Is your Neighborhood Pharmacist a Crook?

Some are, but maybe not your local friendly, helpful health professional!

sessions and weed
You can bet the drug industry and the Medicare fraudsters were happy to see Sessions out as Attorney General

A little over six months ago, then Attorney General Jeff Sessions announced a major federal crackdown on doctors, pharmacists and other health providers for fueling the opioid crisis and using your Medicare and Medicaid dollars to line their pockets.

Here is a bit of one story about Sessions’ announcement.

From State News June 28, 2018:

Federal agencies on Thursday announced charges in what Attorney General Jeff Sessions called “the largest health care fraud takedown in American history,” an investigation into over $2 billion in alleged fraud by doctors, pharmacists, and nurses.

Many of the allegations centered on illegitimate opioid prescriptions. The Justice Department charged 162 defendants, including 76 doctors, for their roles dispensing opioids and narcotics, the result of investigations spanning 30 state Medicaid programs and numerous enforcement agencies.

[….]

“Some of our most trusted medical officials, professionals, look at their patients, vulnerable people suffering from addiction, and they see dollar signs,” Sessions said.

The alleged fraud and false billings collectively accounted for 13 million illegal opioid dosages, the Justice Department said, and also included 23 pharmacists and 19 nurses.

The Department of Health and Human Services also announced that since July 2017, it has excluded over 2,700 individuals and 587 providers from Medicare and Medicaid “for conduct related to opioid diversion and abuse” — including 67 doctors, 402 nurses, and 40 pharmacy services.

More here.

Here are a couple of more recent cases of Pharmacy fraud

Don’t miss my post from last week about Pharmacist Haytham “Tom” Fakih in Dearborn, Michigan.

Florida Fraudster

From a Justice Department Press release in December, here.

The owner of a Miami, Florida-area pharmacy who caused Medicare to pay more than $8.4 million over a six-year period for prescription drugs that were never provided to beneficiaries was sentenced today to 87 months in prison.

[….]

Antonio Perez Jr., 48, of Miami Beach, Florida, was sentenced by U.S. District Judge Federico A. Moreno of the Southern District of Florida, who also ordered Perez to pay $8,415,824 in restitution and to forfeit the same amount. Perez was ordered to forfeit four Miami-area properties worth approximately $700,000 and multiple bank accounts totaling over $250,000. Perez previously pleaded guilty to one count of conspiracy to commit health care fraud.

[….]

During the course of the scheme, Medicare paid Valles Pharmacy Discount over $32 million, of which at least $8.4 million was for prescription drugs that Valles Pharmacy never purchased and never provided to Medicare beneficiaries, Perez admitted.

 

ahktmar-pharmacy
The owner of Akhtamar Pharmacy will be sentenced in February.

 

California case

Also in December a federal jury found Pharmacist Tamar Tatarian, 39, of Pasadena, California guilty of a Medicare fraud scheme after she billed Medicare $1.3 million for drugs she never purchased or distributed.

You will be interested to see that she was one of those caught in Sessions’ big sweep earlier this year.

Tatarian, the owner of Akhtamar Pharmacy, will be sentenced next month.

 

question markSecret decoder ring at work!  Tatarian must be Armenian. See the Legend of Akhtamar.  My reference to Secret decoder ring comes from Ann Coulter’s ‘Adios America’ where she rightly points out that readers of news stories about crooks and criminals must search for clues about where the alleged perp might come from and how he/she got in to the country.
Exception!  See yesterday’s post about the Russians ripping off Washington staters! There the reporter actually says where those arrested were from.

 

Alert: Beware of Medical Supply Phone Fraud

Have you been getting calls that start with a recorded voice saying “Don’t hang up!”? The caller says he/she has important information about relieving chronic pain with neck, back or knee braces (that Medicare will pay for).

scam alert logo

I get those and so I noticed this news story from Fruitland, Maryland ten days ago about how phone scammers clone a number (in this case they cloned the police department!) and use it to make their fraud calls.

Then I found a letter to the editor from a man in Wilson, NC who, although suspicious of the call, did talk with the ‘supplier’ of braces, and here is what he said,

I have received dozens of calls concerning braces for pain in my back, shoulders, etc., none of which is true! On those calls where I actually talked to the callers, I told them exactly that and apparently I was ignored. They told me it will cost me absolutely nothing and Medicare will pay for everything. I again told them no, I don’t need them, nor do I want them. They told me they would send them anyway and they would be absolutely free and Medicare would pay.

Guess what? On a recent Thursday, a package arrived from Trilogy Medical Supply of West Palm Beach, Florida. I refused acceptance and UPS took the unopened package back. Now the fun part!

I called Medicare and after speaking to three individuals, was told that this company had indeed billed Medicare more than $3,400 for something I neither wanted nor asked for and in fact refused. Medicare has opened an investigation into this and will refuse payment for my “pain relief braces!”

So, it appears that the feds were promptly paying out to Trilogy Medical Supply.* It is not clear if the letter-writer gave out his Medicare card number to the callers.

Check your Medicare statements when they come in and look for items you were billed for.  One friend of mine said there were amounts of certain medications (for pain!) that were larger than she had received.

Yesterday a Better Business Bureau in Ohio published a list of the Top Seven phone fraud schemes they had been notified about in 2018.

