WASHINGTON—Two health care clinic owners were sentenced today in connection with an $8 million health care fraud scheme involving the now-defunct home health care company Flores Home Health Care Inc.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office, and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office made the announcement.
Miguel Jimenez, 43, and Marina Sanchez Pajon, 29, both of Miami, were sentenced by U.S. District Judge Ursula Ungaro in the Southern District of Florida. Jimenez was sentenced to serve 87 months in prison, and Pajon was sentenced to serve 57 months in prison. Jimenez and Pajon pleaded guilty in August to conspiracy to commit health care fraud.
Jimenez and Pajon, who are married, were owners and operators of Flores Home Health, a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries.
According to court documents, Jimenez and Pajon operated Flores Home Health for the purpose of billing Medicare for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or not provided. Jimenez’s primary role at Flores Home Health involved controlling the company and running and overseeing the schemes conducted through Flores Home Health. Both Jimenez and Pajon were responsible for negotiating and paying kickbacks and bribes, interacting with patient recruiters, and coordinating and overseeing the submission of fraudulent claims to the Medicare program.
Jimenez, Pajon, and their co-conspirators paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Flores Home Health for home health and therapy services that were medically unnecessary and/or not provided. They also paid kickbacks and bribes to co-conspirators in doctors’ offices and clinics in exchange for home health and therapy prescriptions, medical certifications, and other documentation. Jimenez, Pajon, and their co-conspirators used the prescriptions, medical certifications, and other documentation to fraudulently bill Medicare for home health care services, which Jimenez and Pajon knew was in violation of federal criminal laws.
From approximately October 2009 through approximately June 2012, Flores Home Health was paid approximately $8 million by Medicare for fraudulent claims for home health services that were not medically necessary and/or not provided.
The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to http://www.stopmedicarefraud.gov.
Tuesday, 3 December 2013
Monday, 2 December 2013
MCW 2014 Summer Undergraduate & Graduate Enrichment Programs
The Office of Student Affairs/Diversity at the Medical College of Wisconsin will again offer our undergraduate summer enrichmentprogram for students from backgrounds that are historically underrepresented in medicine and biomedical research. The Diversity Summer Health-related Research Education Program (DSHREP) will give students an excellent opportunity to explore research in the Milwaukee Metropolitan area.
DSHREP is a 10-week summer program supported through an R25 research education grant funded by National Heart, Lung, Blood Institute (NHLBI), an agency of National Institutes of Health (NIH). All research is conducted by MCW faculty, focusing on cardiovascular, hematological, and pulmonary diseases. Interested students should be available from May 28, 2014 to August 1, 2014. Summer programs are offered at no cost to students. The application deadline is Saturday, February 1, 2014 by 5 p.m. CST
Apply Today!
Unique program opportunity for students to develop biomedical research skills through the Medical College of Wisconsin. Start the application now by clicking the following link: DSHREP Application. To check eligibility, please review the following brochure: DSHREP
Before your START your application:
You will need to request an official transcript. Transcripts should be mailed directly to the Office of Student Affairs/Diversity using the address provided below. Before beginning your application, you will also need the following information about your recommenders: Name, Title, E-mail Address and Phone Number.
Medical College of Wisconsin
Office of Student Affairs/Diversity
Attn: Recruiter / Program Coordinator
8701 Watertown Plank Road
Milwaukee, WI 53226
The application process should take about half an hour, please be sure to allot ample time to complete this form without interruption. Once you begin the application, it is recommended that you complete it in its entirety.
Friday, 22 November 2013
Owner of Home Health Companies Sentenced for Role in $20 Million Health Care Fraud Scheme
WASHINGTON—The owner and operator of several Miami health care agencies was sentenced today to serve 120 months in prison for his role in a health care fraud scheme involving defunct home health care company Trust Care Health Services Inc.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office; and Acting Special Agent in Charge Michael J. DePalma of the Internal Revenue Service-Criminal Investigation’s (IRS-CI) Miami Field Office made the announcement.
