Los Angeles Medicare Fraud

Published on: April 18, 2012

Will You Ever Practice Again After Your Los Angeles Medical Fraud Charges?

The Obama Administration is “on the hunt” for doctors, chiropractors, dentists, and other providers who violate Los Angeles Medicare fraud laws.

If you or someone you care about recently got swept up into that dragnet – or if you have come under investigation – you are obviously panicked about your potential punishments:

• The lifestyle changes that you inevitably will have to make;

Published on: April 13, 2012

Life After Southern California Medicare Fraud – Start Planning Now

by Michael Kraut

If you are a physician who has recently been arrested for Los Angeles Medicare fraud due to double billing or overbilling — or as an accomplice to a larger and more sophisticated scheme that spanned several years — you’re probably terrified. How will the arrest (and potential conviction) impact your career, your freedom (jail time or not?), your finances, your relationships with the people closest to you, and your professional reputation (or what’s left of it)?

Odds are, in fact, that you are overwhelmingly focused on the potential negatives of the situation. In some ways, this makes sense. Now is a good time for reflection and sober strategic thinking, particularly if you did commit criminal activity. A Southern California Medicare or Medi-Cal fraud lawyer can help you devise and execute an intelligent response to the charges against you. And you should certainly introspect and analyze how you got into the situation in the first place. But you might also find it extremely resourceful to focus on potential positive outcomes.

The brain works in mysterious ways. Since the 1950s, neurologists have studied an activity center in the brain called the reticular activating system (RAS). This is a region of our brain that helps to manage and process attention and focus. Obviously, the neurology of the RAS is too complicated for this blog to address, but the takeaway is pretty profound. Science suggests that how and when and where we hold our focus can color not only our perceptions of our experiences but also our strategies for dealing with crises.

Published on: April 2, 2012

What is Los Angeles Healthcare Fraud, Anyway, and What Should You Do If You Are Accused?

by Michael Kraut

With the Obama administration cracking down hard, nationwide, on Medicare and Medicaid fraud, analysts expect that many more doctors, chiropractors, and other caregivers in Los Angeles will be arrested and charged with Southern California healthcare fraud. If you or a family member has come under investigation for fraud, you need to act decisively, legally, and quickly to protect your rights and minimize the potential damage to your career, assets, and freedom.

Individuals convicted of Southern California healthcare billing fraud can be slapped with charges pursuant to Insurance Code Section 1871.4, Penal Code Section 550, Penal Code Section 118(for perjury), and Labor Code Section 3700 (if you’re an employer who committed healthcare fraud). Depending on the nature and extent of the alleged misconduct, you could lose your license to practice, face jail time and massive fines, and see the destruction of your professional reputation and your ability to earn in the future. Given what’s at stake, you probably want to know what might constitute this crime. Here are two examples:

1. Creating false medical records and billing insurance carriers or Medicaid or MediCal for services that you never rendered (or that you described in a very overinflated way).

Published on: March 26, 2012

Los Angeles Medicare Fraud: Coming to Terms with What You Have Done

by Michael Kraut

As someone who has recently been arrested for Los Angeles Medicare fraud (or insurance fraud, identity theft or another Southern California White Collar Crime), your life is in chaos right now. The arrest has terrified you, caused difficulties in your relationships, and perhaps even thrown your health out of whack. At some point within the next few weeks or months or years, you are going have to look in the mirror and try to come to terms with how you got into this position – being a Los Angeles white collar criminal defendant – and where you want to go from here with your life and your profession.

Looking objectively in the mirror is not easy for anyone in any circumstances. Introspection is a difficult skill, and it is a skill that we are generally not taught in school or elsewhere. Looking in the mirror objectively when we have committed something that society deems “wrong” or “awful” is even harder, especially if you have being living in a kind of self created delusion.

Also, most people simply don’t have empathy for defendants. They assume that the world is split into we versus them. “We” are the “good guys” who abide by the law and have a moral code. “Them” are the criminals who flout our society’s laws and have no moral code. As a defendant, you probably take a certain amount of umbrage to this stereotype – you have a strong moral code, despite the charges against you. Likely, you’ve justified your actions in some way. For instance, if you are a physician or a dentist who committed Medicare fraud, maybe you just got fed up with the crazy Medicaid reimbursement system – all the red tape and hassle. So you decided that “you were going to get yours” since the system had taken so much from you. Thus, you went down the not-so primrose path.

Published on: March 19, 2012

At Least Your Los Angeles Medicare Fraud Charges Aren’t As Bad As This Guy’s…

by Michael Kraut

If you, a spouse, or a close family member was recently arrested and charged with Medicare fraud in Los Angeles—or some other Southern California white-collar crime—you’re probably very frightened right now. You might fear the prospect of going to jail, losing your dental, medical, or chiropractic license, getting kicked out of a professional association, paying massive fines, and seeing your reputation and character besmirched. These are very legitimate concerns. Depending what you did or did not do, you can certainly suffer all those penalties—and more.

