New Americans Sent to Slammer over Massive Health Care Fraud Scheme

12/31/2019 ~ Ann Corcoran ~ 3 Comments

“[A]fter arriving in the United States from Cuba on a raft seeking refuge and a better life…they proceeded to build a vast empire of fraud.”

I could not find a photo of the Cuban crooks.

Here is the news directly from the US Justice Department, and I must say this is one of the better press releases I’ve seen from the feds especially for its mention of the fact that the Cuban crooks were refugees who then took advantage of us. (Immigration history is rarely mentioned.)

(Thanks to one of my many readers who share tips with me.)

We gave them an opportunity for a good life, they ripped us off and now we must pay for their incarceration!

Husband and Wife Sentenced to Prison for Roles in $38 Million Health Care Fraud and Wire Fraud Scheme

Rodolfo Pichardo, 71, of Hialeah, Florida was sentenced to more than 15 years in prison for masterminding a $38 million health care fraud and wire fraud scheme. His wife Marta Pichardo, 66, was sentenced to 8 years in prison for her role in the scheme.

[….]

Rodolfo Pichardo and Marta Pichardo previously pled guilty to conspiracy to commit health care fraud and wire fraud. On December 4, 2019, Rodolfo Pichardo, was sentenced by U.S. District Judge Rodolfo A. Ruiz to 188 months in prison, to be followed by 3 years of supervised release. He was ordered to pay $33,841,576 in restitution. Today, Marta Pichardo was sentenced by Judge Ruiz to 96 months in prison, to be followed by 3 years of supervised release. She was ordered to pay $10,482,178 in restitution.

According to court documents, after arriving in the United States from Cuba on a raft seeking refuge and a better life, the Rodolfo Pichardo and his wife Marta Pichardo settled in Miami-Dade County, Florida where they proceeded to build a vast empire of fraud, consisting of at least six fraudulent home health agencies, three fraudulent therapy staffing companies, and two fraudulent pharmacies. Each of these entities purportedly provided home health services, therapy services, and prescription drugs, respectively, to qualified Medicare beneficiaries, though in fact and as both Rodolfo and Marta Pichardo knew, they did not.

From May 2010 through September 2016, the Pichardos and their co-conspirators used this empire to submit more than $38 million in false and fraudulent claims to Medicare, for which the trust-based program then paid out more than $33 million.

Fueled their lavish lifestyle with your money!

The Pichardos then used this money to purchase multiple properties, high-end vehicles, expensive jewelry, plane tickets, vacations, cosmetic procedures, and more, both for themselves and their family members.

As part of the scheme, Rodolfo Pichardo offered and paid kickbacks, both by cash and by check, to numerous patient recruiters, in exchange for the referral of Medicare beneficiaries to home health agencies that he owned. The conspirators also offered and paid cash kickbacks to owners and operators of multiple Miami-Dade medical clinics, in return for acquiring medically unnecessary home health prescriptions for the recruited Medicare beneficiaries. These prescriptions were then used by the Pichardos’ various home health agencies and pharmacies to bill Medicare for purported services and pharmaceutical drugs that were provided to allegedly qualified Medicare beneficiaries

During the long-running scheme, the Pichardos took several calculated steps to conceal the fraud and avoid detection, including using nominee owners, changing names and locations of their fraudulent entities, and creating shell companies to conceal the receipt of the fraud proceeds, hide assets and transactions, and divert proceeds for both personal use and to further the fraud.

There is a bit more here.

So much for Michael Bloomberg’s New American Economy built on immigrant entrepreneurs.

As I have said before, the President should work some of the fantastic fraud busts his Justice Department is exposing into each rally he attends. He could direct his staff to find one or two relevant to whatever state he is visiting.

I think Florida fraudsters might outnumber Michigan schemers here at ‘Frauds and Crooks’, but I’ll check my archives tomorrow on this blogs first anniversary!

Don’t forget to check in at Refugee Resettlement Watch which has been taking most of my attention in recent weeks!