Roberto Marrero, 60, of Miami, was sentenced by U.S. District Judge K. Michael Moore in the Southern District of Florida. In September 2013, Marrero pleaded guilty to conspiracy to commit health care fraud and conspiracy to receive and pay health care kickbacks.
Marrero was an owner and operator of Trust Care, a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries.
Co-conspirators Sandra Fernandez Viera, 49; Patricia Morcate, 34; and Enrique Rodriguez, 59, all of Miami, have also pleaded guilty to related charges, including conspiracy to commit health care fraud and conspiracy to receive and pay health care kickbacks. On November 13, 2013, Fernandez Viera was sentenced to serve 120 months in prison; Morcate was sentenced to serve 60 months; and Rodriguez was sentenced to serve 57 months.
Together with Marrero, Fernandez Viera was an owner and operator of Trust Care. Morcate worked at and was an investor in Trust Care. Rodriguez served as a patient recruiter on behalf of Trust Care.
According to court documents, Marrero and his co-conspirators operated Trust Care for the purpose of billing the Medicare Program for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or were not provided.
Marrero primarily controlled Trust Care and, in light of that role, oversaw the schemes operating out of the company. Marrero was also responsible for negotiating and paying kickbacks and bribes, interacting with patient recruiters, and coordinating and overseeing the submission of fraudulent claims to the Medicare program.
Marrero and his co-conspirators paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Trust Care for home health and therapy services that were medically unnecessary and/or not provided. Marrero and his co-conspirators at Trust Care also paid kickbacks and bribes to co-conspirators in doctors’ offices and clinics in exchange for home health and therapy prescriptions, medical certifications and other documentation. Marrero and his co-conspirators used these prescriptions, medical certifications, and other documentation to fraudulently bill the Medicare program for home health care services, which Marrero knew was in violation of federal criminal laws.
From approximately March 2007 through at least October 2010, Trust Care submitted more than $20 million in claims for home health services. Medicare paid Trust Care more than $15 million for these fraudulent claims.
Marrero and his co-conspirators have also acknowledged their involvement in similar fraudulent schemes at several other Miami health care agencies in addition to Trust Care with estimated total losses of approximately $50 million. Those agencies include A&B Health Services Inc., Centrum Home Health Care Inc., Global Nursing Home Health Inc., Lovable Home Health Services Corp., New Concepts In Health Inc., Nursemed Home Care Corp., R&M Health Care Inc., Ubieta Health System Inc., and Vital Care Home Health Services Inc.
The case was investigated by the FBI and HHS-OIG, with the assistance of IRS-CI, and was brought as part of the Medicare Fraud Strike Force initiative, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office; and Acting Special Agent in Charge Michael J. DePalma of the Internal Revenue Service-Criminal Investigation’s (IRS-CI) Miami Field Office made the announcement.
Roberto Marrero, 60, of Miami, was sentenced by U.S. District Judge K. Michael Moore in the Southern District of Florida. In September 2013, Marrero pleaded guilty to conspiracy to commit health care fraud and conspiracy to receive and pay health care kickbacks.
Marrero was an owner and operator of Trust Care, a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries.
Co-conspirators Sandra Fernandez Viera, 49; Patricia Morcate, 34; and Enrique Rodriguez, 59, all of Miami, have also pleaded guilty to related charges, including conspiracy to commit health care fraud and conspiracy to receive and pay health care kickbacks. On November 13, 2013, Fernandez Viera was sentenced to serve 120 months in prison; Morcate was sentenced to serve 60 months; and Rodriguez was sentenced to serve 57 months.
Together with Marrero, Fernandez Viera was an owner and operator of Trust Care. Morcate worked at and was an investor in Trust Care. Rodriguez served as a patient recruiter on behalf of Trust Care.
According to court documents, Marrero and his co-conspirators operated Trust Care for the purpose of billing the Medicare Program for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or were not provided.