The federal government is getting extremely serious about cracking down on Medicare fraud. Three weeks ago, federal officials busted an alleged scam in Dallas, Texas. Observers are calling it the biggest case of Medicare fraud in US history. Allegedly, a 54-year old Dr. Jacques Roy masterminded a $375 million scam, by certifying Medicare reimbursement claims fraudulently and then keeping payments without providing services.

Prosecutors allege that Roy created a sophisticated “boiler room” to run his scam. He found homeless people to pose as patients and created thousands of fraudulent Medicare claims. Assistant Attorney General Lanny Breuer said that the Medicare Fraud Strike Force found that “Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise . . . making millions by recruiting thousands of patients for unnecessary services and billing Medicare for those services.” During the six years of his scam, according to ABC News, “Dr. Roy . . . had more patients than any other medical practice in the United States.” The 13-count indictment is loaded with serious charges. If convicted, Dr. Roy faces life imprisonment.

Published on: February 20, 2012

Watch Out Would Be Los Angeles Medicare Fraud Perpetrators: Obama Administration Pulling Out All the Stops

by Michael Kraut

In 2008, the Federal Government recouped $2.14 billion from people who committed Southern California Medi-Cal fraud and other similar crimes across the nation. Last year, thanks to a dedicated effort inside the Obama Administration, the Federal Government recouped $4.1 billion — nearly double the 2008 amount. The number of people charged with fraud across the U.S. also bumped up 75% over the 2008 numbers.

Unsurprisingly, the Obama Administration has been celebrating. Kathleen Sebelius, the Health and Human Service Secretary, blogged about the report: “The Obama Administration is doing more to stop fraud before it happens… Department of Justice officials are tracking fraud scams as they move across the country, so that criminals are spotted when they try to re-enroll into Medicare or Medicaid.”

Good news for tax payers – but what if you’ve been caught up in the dragnet and charged with Southern California Medicare fraud?

Published on: February 13, 2012

Not a Los Angeles Medicare Fraud Verdict of $21 million, But It Easily Could Have Been…

by Michael Kraut

Last week, a man pleaded guilty to a $21 million fraud plot that reads like something out of the annals of Los Angeles Medicare fraud files. And the story did take place in “LA”—but Louisiana, LA, not Los Angeles, LA.

Still, the story is pregnant with lessons for people (and family members of people) who have been recently arrested and charged with crimes like Southern California insurance fraud, Los Angeles credit card fraud, and all other types of Los Angeles white-collar crime.

The accusations are, sadly, typical and mundane. According to the Associated Press, Rodney Taylor, a 45-year-old Louisiana man, recruited state companies to bill Medicare fraudulently for certain pieces of medical equipment. This scam, which persisted from 2004 to 2009, ultimately led to $21 million in fraudulent claims, according to prosecutors.

Published on: January 30, 2012

The Slippery Slope to Los Angeles Medicare Fraud (And Other Crimes)

by Michael Kraut

Angelenos read the stories all the time and judge harshly: when doctors, chiropractors, dentists, pharmacists and other providers commit healthcare fraud in Los Angeles, we have a visceral reaction of disgust.

• How could someone charged with caring for the lives of our neighbors so grotesquely take advantage of their positions of power?

• Given our fiscal crisis at home here in California and nationwide, why would anyone try to rob the already fast-dwindling Medicare coffers?

Published on: January 16, 2012

Los Angeles Medicare Fraud Scheme Lands Pastor 15 Years Behind Bars and nearly $7 Million in Reimbursements

by Michael Kraut

Last Monday, 61-year-old Christopher Iruke was sentenced to 15 years in federal prison for designing and executing a Los Angeles Medicare fraud scheme; he leveraged his position as a local pastor to defraud the government. Iruke and his wife, Connie Ikpoh, and Aura Marroquin (an employee) were convicted in August of Los Angeles health care fraud and conspiracy to commit fraud.

Last Monday, US District Judge Terry Hatter sentenced Iruke for his role in the complicated scheme. According to a CNN report, during the 2011 trial, prosecutors presented evidence “that Iruke bought fraudulent prescriptions and documents…to bill Medicare for equipment that were either medically unnecessary or never provided”…for instance, they billed Medicare of about $6,000 for a power wheelchair that actually cost closer to $900.

As Iruke’s situation escalated and became more legally and logistically entangled, he asked his sister to protect him from a Medicare audit by opening two additional medical supply firms. Witnesses told jurors that Iruke and his coconspirators “paid kickbacks to street level marketers to offer Medicare beneficiaries free [devices and equipment] in exchange for the beneficiaries’ Medicare numbers and personal information.” Iruke and his conspirators allegedly leveraged these data as part of their complicated scheme.