Happy New Year!

They Wanted Brazilian Butt Tucks, but Ended up Dead or Deformed

12/17/2019 ~ Ann Corcoran ~ 4 Comments

Editor: As you know I have been deep in the weeds of the President’s offer to local elected officials and state governors to determine if they want to receive refugees later in 2020. It is frankly a bureaucratic morass and I needed a break from it so I had a look at some ‘frauds and crooks’ news this morning.

Please visit Refugee Resettlement Watch because there are new posts there every day like this one: Appomattox County, Virginia says no thanks to refugees, likely first in the nation county to say NO!

For a change, this is really disturbing news for a whole host of reasons.

Before getting to the story that you may have seen because it was fairly widely reported, learn what a Brazilian butt lift entails. See here.

I sure hope our tax dollars in no way support this foolish (deadly!) medical procedure.

From the UK Daily Mail (where photos are always the best):

Botched cut-rate operations at plastic surgery clinics operated by FELONS in Florida cost 13 women their lives – but state law can do nothing to close down the lethal businesses

At least 13 women have died after undergoing plastic surgery at Florida clinics founded by felons, a new investigation reveals.

They came for discounted butt lifts and tummy tucks from surgeons in world-renowned South Beach, Florida.

But these women were left with complications that cost them their lives, after operations that were performed by surgeons hired by for felons, USA Today’s investigation revealed.

Dr Osakatukei Omulepu had failed his board exams multiple times, and had never been board certified in plastic surgery, says the Daily Mail.

It dug into the sordid histories of four clinics founded by people had been convicted of crimes – mostly financial ones – but were allowed to run cosmetic surgery shops that crowded patients in and cut corners to make more money more quickly.

The clinics, where women died of fat embolisms, deadly mixtures of sedatives and puncture wounds to organs, were cited for these deaths and for dirty operating rooms.

Yet they were never shut down. Blindspots in regulatory oversight and hamstrung lawmakers allowed these facilities to continue operating despite the littany of problems – in one case, even while the owner was waiting for his prison sentence to start.

[….]

Juan Hernandes was convicted in a $1.2 million Medicare billing fraud case while running Spectrum Aesthetics

Juan Hernandes co-founded Spectrum Aesthetics in 2012. He and his business partner, Evelyn Parrado were charged with fraudulently billing $1.2 million to Medicare for drugs from the pharmacy they ran together.

Under the impression that Spectrum was staffed and run by board certified surgeons, the court allowed Hernandes to continue to operate the clinic.

He employed and oversaw the physicians there, including Dr Osakatukei Omulepu, who had failed his board exams multiple times, and never been board certified in plastic surgery.

Yet the unqualified surgeon performed Brazilian butt lifts, the most dangerous cosmetic operation.

During two such operations, he punctured or stabbed organs including the liver and small intestine.

A surgical sponge was left inside Porche Campbell, 40, when she had a procedure there.

Nicola Mason, 46, came to Spectrum from Maryland for a Brazilian butt lift.

But, a complaint she filed against Dr Omulepu claims he performed a tummy tuck – the wrong surgery – on her, instead.

And the unwanted tummy tuck she got left Mason with large scars on the side of her abdomen.

Dr Omulepu’s records claim that he determined that Mason wasn’t a good candidate for butt lift, according to USA TODAY, and that the two instead agreed upon her tummy tuck.

Last year, Adianet Galvan visited New Life Plastic Surgery for the same risky procedure: a Brazilian butt lift.

She suffered the same fate countless others have under the knife. Galvan died of a fat embolism, according to USA Today’s analysis of her autopsy records.

‘I never thought my daughter would come to this country and die at the age of 30,’ her mother, Arelys Gonzalez told USA Today. [Were these women in the country legally?—ed]

Continue reading here.

You will notice that most of those involved with the fraudulent surgical centers appear to be ‘new Americans.’

Miami: Dozens Busted in Medicare Drug Fraud Scheme

11/21/2019 ~ Ann Corcoran

According to one article on the latest fraud bust involving Medicare, Florida is number one in the nation for such schemes.