Marrero primarily controlled Trust Care and, in light of that role, oversaw the schemes operating out of the company. Marrero was also responsible for negotiating and paying kickbacks and bribes, interacting with patient recruiters, and coordinating and overseeing the submission of fraudulent claims to the Medicare program.
Marrero and his co-conspirators paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Trust Care for home health and therapy services that were medically unnecessary and/or not provided. Marrero and his co-conspirators at Trust Care also paid kickbacks and bribes to co-conspirators in doctors’ offices and clinics in exchange for home health and therapy prescriptions, medical certifications and other documentation. Marrero and his co-conspirators used these prescriptions, medical certifications, and other documentation to fraudulently bill the Medicare program for home health care services, which Marrero knew was in violation of federal criminal laws.
From approximately March 2007 through at least October 2010, Trust Care submitted more than $20 million in claims for home health services. Medicare paid Trust Care more than $15 million for these fraudulent claims.
Marrero and his co-conspirators have also acknowledged their involvement in similar fraudulent schemes at several other Miami health care agencies in addition to Trust Care with estimated total losses of approximately $50 million. Those agencies include A&B Health Services Inc., Centrum Home Health Care Inc., Global Nursing Home Health Inc., Lovable Home Health Services Corp., New Concepts In Health Inc., Nursemed Home Care Corp., R&M Health Care Inc., Ubieta Health System Inc., and Vital Care Home Health Services Inc.
The case was investigated by the FBI and HHS-OIG, with the assistance of IRS-CI, and was brought as part of the Medicare Fraud Strike Force initiative, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Durable Medical Equipment Clinic Owner Pleads Guilty in Miami for Role in $11 Million Health Care Fraud Scheme
WASHINGTON—The former owner of a defunct durable medical equipment (DME) clinic based in Miami pleaded guilty today for his role in an $11 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office, and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations’ Miami Office made the announcement.
Francisco Enrique Chavez, 36, of Miami, pleaded guilty before U.S. District Judge Patricia A. Seitz in the Southern District of Florida to one count of health care fraud. He faces a maximum penalty of 10 years in prison when he is sentenced on February 11, 2014.
According to court records, Chavez served as the president and sole corporate officer of World Class Medical Clinic Corp. (World Class). From March 27, 2006, through August 22, 2006, Chavez submitted or caused to be submitted approximately $11,303,494 in fraudulent claims to the Medicare program on behalf of World Class for DME that was neither prescribed by a physician nor medically necessary. Medicare paid more than $1,713,959 on these fraudulent claims. The proceeds of the World Class fraud scheme were deposited into corporate bank accounts that were controlled by Chavez, and he made numerous cash withdrawals and deposits into personal and shell entity bank accounts to conceal the nature of the scheme.
Chavez was a fugitive who was extradited from Spain to Miami on August 30, 2013.
This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorneys Allan J. Medina and Sarah M. Hall of the Fraud Section. The Criminal Division’s Office of International Affairs provided significant assistance in the extradition.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office, and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations’ Miami Office made the announcement.
Francisco Enrique Chavez, 36, of Miami, pleaded guilty before U.S. District Judge Patricia A. Seitz in the Southern District of Florida to one count of health care fraud. He faces a maximum penalty of 10 years in prison when he is sentenced on February 11, 2014.
According to court records, Chavez served as the president and sole corporate officer of World Class Medical Clinic Corp. (World Class). From March 27, 2006, through August 22, 2006, Chavez submitted or caused to be submitted approximately $11,303,494 in fraudulent claims to the Medicare program on behalf of World Class for DME that was neither prescribed by a physician nor medically necessary. Medicare paid more than $1,713,959 on these fraudulent claims. The proceeds of the World Class fraud scheme were deposited into corporate bank accounts that were controlled by Chavez, and he made numerous cash withdrawals and deposits into personal and shell entity bank accounts to conceal the nature of the scheme.
Chavez was a fugitive who was extradited from Spain to Miami on August 30, 2013.
