushing opiods, but he was given that long sentence because his crimes were much worse. Even worse than bilking Medicare.

 

Michigan: See List of Docs Illegally Pushing Opiods

From the Macomb Daily:

Farid Fata seeks ‘compassionate’ release due to potential for contracting coronavirus

Former cancer doctor Farid Fata, imprisoned for illicit treatment of patients, is seeking release from his 45-year term due to “deteriorating health” and the likelihood he will contract COVID-19.

Fata, 55, of Oakland Township, claims he suffers from several medical issues and is susceptible to contracting and dying from the coronavirus, which has spread through the federal prison system,according to document filed Tuesday in U.S. District Court in Detroit.

“With Fata’s medical conditions and age, contracting COVID-19 could very well prove fatal,” his attorney, Jeremy Gordon, says in a 13-page legal brief accompanied by exhibits submitted to Judge Paul Borman.

[….]

Gordon notes there have been at least 40 deaths of inmates in federal prisons nationwide due to the coronavirus pandemic, and nearly 2,000 inmates and 356 Bureau of Prisons staff have tested positive for the virus.

He says several inmates have been granted “compassionate release” due to the coronavirus, including many in the past week alone.

Fata’s request prompted a disgusted response from attorney Brian McKeen, who represented dozens of victims in a malpractice lawsuit against Fata.

 

“What a joke,” McKeen said. “The man got what he deserved. He had no compassion for the lives of his patients. He caused unspeakable suffering and pain, and deserves to be where he is for the rest of his life. People went through living hell because of Dr. Fata.”

[….]

He made millions of dollars providing 2,770 unnecessary chemotherapy treatments to 100 patients; in all, there were more than 550 victims from throughout Southeast Michigan. Advocates for some deceased patients say Fata was responsible for their demise, and many patients suffered various ailments due to unnecessary treatment, such as organ damage, lost teeth, nerve damage and lost bone in sinus cavities.

Fata was ordered to pay $26.5 million in restitution to individuals, health insurance companies and federal agencies.

Much more here.

Whistleblowers Earn Millions Turning in Medicare/Medicaid Scammers

~ Ann Corcoran ~ 1 Comment

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.

 

Florida: Another ‘New American’ Doctor Charged, Rips US Off for Millions!

~ Ann Corcoran ~ 1 Comment

Some of the headlines call Moses deGraft-Johnson a “Tallahassee doctor,” but African media doesn’t pull punches and refers to him as a “Ghanaian doctor.”

This foreign doctor sure didn’t benefit the US economy as Michael Bloomberg’s New American Economy trumpets about immigrants we ‘welcome’ to America.

From WCTV:

Tallahassee doctor indicted for more than $23M in healthcare fraud

TALLAHASSEE, Fla. (WCTV) — A federal grand jury has indicted a Tallahassee doctor, accusing him of more than $23 million in healthcare fraud.

According to court documents, Moses deGraft-Johnson owned and operated the Heart and Vascular Institute of North Florida since September 2015. Kimberly Austin – his office manager – was also indicted.

Duel citizen Moses deGraft-Johnson benefited the US economy! NOT!

Federal prosecutors said in court Friday afternoon they believe there were more than 3,600 surgeries billed over the last five years, with 85 to 90% of them being fraudulent.

The 58 count indictment, which was unsealed Thursday, alleges deGraft-Johnson defrauded Medicare and Medicaid by billing them for dozens of procedures that he never performed.

A detailed list shows each of the claims was for more than $21,000. Federal prosecutors said in court that the amount of money that was improperly billed reached $23 million.

A later motion alleges deGraft-Johnson’s calendar showed he performed 14 surgeries in one day.

[….]

The indictment contends deGraft-Johnson wasn’t even in the United States on some of those days, but rather was traveling to Madrid, London and other cities in Ghana and China.

[….]

Culture of corruption? Since we have had so many fraud and crime stories perpetrated by Nigerians, I figured I would use this map to show you where both Ghana and Nigeria are located.

Federal prosecutors requested in court Friday that deGraft-Johnson be detained until his trial, saying the doctor poses a “serious risk of flight.”

Prosecutors contend deGraft-Johnson is a naturalized U.S. citizen born in Ghana. They say he has “the motive, the means and the opportunity to flee from the United States to Ghana.”

