Fraud

[Dima424]

Здесь я помещу некоторые ссылки на статьи интересующие меня... может и вас тоже заинтереуют...

Ex-eye doctor gets 14 months for $2.8 million insurance fraud

Read more: http://www.nydailynews.com/new-york/...#ixzz2n8RyMOHW

[Dima424]

O.C. nursing home firm pays $48 million to settle Medicare fraud case

http://www.latimes.com/business/mone...#ixzz2n8SLwIug

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10/28/13

Medicare Fraud Remains Rampant, Audacious
The government launched a task force against fraud, but abuse of the system is just too easy.

http://www.psmag.com/health/medicare...dacious-68991/

"Federal inspectors there found that 481 of 1,600 randomly visited Medicare-billing businesses did not even exist—but not before those 481 businesses submitted $237 million in bills."

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http://medicare-fraud.net/

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5/14/13

89 charged in Medicare fraud busts in 8 cities

http://www.cbsnews.com/news/89-charg...s-in-8-cities/

Miami, long known as ground zero for the complex scams, was again at the center of Tuesday's busts with 25 people charged for their role in various schemes. Authorities allege five defendants in one scheme bribed Medicare patients for their ID numbers, allowing them to bill for $51 million in home health services that were never given or were not medically necessary.

Nearly 20 people, including two doctors, a physician's assistant and two therapists, were charged in various scams in Detroit. In one case, three posed as licensed physicians and wrote bogus prescriptions for drugs and psychotherapy services totaling $12 million, the Health and Human Services and Justice departments said in a statement.

In Los Angeles, 13 people were charged in various scams totaling $23 million. In one case, authorities said three people hired workers to recruit Medicare patients. Once the defendants received the patient's Medicare ID numbers, they worked with doctors and medical clinics to get prescriptions for power wheelchairs, which they sold for kickbacks, authorities said in a statement.

[Dima424]

11/14/13

Irina Shelikhova, Medicare Fraud “Mastermind,” Sentenced To 15 Years

http://www.bensonhurstbean.com/2013/...a-bay-medical/

"The 50-year-old leader of a massive $77 million Medicare fraud ring in Southern Brooklyn was sentenced to 15 years in prison and ordered to forfeit $36,241,545 to the government on Tuesday, announced United States Attorney Loretta Lynch."

"Among those recruited for the scheme was Shelikhova’s own 29-year-old son, Maksim, who pleaded guilty for his role in the ripoff in 2011 and became a government witness while his mother remained on the run.

Max Shelikhov’s taxpayer-funded lifestyle made headlines in May, when it was revealed by the New York Post that he lived a hustler lifestyle, using millions from the scheme to purchase a BMW, a Mercedes-Benz, an Aston Martin, a Range Rover and a $100,000 diamond engagement ring for his then-girlfriend.

The no-show doctor involved in the scheme, Gustave Drivas, received 12 years in prison and was ordered to pay $51 million in restitution in September."

[Dima424]

[http://www.medicarenewsgroup.com/new...-c77cfba68367]

How Much Money Is Lost to Medicare Fraud Annually?

Medicare has no official estimate of the amount of money lost to fraud each year, but the Federal Bureau of Investigation refers to estimates of 3-10 percent of all health care billings. In 2011, Medicare expenditures totaled approximately $565 billion. If the FBI percentages are applied to this amount, the cost of Medicare fraud for the 2011 fiscal year was anywhere from $17-57 billion.

CMS also estimates that the federal government distributed about $65 billion in improper payments (payments that shouldn't have been made or were for an incorrect amount) through Medicare and Medicaid combined in fiscal year 2011.

мне кажется 3-10 процентов, это ундерэстимэйтед... считая что во флориде 30% мест кто счета выписывал вообще не существует

[Dima424]

10/31/13

http://nypost.com/2013/10/31/shrink-...edicare-fraud/

Shrink faces 10 years in jail for Medicare fraud

"A crooked Brooklyn shrink faces a decade in jail after pleading guilty Wednesday to lying about treating veterans while he was actually vacationing in China — bilking Medicare out of more than $1 million.
Dr. Mikail Presman, who was fired from his full-time job at the Brooklyn VA Hospital, copped to the charges in Brooklyn federal court, and faces $3.6 million in fines and restitution in addition to potential prison time, prosecutors said.
Presman, 56, claimed to have treated a steady parade of patients at his home between 2006 and 2013, billing Medicare for millions, according to court papers."

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10/19/13

Churchville man convicted of $14M Medicare fraud

http://www.phillyburbs.com/00redesig...18e6e8c7c.html

"Kolodesh's business, Home Care Hospice, located in the 2800 block of Grant Avenue in Philadelphia, submitted claims totaling about $14.3 million for patients who were not eligible for or did not receive the hospice services billed to Medicare, authorities said."

[Dima424]

http://www.ca4.uscourts.gov/Opinions...d/081564.P.pdf