Health Care Fraud

One of the financial fraud trends we have highlighted here is the movement of federal and state financial fraud prosecutors to the private sector, where they become white collar criminal defense lawyers. We believe that this movement is going to continue, and probably grow, in 2012. 

Assistant Attorney General Lanny A.

What do you get for defrauding Medicare and preying on vulnerable people suffering from Alzheimer’s disease, dementia, and substance abuse? You get 50 years in prison – the longest prison sentence ever in a Medicare fraud case. 

Matthew Paul Brown impersonated a doctor, treated over 1,000 patients, and, to boot, wrongfully disclosed their health information. Now, he has pleaded guilty in federal district court to charges of health care fraud and wrongful disclosure of individually identifiable health information. 

Jerome H. Feldman, once a practicing psychiatrist, defrauded Medicare by receiving funds he was not entitled to receive and then fled the U.S. to live as a fugitive in the Philippines. There, Feldman created the website www.liver4you.org, fraudulently promising to provide critically ill patients liver or kidney transplants for $65,000 to $130,000.

U.S. Attorney General Eric Holder and the Department of Health and Human Services (HHS) Secretary Kathleen Sebelius visited Philadelphia today where they participated in the sixth regional health care fraud prevention summit. The summits are part of a federal government effort to root-out waste, fraud and abuse within the U.S. health care system. Here are some highlights of this summit:

Two Miami-area corporations, American Therapeutic Corporation (ATC) and Medlink Professional Management Group Inc., have pleaded guilty for a fraud scheme that resulted in the submission of more than $200 million in fraudulent claims to Medicare. 

A New Jersey man has admitted to posing as a licensed physician and unlawfully treating patients, prescribing medicine, and ordering procedures at an Elizabeth, N.J., medical practice for $10 an hour. 

An owner and a physician associated with a Detroit-area infusion therapy clinic were sentenced to 120 months and 97 months in prison, respectively, for their roles in a $2.3 million Medicare fraud scheme. 

The American Bar Association’s Criminal Justice Section, White Collar Crime Committee, Mid-Atlantic Region, is having an important financial fraud program on March 9 at Seton Hall University School of Law in Newark, N.J. “Current Issues in Securities Fraud, Health Care Fraud and Corporate Investigations & Prosecutions” will begin with opening remarks by Paul J. Fishman, U.S. Attorney for the District of New Jersey.