According to prosecutors, he has two passports, both showing that he has dual citizenship for the United States and Ghana.

Unlimited hubris!

Prosecutors also contend that deGraft-Johnson has stated his ultimate long-term professional goal is “to be the President of Ghana.”

[….]

Court documents indicate deGraft-Johnson deposited more than $32 million in health care funds into his bank account between November 2015 and August 2019. Prosecutors say that the majority of funds were transferred to other accounts.

[….]

At one point, deGraft-Johnson told federal agents he had no cash that was not in a bank, but agents found $40,000 cash at one of his residences.

“This suggests that there may be other cash hoards in any of Defendant’s five other residences,” prosecutors wrote.

The doctor’s other residences are located in Miami, Manhattan, Hampton and Texas, prosecutors said in court.

Prosecutors also detailed lavish spending, including millions spent on Tiffany and Cartier jewelry, two Mercedes, and the recent leases of a Ferrari and a Lamborghini.

There is much more!

The President is missing an opportunity!

Honestly, I think Trump is making a big mistake not highlighting some of the major Medicare and Medicaid fraud prosecutions his administration is undertaking.

At every rally he should tell a story or two about how they caught some big crooks stealing from middle class Americans!

To be fair and balanced he could throw in a few American fraudsters along with the ‘new American’ ones!

Florida? Texas? Michigan? California? Which state has the most fraudulent medical practitioners?

 

Detroit Area ‘New American’ Doctors Guilty in $150 Million Rip-off of Medicare Program

~ Ann Corcoran ~ 5 Comments

Is the word out all over the world for foreign docs to head to the Detroit area and set up scams to rip-off American taxpayers? It seems that way considering the number of cases of fraud I’ve reported from Michigan.

See this post about Opiod pushing docs in Michigan because they aren’t just ripping us off financially, but hurting Americans as well.

Here is the latest from ClickonDetroit.com:

Metro Detroit physicians found guilty of defrauding Medicare, prescribing unnecessary opioids

Four Metro Detroit physicians were found guilty of health care fraud for their roles in a scheme to administer unnecessary back injections to patients in exchange for prescriptions of medically unnecessary opioids.

The doctors all worked for Tri-County Group owned by co-conspirator Mashiyat Rashid. https://www.justice.gov/opa/pr/health-care-ceo-pleads-guilty-150-million-health-care-fraud-scheme-involving-harmful

Officials said patients were required to get the injections in order to get the prescriptions. Some of the opioids were resold by drug dealers.

Spilios Pappas, 62, of Lucas County, Ohio, Joseph Betro, 59, of Oakland County, Michigan, Tariq Omar, 62, of Oakland County, Michigan, and Mohammed Zahoor, 53, of Oakland County, Michigan, were each found guilty of one count of conspiracy to commit health care fraud and wire fraud, and one count of health care fraud.

“These physicians subjected patients to medically unnecessary injections to reap millions in fraudulent billings. Worse still, they incentivized those treatments by offering opioid prescriptions in sky-high dosages meant for the terminally ill,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “Today’s verdict shows that the Department will root out physicians who let dollar signs rather than medical need drive their treatment of patients.”

Evidence at trial showed that from 2008 to 2016 Pappas, Betro, Omar and Zahoor worked at numerous medical clinics in Michigan and Ohio, which were operated under the name of the Tri-County Group (Tri-County) and owned by co-conspirator Mashiyat Rashid.

While working at Tri-County they engaged in a scheme to defraud Medicare of over $150 million by billing for medically unnecessary facet joint injections, unnecessary urinary drug screens, home health and more.

Officials said they offered prescriptions of oxycodone 30 mg to patients who were in pain, drug dealers, or opioid addicts. Those patients were forced to submit to unnecessary facet injections for the prescription.

The four defendants were all ranked in the top 25 doctors for dollars paid by Medicare for facet joint injections, even though they only worked a few hours a week. The defendants practice was described during trial as an assembly line, where the four defendants earned anywhere from $1,100 to $3,500 an hour for performing the injections.

Seniors:  If you are seeing a doctor, especially for pain medications and you see something suspicious, report it to Medicare.gov.  Check your Medicare statements carefully.  One friend who was receiving pain meds told me that her doctor had billed Medicare for a much larger amount than she was prescribed.  Maybe by mistake? But, best to report anything suspicious!