This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorneys Allan J. Medina and Sarah M. Hall of the Fraud Section. The Criminal Division’s Office of International Affairs provided significant assistance in the extradition.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Thursday, 21 November 2013
Federal Jury Convicts Brunswick Woman in $4 Million Medicaid Fraud Scheme
BRUNSWICK, GA—Schella Logan Hope, 47, of Brunswick, Georgia, was convicted earlier this month by a federal jury of various health care fraud, aggravated identity theft, and money laundering offenses for her role in a $4 million scheme upon the Georgia Medicaid program. Chief United States District Court Judge Lisa Godbey Wood presided over Hope’s five-day jury trial.
According to evidence presented during the trial, Hope was a licensed dietician who ran a business located in Brunswick, Georgia, known as Hope Nutritional Services. From 2005 through 2011, Hope stole the identities of thousands of needy children between the ages of zero and five that were enrolled in Head Start programs located throughout the state of Georgia. Once Hope obtained the identities of these children, Hope fabricated patient files, falsified prescriptions from doctors, and submitted $4 million worth of claims to Medicaid for nutritional services that were not provided. Hope then used the money she stole from Medicaid to pay for luxury automobiles, designer clothing, and vacations, among other things.
Co-conspirator Arlene Murrell pled guilty before Hope’s trial to her role in the scheme. Murrell testified against Hope at trial and detailed how she helped Hope commit the fraud.
Hope was convicted of 58 counts of conspiracy to commit health care fraud; health care fraud; aggravated identity theft; and money laundering. Upon her convictions for these offenses, Chief Judge Wood remanded Hope to the custody of the United States Marshals pending sentencing in the case.
United States Attorney Edward J. Tarver stated, “Defendant Hope preyed upon American taxpayers by stealing the identities of low-income Georgia families and then billing Medicaid for over $4 million in nutrition services that were never provided. This United States Attorney’s Office will continue its efforts to prosecute all who seek to defraud American taxpayers by scamming federal programs. Because of Ms. Hope’s criminal efforts to feed her extravagant lifestyle, she will have to rely upon the federal prison system for her own nutritional services.”
“The Head Start Program provides many of our nation’s children with invaluable services and opportunities,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office. “To use the Head Start Program as a vehicle to submit false and fraudulent claims to the Medicaid system is unacceptable, and the OIG will continue to pursue these kinds of egregious cases.“
Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated, “Those who defraud our publicly funded healthcare programs such as Medicaid and Medicare are taking valuable services and resources away from those in need. This guilty verdict reaffirms that the FBI will continue to provide significant investigative resources toward identifying, investigating, and presenting for prosecution such individuals that, by engaging in such criminal conduct, put themselves before others."
Georgia Attorney General Sam Olens said, “Fraud of taxpayer monies will not be tolerated in any form. Head Start is a program intended to offer assistance to children from low income families. The fact that this defendant used the Head Start Program and children in need to assist in her scam is especially appalling.”
“The Georgia Department of Community Health has made it a top priority to ferret out fraud, waste, and abuse in our Medicaid program. Our collaborative work with state and federal agencies enables us to ensure Medicaid program dollars are being used to provide health care services to Georgia’s most vulnerable populations,” said Clyde L. Reese, III, Esq., commissioner of the Georgia Department of Community Health.
At sentencing, Hope faces 10 years in prison for each of the 17 health care fraud offenses; 20 years in prison for the various money laundering offenses; and two years consecutive prison sentences for each of the various aggravated identity theft offenses. Hope also faces up to three years of supervised release and may be ordered to pay restitution to the victims in this case.
The convictions of Hope and Murrell resulted from a joint investigation by the United States Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; Georgia’s Department of Community Health; and the Georgia Attorney General’s Medicaid Fraud Control Unit.
Assistant United States Attorneys Brian T. Rafferty and David Stewart, along with Assistant Attorney General Robin Daitch, prosecuted the case on behalf of the United States. For additional information, please contact First Assistant United States Attorney James D. Durham at (912) 201-2547.