See them all but especially #2:  The Grandparents Scam!

Another of my friends reported that an elder family member fell for this one and actually drove out late at night to wire cash to the unknown caller!

question mark*We have no idea who owns Trilogy Medical Supply (could be perfectly legit).  But, as soon as the Department of Justice website is up and running again (after the shutdown), I’ll check if they show up there.

 

 

Are “New American” Doctors Fueling the Opioid Crisis?

Screenshot (821)
No bond for Dr. Rajendra Bothra

Surely some of the doctors who prescribe unnecessary pain medications and hook hundreds of thousands of Americans on drugs are American born and bred, but check out this story from Michigan in December.

Not only did these ‘new American’ doctors and health professionals turn unsuspecting Americans into drug addicts, but they did it by using your taxpayer dollars in multi-million dollar fraud schemes involving Medicare and Medicaid.

They got rich destroying lives!

And, when they got caught, many fled the country!

From the Detroit News:

Rich and on the run: Doctors flee country amid fraud, opioid crackdown

Detroit — More than a dozen doctors and medical professionals charged with federal crimes locally have fled the country in recent years amid a federal crackdown on illegal opioid use and health care fraud.

Prosecutors used the fugitive status of 16 medical professionals who have fled since 2011 to keep Dr. Rajendra Bothra jailed Wednesday while he awaits trial in a nearly $500 million conspiracy, one of the largest health care fraud cases in U.S. history.

Here is a bit more, but please read the shocking story!

The medical professionals who have fled for overseas destinations including Jordan, Pakistan and Egypt in recent years have two things in common: foreign ties and big bank accounts that have financed flights from justice. In Bothra’s case, he has eight siblings in India and amassed a $35 million fortune and vast-real estate holdings, including a $1.99 million island estate.

 

Screenshot (822)
The Detroit News did a great service by publishing this list of Detroit doctors/medical professionals who have left the country to avoid prosecution. Too bad those last two columns are blank!

 

More here.

In case you have forgotten, last summer then Attorney General Jeff Sessions announced the largest healthcare bust of Medicare and Medicaid fraud scammers in US history and linked it to the opioid crisis.

Medicare Fraud Strike Force

To help find and prosecute frauds and crooks, the feds established the Medicare Fraud Strike Force involving a coordinated effort between the Fraud Section of the US Justice Department, US Attorney’s offices, the FBI, the Department of Health and Human Services Inspector General and local law enforcement.

I bet you’ve never even heard of it because the national media rarely (if ever!) mentions its work, which the Strike Force says has resulted in successful prosecutions of 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.

In addition to the Detroit area, the Strike Force is operating in 12 locations around the US: Miami, FL, Los Angeles, CA, Houston, TX, Brooklyn, NY, Baton Rouge and New Orleans, LA, Tampa and Orlando, FL, Chicago, IL, Dallas, TX, Washington, DC, Newark, NJ, Philadelphia, PA and the Appalachian Region.

question mark

I wonder why these huge Medicare and Medicaid fraud stories never seem to be front page news across the country and why aren’t they widely reported by cable news?

 

 

Michigan: Complaint filed against Sonic Drive-in Owner for Defrauding Medicare and Medicaid to the Tune of $1.2 Million

 

Editor: This is the first of several such stories I have lined up to report from Michigan!

I can’t say this better than the Detroit News says it,

A Dearborn pharmacist, hailed earlier this year for opening the nation’s first halal-certified Sonic Drive-In restaurant, cheated Medicare and Medicaid by charging for medication prescribed to dead people, according to federal prosecutors.

Trudell Pharmacy owner Haytham “Tom” Fakih also committed health care fraud by billing for expensive medication that was not dispensed to patients, prosecutors alleged in a criminal complaint filed against the pharmacist in federal court Sunday. In all, the fraud cost more than $1.2 million, authorities allege.

[….]

The investigation emerged publicly in September when federal agents seized more than $350,000 during a series of raids that happened five months after Fakih staged a ribbon-cutting ceremony at his Sonic Drive-In restaurant with Dearborn Mayor John O’Reilly Jr. and other community leaders.

Sonic ribbon-cutting

 

Sonic drive in opening
The bearded guy in the middle is Dearborn’s mayor with “Tom” Fakih on his right. Photo is from the Press and Review story about the grand opening of Sonic’s Halal fast food restaurant.

 

In April of last year Fakih, 53, opened a halal drive-in restaurant to much fanfare, says a Press and Guide report,

Representatives from the city, the Dearborn Area Chamber of Commerce, local religious organizations, Dearborn Public Schools, the American Arab Chamber of Commerce and friends of franchise owner Tom Fakih came out to support the new business during its celebration on Wednesday. Mayor John O’Reilly Jr. cut the ribbon…

The offerings showed off the halal options that make the Dearborn location unique. It is the only Sonic in the country to offer them.

According to the Detroit News,

On Sunday, Fakih was released on $10,000 unsecured bond after making an initial appearance in federal court. If convicted, he could spend up to 10 years in prison.

More at the Detroit News.

*Note* a charge by the government is not a determination of guilt.

More tomorrow about Michigan!

question mark

I suppose I could do some digging to find out more about Fakih, apparently a well-established and well-connected businessman in Dearborn, but news reports don’t mention his nationality or anything else about him.