And, every time I see a story like this I imagine the massive fraud we would have if Elizabeth Warren got her dream program—Medicare for all!

Some of the names of those ‘new Americans’ arrested include: Ingrid Perdomo, Stirlitz Pio Diaz, Luiba Rodriguez Leyva, Diana Cabrera, Katia Ramirez, Daymis Sanchez, and Yanelys Lozano. Cubans I’m guessing.

New American Economy?

When you hear from groups like Michael Bloomberg’s New American Economy about the entrepreneurial spirit and economic benefits ‘new Americans’ contribute to our country think about this bunch! And, don’t forget, Bloomberg is a leading advocate for more immigration!

There are actually two separate busts…

Here is the first story from Tuesday that explains how the scam works from NBC Miami:

Nearly 20 Suspects Charged in Multi-Million Dollar Medicare Fraud Across 2 Miami Pharmacies

Nearly two dozen people have been charged by Florida’s Office of Statewide Prosecution for their involvement in a multi-million dollar Medicare fraud scheme that took place at two Miami pharmacies over the course of several years.

A total of 19 suspects are facing charges including organized fraud, racketeering, grand theft and money laundering, according to arrest warrants released Tuesday.

The scheme made use of professional beneficiaries, which are people who allow their Medicare benefits to be exploited by fraudsters in exchange for monetary compensation, the warrants said.

In this case, the professional beneficiaries involved were receiving up to 30 percent of the profits from each medication that was fraudulently billed by either Santander Pharmacy or Wynwood Family Pharmacy Corporation, the warrants said.

The beneficiaries would visit doctors in order to acquire prescriptions for medications they did not need. The prescriptions would be taken to Santander or Wynwood pharmacies, where the drugs would be charged to Medicare even though the drugs would never actually be dispensed or received.

The drugs that were fraudulently billed tended to be highly expensive, such as anti-psychotic drugs, according to the arrest warrants.

Since the operation began in Santander Pharmacy in 2015, more than $4 million in federal funds has been stolen using this method.

According to the arrest warrants, South Florida leads the country in this kind of Medicare fraud, particularly Miami-Dade and Broward counties.

Individuals establish a pharmacy by submitting corporate documents and obtaining a pharmacy license from the Florida Department of Health, and then commit fraud by submitting claims to Medicare for services that are never actually rendered or needed.

More here.

From the Miami Herald yesterday:

At least 30 people have been charged in connection with a string of South Florida pharmacies state authorities say fraudulently billed Medicare — a scam that continues to be one of Miami’s most lucrative illegal industries.

Police officers on Tuesday began arresting dozens associated with Tata Pharmacy Discount, Lozano Health Care, and in a separate case, Wynwood Family Pharmacy and Santander Pharmacy.

Those arrested in the sprawling case are facing charges of racketeering, organized scheme to defraud and money laundering.

The investigation was spearheaded by the Statewide Prosecutor’s Office, Miami-Dade police and U.S. Department of Health and Human Services.

Medicare fraud has long been rampant in South Florida, costing taxpayers billions. Over the past decade, pharmacies have become particular cash cows, with owners and middlemen scouring nursing homes, paying kickbacks to elderly patients in exchange for allowing them to bill for unnecessary medicines in their names.

Continue reading here.

I have more Medicare/Medicaid/Food Stamp fraud cases in my queue to post which I hope to get to in the coming days.

Virginia Pharmacy Owner Sentenced for Prescription Medication Fraud

10/08/2019 ~ Ann Corcoran ~ 1 Comment

But, it sure strikes me that there must be more to this story than we are being told!

My first question is how does a 29-year-old, Latif Mohamed Chowdhury, aka Gulam Latif Chaudhury, who is not a Pharmacist, come to own two pharmacies and set up this elaborate scheme to get his hands on dangerous drugs and bilk insurance companies and Medicare and Medicaid out of hundreds of thousands of dollars? A 29-year-old! Clearly there is something more.