According to evidence presented during the trial, Hope was a licensed dietician who ran a business located in Brunswick, Georgia, known as Hope Nutritional Services. From 2005 through 2011, Hope stole the identities of thousands of needy children between the ages of zero and five that were enrolled in Head Start programs located throughout the state of Georgia. Once Hope obtained the identities of these children, Hope fabricated patient files, falsified prescriptions from doctors, and submitted $4 million worth of claims to Medicaid for nutritional services that were not provided. Hope then used the money she stole from Medicaid to pay for luxury automobiles, designer clothing, and vacations, among other things.
Co-conspirator Arlene Murrell pled guilty before Hope’s trial to her role in the scheme. Murrell testified against Hope at trial and detailed how she helped Hope commit the fraud.
Hope was convicted of 58 counts of conspiracy to commit health care fraud; health care fraud; aggravated identity theft; and money laundering. Upon her convictions for these offenses, Chief Judge Wood remanded Hope to the custody of the United States Marshals pending sentencing in the case.
United States Attorney Edward J. Tarver stated, “Defendant Hope preyed upon American taxpayers by stealing the identities of low-income Georgia families and then billing Medicaid for over $4 million in nutrition services that were never provided. This United States Attorney’s Office will continue its efforts to prosecute all who seek to defraud American taxpayers by scamming federal programs. Because of Ms. Hope’s criminal efforts to feed her extravagant lifestyle, she will have to rely upon the federal prison system for her own nutritional services.”
“The Head Start Program provides many of our nation’s children with invaluable services and opportunities,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office. “To use the Head Start Program as a vehicle to submit false and fraudulent claims to the Medicaid system is unacceptable, and the OIG will continue to pursue these kinds of egregious cases.“
Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated, “Those who defraud our publicly funded healthcare programs such as Medicaid and Medicare are taking valuable services and resources away from those in need. This guilty verdict reaffirms that the FBI will continue to provide significant investigative resources toward identifying, investigating, and presenting for prosecution such individuals that, by engaging in such criminal conduct, put themselves before others."
Georgia Attorney General Sam Olens said, “Fraud of taxpayer monies will not be tolerated in any form. Head Start is a program intended to offer assistance to children from low income families. The fact that this defendant used the Head Start Program and children in need to assist in her scam is especially appalling.”
“The Georgia Department of Community Health has made it a top priority to ferret out fraud, waste, and abuse in our Medicaid program. Our collaborative work with state and federal agencies enables us to ensure Medicaid program dollars are being used to provide health care services to Georgia’s most vulnerable populations,” said Clyde L. Reese, III, Esq., commissioner of the Georgia Department of Community Health.
At sentencing, Hope faces 10 years in prison for each of the 17 health care fraud offenses; 20 years in prison for the various money laundering offenses; and two years consecutive prison sentences for each of the various aggravated identity theft offenses. Hope also faces up to three years of supervised release and may be ordered to pay restitution to the victims in this case.
The convictions of Hope and Murrell resulted from a joint investigation by the United States Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; Georgia’s Department of Community Health; and the Georgia Attorney General’s Medicaid Fraud Control Unit.
Assistant United States Attorneys Brian T. Rafferty and David Stewart, along with Assistant Attorney General Robin Daitch, prosecuted the case on behalf of the United States. For additional information, please contact First Assistant United States Attorney James D. Durham at (912) 201-2547.
Prominent Tri-State Cardiologist Sentenced to 78 Months in Prison in $19 Million Fraud Scheme and for Exposing Patients to Unncessary Medical Treatment
NEWARK, NJ—A well-known cardiologist and the founder, CEO, and sole owner of two large medical services companies in New Jersey and New York was sentenced today to 78 months in prison and ordered to pay $19 million in restitution for conspiring in a multi-million-dollar health care fraud scheme that subjected thousands of patients to unnecessary tests and potentially life-threatening, unneeded treatment, as well as treatment by unlicensed or untrained personnel. The sentence was announced today by U.S. Attorney Paul J. Fishman of the District of New Jersey.
Jose Katz, 69, of Closter, New Jersey, previously pleaded guilty to an information charging him with one count of conspiracy to commit health care fraud and one count of Social Security fraud arising from a separate scheme to give his wife a “no show” job and make her eligible for Social Security benefits. Judge Linares imposed the sentence today in Newark federal court.
“Katz prized illegal profits over patients to a staggering degree, committing record-breaking fraud and compromising care,” said U.S. Attorney Fishman. “Prison is an appropriate consequence for ripping off the government and insurance companies through the shocking exposure of patients to unneeded or untrained treatment.”
As part of his plea agreement with the government, Katz agreed that the loss amount sustained by Medicare, Medicaid, and other insurers victimized by the fraudulent billings was $19 million. U.S. Department of Health and Human Services-Office of the Inspector General and FBI records indicate the loss amount suffered by the victims is the largest recorded in New Jersey, New York, and Connecticut for an individual practitioner convicted of health care fraud.
According to documents filed in this case and statements made in court:
Katz was the founder, CEO, and sole equity-holder of Cardio-Med Services LLC (Cardio-Med) and Comprehensive Healthcare & Medical Services LLC (Comprehensive Healthcare). From 2004 through 2012, Cardio-Med had offices in Union City, Paterson, and West New York, New Jersey, and Comprehensive Healthcare had offices in Manhattan and Queens, New York. Both Cardio-Med and Comprehensive Healthcare provided cardiology, internal medicine, and other medical services to individual patients. During that time period, Katz conspired to bill Medicare Part B, Medicaid, Empire BCBS, Aetna, and others for unnecessary tests and unnecessary procedures based on false diagnoses and for medical services rendered by unlicensed practitioners.
Between July, 2006 and February, 2009, Katz spent more than $6 million for advertising on Spanish-language television and radio stations. The ads attracted hundreds of patients to Cardio-Med and Comprehensive Healthcare every day. Overall, Katz was able to bill Medicare and Medicaid more than $75 million for his services from 2005 through 2012.
Over the course of the conspiracy, Katz ordered and performed essentially the same battery of diagnostic tests for nearly all the patients he treated, regardless of their symptoms. Katz also instructed his non-physician employees to order and perform diagnostic tests for patients of other doctors working at his offices, even though he had not examined those patients and the other physicians had not ordered the tests.
Most significantly, Katz admitted that he falsified patient charts with fictitious and boilerplate symptoms and falsely diagnosed a majority of his Medicare and Medicaid patients with coronary artery disease and debilitating and inoperable angina. He also admitted to making the diagnoses to justify prescribing and administering an unnecessary treatment for those patients called enhanced external counter pulsation, or EECP. Katz even prescribed EECP treatments for some patients with contraindications for the treatment, therefore subjecting those patients to a substantial risk of serious injury or death.
From 2005 through 2012, Medicare and Medicaid paid Katz more than $15.6 million just for his EECP treatments, most of which were fraudulent.
In addition, Katz ordered conspirator Mario Roncal, 62, of Woodland Park, New Jersey—who had a medical degree from San Juan Bautista School of Medicine in San Juan, Puerto Rico, but did not have a license to practice medicine in any of the 50 states—to treat patients, knowing he was not licensed. At Katz’s direction, Roncal held himself out to fellow employees and to patients as “Dr. Roncal,” examined new patients as well as Katz’s follow-up patients, ordered diagnostic tests, diagnosed patients with medical conditions and diseases, and recommended and prescribed courses of treatment and surgery—including falsely diagnosing patients with angina and prescribing EECP treatments for those patients.
To conceal this illegal and unlicensed practice of medicine, Roncal forged Katz’s signature on paperwork associated with Roncal’s unlawful medical services, including on patient charts. During the conspiracy, Katz used his own billing numbers to bill Medicare Part B and Medicaid for the illegal services Roncal provided as though they were provided by Katz.