Indeed I wonder how he managed such a light sentence—4 years—when he could have gotten twenty as noted here in an earlier article about his arrest.

Did he cut some deal with the feds to help them find bigger fish involved in the scheme?

This is the press statement from the US Justice Department on Chowdury’s sentencing. Thanks as always to readers who find important stories like this one that doubtless few will ever hear about otherwise.

Former Pharmacy Owner Sentenced for Prescription Medication Fraud

ALEXANDRIA, Va. – A former pharmacy owner was sentenced today [September 27th—ed] to four years in prison for fraudulently filling and dispensing thousands of prescription medications, including opioids, outside the usual course of professional practice.

“Chowdhury blithely violated his position of trust,” said G. Zachary Terwilliger, U.S. Attorney for the Eastern District of Virginia. “Chowdhury’s warped business philosophy led him to illegally distribute a significant number of prescription medications, including dangerous, addictive opioids. Moreover, his reckless actions add to the financial cost of health care as he fraudulently billed at least $500,000 to health insurance programs for prescriptions that were never filled.”

According to court documents, Latif Mohamed Chowdhury, aka Gulam Latif Chaudhury, 29, operated and controlled two now-defunct pharmacies known as Alexandria Care Pharmacy LLC (ACP-1) and Alexandria Care Pharmacy Store #2 LLC (ACP-2). Chowdhury has never been a licensed pharmacist and has no medical qualifications. Nonetheless, between August 2015 and February 2016, Chowdhury fraudulently operated ACP-1 and ACP-2 by personally filling and dispensing thousands of dosage units of medications, including opioids, without a licensed pharmacist on-site. Chowdhury used the identities of licensed pharmacists, without their permission, to carry out his scheme.

“Chowdhury used his trusted position to enrich himself at the expense of others,” said Timothy M. Dunham, Special Agent in Charge, Criminal Division, FBI Washington Field Office. “Today’s sentencing makes it clear that the illegal distribution of opioids will not be tolerated. The FBI will work closely with our partners to continue to investigate allegations of healthcare fraud.”

Chowdhury admitted to fraudulently billing health insurance benefit programs, including Medicare and Medicaid, for refills of prescription medications that were not delivered to customers even though his pharmacies received payment for these prescriptions. Chowdhury also submitted fraudulent health insurance claims in the names of pharmacy customers for medications that were not authorized by any physician, and were not dispensed to any of the customers, in order to enrich himself through illicit profits generated by ACP-1 and ACP-2.

More here.

Of course no mention is made of his immigration status.

Michigan: 'New American' Pharmacists Charged in Medicare Fraud Case; Billed for Meds for Dead People

04/13/201909/21/2019 ~ Ann Corcoran ~ 1 Comment

Until I started investigating fraud cases involving Medicare and Medicaid, I had no idea that there were so many pharmacists on-the-take. And, this is one more case that makes me ask—What! Don’t we have enough US born and educated pharmacists without importing foreign ones?
Of course, as is almost always the case, there is no mugshot, and no information on the nationality and immigration status of this bunch of alleged crooks named by the US Justice Department in an unsealed indictment earlier this week charging that they ripped us off for $9.2 million:

Wansa Nabih Makki, 41, of Dearborn

Mohamad Ali Makki, R.Ph., 43, of Dearborn Heights

Mahmoud Makki., 36, of Dearborn

Hossam Tanana, 53 of Dearborn

Pharmacy fraud — According to a Press & Guide story: “The pharmacy in Livonia that some of the defendants were working out of, bore no signs that anything other than a dental office was inside.” http://www.pressandguide.com/news/four-people-indicted-in-million-laundering-scheme-at-area-pharmacy/article_76eec6fc-5c80-11e9-890c-bb73ed71aebf.html

By the way, I think Michigan may ultimately win the prize for the state with the most frauds and crooks (aka new American entrepreneurs) ripping off the US health care system.
Continue reading →