Roncal was indicted on March 2, 2012, for conspiracy to commit health care fraud. He entered a guilty plea on January 4, 2013, and awaits sentencing.
Katz also admitted to a Social Security fraud scheme in which, from 2005 through 2012, he kept his wife on Cardio-Med’s payroll though she performed little or no work. During the course of the scheme, Katz sent false W-2 forms for calendar years 2005 through 2011 to the U.S. Social Security Administration purportedly reflecting $1,251,604 in earnings for his wife, making her eligible for an estimated $263,000 in Social Security benefits to which she was not entitled.
In addition to the prison term and restitution, Judge Linares sentenced Katz to serve three years of supervised release.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Aaron T. Ford; the U.S. Department of Health and Human Services, Office of the Inspector General, under the direction of Special Agent in Charge Thomas O’Donnell; the U.S. Postal Inspection Service, under the direction of Inspector in Charge Maria Kelokates; the Social Security Administration, Office of the Inspector General, under the direction of Special Agent in Charge Edward J. Ryan; IRS-Criminal Investigation, under the direction of Special Agent in Charge Shantelle P. Kitchen; and criminal and civil investigators with the U.S. Attorney’s Office for the investigation leading to today’s sentence. He also thanked the Medicaid Fraud Division of the Office of the New Jersey State Comptroller for its assistance.
The government is represented by Assistant U.S. Attorney Scott B. McBride of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
Jose Katz, 69, of Closter, New Jersey, previously pleaded guilty to an information charging him with one count of conspiracy to commit health care fraud and one count of Social Security fraud arising from a separate scheme to give his wife a “no show” job and make her eligible for Social Security benefits. Judge Linares imposed the sentence today in Newark federal court.
“Katz prized illegal profits over patients to a staggering degree, committing record-breaking fraud and compromising care,” said U.S. Attorney Fishman. “Prison is an appropriate consequence for ripping off the government and insurance companies through the shocking exposure of patients to unneeded or untrained treatment.”
As part of his plea agreement with the government, Katz agreed that the loss amount sustained by Medicare, Medicaid, and other insurers victimized by the fraudulent billings was $19 million. U.S. Department of Health and Human Services-Office of the Inspector General and FBI records indicate the loss amount suffered by the victims is the largest recorded in New Jersey, New York, and Connecticut for an individual practitioner convicted of health care fraud.
According to documents filed in this case and statements made in court:
Katz was the founder, CEO, and sole equity-holder of Cardio-Med Services LLC (Cardio-Med) and Comprehensive Healthcare & Medical Services LLC (Comprehensive Healthcare). From 2004 through 2012, Cardio-Med had offices in Union City, Paterson, and West New York, New Jersey, and Comprehensive Healthcare had offices in Manhattan and Queens, New York. Both Cardio-Med and Comprehensive Healthcare provided cardiology, internal medicine, and other medical services to individual patients. During that time period, Katz conspired to bill Medicare Part B, Medicaid, Empire BCBS, Aetna, and others for unnecessary tests and unnecessary procedures based on false diagnoses and for medical services rendered by unlicensed practitioners.
Between July, 2006 and February, 2009, Katz spent more than $6 million for advertising on Spanish-language television and radio stations. The ads attracted hundreds of patients to Cardio-Med and Comprehensive Healthcare every day. Overall, Katz was able to bill Medicare and Medicaid more than $75 million for his services from 2005 through 2012.
Over the course of the conspiracy, Katz ordered and performed essentially the same battery of diagnostic tests for nearly all the patients he treated, regardless of their symptoms. Katz also instructed his non-physician employees to order and perform diagnostic tests for patients of other doctors working at his offices, even though he had not examined those patients and the other physicians had not ordered the tests.
Most significantly, Katz admitted that he falsified patient charts with fictitious and boilerplate symptoms and falsely diagnosed a majority of his Medicare and Medicaid patients with coronary artery disease and debilitating and inoperable angina. He also admitted to making the diagnoses to justify prescribing and administering an unnecessary treatment for those patients called enhanced external counter pulsation, or EECP. Katz even prescribed EECP treatments for some patients with contraindications for the treatment, therefore subjecting those patients to a substantial risk of serious injury or death.
From 2005 through 2012, Medicare and Medicaid paid Katz more than $15.6 million just for his EECP treatments, most of which were fraudulent.
In addition, Katz ordered conspirator Mario Roncal, 62, of Woodland Park, New Jersey—who had a medical degree from San Juan Bautista School of Medicine in San Juan, Puerto Rico, but did not have a license to practice medicine in any of the 50 states—to treat patients, knowing he was not licensed. At Katz’s direction, Roncal held himself out to fellow employees and to patients as “Dr. Roncal,” examined new patients as well as Katz’s follow-up patients, ordered diagnostic tests, diagnosed patients with medical conditions and diseases, and recommended and prescribed courses of treatment and surgery—including falsely diagnosing patients with angina and prescribing EECP treatments for those patients.
To conceal this illegal and unlicensed practice of medicine, Roncal forged Katz’s signature on paperwork associated with Roncal’s unlawful medical services, including on patient charts. During the conspiracy, Katz used his own billing numbers to bill Medicare Part B and Medicaid for the illegal services Roncal provided as though they were provided by Katz.
Roncal was indicted on March 2, 2012, for conspiracy to commit health care fraud. He entered a guilty plea on January 4, 2013, and awaits sentencing.
Katz also admitted to a Social Security fraud scheme in which, from 2005 through 2012, he kept his wife on Cardio-Med’s payroll though she performed little or no work. During the course of the scheme, Katz sent false W-2 forms for calendar years 2005 through 2011 to the U.S. Social Security Administration purportedly reflecting $1,251,604 in earnings for his wife, making her eligible for an estimated $263,000 in Social Security benefits to which she was not entitled.
In addition to the prison term and restitution, Judge Linares sentenced Katz to serve three years of supervised release.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Aaron T. Ford; the U.S. Department of Health and Human Services, Office of the Inspector General, under the direction of Special Agent in Charge Thomas O’Donnell; the U.S. Postal Inspection Service, under the direction of Inspector in Charge Maria Kelokates; the Social Security Administration, Office of the Inspector General, under the direction of Special Agent in Charge Edward J. Ryan; IRS-Criminal Investigation, under the direction of Special Agent in Charge Shantelle P. Kitchen; and criminal and civil investigators with the U.S. Attorney’s Office for the investigation leading to today’s sentence. He also thanked the Medicaid Fraud Division of the Office of the New Jersey State Comptroller for its assistance.
The government is represented by Assistant U.S. Attorney Scott B. McBride of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
Tuesday, 19 November 2013
January 2014 – January 2015 MCAT Test Information
The MCAT Essentials
The MCAT Essentials for 2014 – January 2015 is the official policy and procedure guide to the MCAT exam. You can find fundamental information about registration, test-day policies, rules to protect the integrity of the exam, and post-test procedures. This includes a brief overview of exam content and scoring, basic suggestions to help an examinee prepare, a list of contacts and online services, as well as other helpful information.
New Registration Fees and Deadline Structure for January 2014 – January 2015
We have introduced a new deadline and fee structure for the January 2014 – January 2015 testing season. Please refer to this chart for all applicable fees and restrictions.
If you did not receive a seat in your preferred location (or date), check again by the gold deadline as seats may free up as that deadline approaches.
Additional registration/scoring items to note:
· Registration is now open for testing dates between January and May of 2014.
· Registration for testing dates from June 2014 through January 2015 will open in February 2014.
· The MCAT exam may be taken a maximum of three times from January 2014 through January 2015.
o No-shows now count toward the maximum.
o Voided exams continue to count toward the maximum.
· Scores will continue to be released 30-35 days after an administration. The score release schedule is available online.
If have questions about any MCAT resources, please contact mcat@aamc.org.
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