Medical Fraud

Published on: November 9, 2013

Los Angeles Drug Crime Charges for Dr. John O. Dimowo for Prescribing Prescription Drugs

Today, we’re going to examine a disturbing Los Angeles drug crime article in the Los Angeles Times that profiled Dr. John O. Dimowo. This Southern California doctor allegedly prescribed narcotics, like Xanax, Vicodin and Adderall, to undercover agents who didn’t need the medications.

Dr. Dimowo was the subject of a 2012 Los Angeles Times investigation on overdose deaths in patients. Although he was never officially charged in patient deaths, he stands accused of seven counts of prescribing narcotics illegally. Five patients fatally overdosed on medications that Dimowo prescribed to them in 2009 and 2010.

Based on these charges, the 55-year-old doctor could face up to 7 years behind bars.

According to an affidavit, Dimowo provided prescriptions that fueled patients’ addictions. He wrote 37 new prescriptions a day, on average. After The Times wrote about him in 2012, authorities investigated complaints by the Medical Board of California – supported by pharmacists and family members of patients.

But there was not enough evidence to hold him liable.

If you are a doctor who’s been charged with a Los Angeles prescription drug crime — or if you are a friend or family member of a doctor, dentist, or other caregiver who’s been accused of Los Angeles Medicare fraud, insurance fraud, or similar crimes — Dimowo’s case can be illuminating. Despite all the accusations, “the evidence didn’t leave a direct path,” according to Los Angeles Deputy District Attorney, John Niedermann.

As we saw with the much more high profile case of Michael Jackson’s physician – who was convicted of criminal behavior in connection with the King of Pop’s death in 2009 – a doctor CAN be held criminally liable, in the event that a patient suffers serious harm or death.

But the prosecution can have a tough, complex road to hoe.

Let’s say a patient dies after ingesting Vicodin or Xanax. Did the patient have a pre-existing condition that made him or her susceptible to early mortality? Can the prosecution prove that the doctor failed to do due diligence? Did the patient mix the prescription drugs with street drugs?

The prosecution must answer a whole host of questions and objections to win a case like this.

So what does this mean if you or a loved one faces Los Angeles drug crime charges or other Southern California white collar crime charges?

As soon as possible, within reason, start to investigate your charges and construct an informed defense strategy. Former prosecutor (Senior Deputy District Attorney for Los Angeles) Michael Kraut of the Kraut Criminal & DUI Lawyers can help you with this challenge.

Mr. Kraut served for nearly a decade and a half as prosecutor; he understands how to fight and succeed in complex drug crime cases.

Published on: October 20, 2013

Can a Senior Citizen Army Stop the Onslaught of Medicare Fraud in Beverly Hills (and Beyond)?

by Michael Kraut

Whether you’re a doctor, chiropractor or dentist accused of Medicare or insurance fraud in Beverly Hills – or a concerned citizen who’s tired of the system’s wastes and unfairness – check this out!

The federal government loses approximately $60 billion a year, due to waste and fraud in the Medicare system. The Affordable Care Act — a.k.a. “Obamacare” — aims to tackle some of this fraud by turning beneficiaries into “fraud fighters.” Approximately 50 million people use the health insurance program to pay bills, buy medicines and deal with their health issues.

Unfortunately, many beneficiaries are sick, undereducated, or otherwise “mentally foggy” – they may be unable to recognize or report fraud or waste.

To empower these seniors, Medicare will provide larger, easier to read Medicare summary notices as well as easy ways to report any suspicious activity – such as the 1-800 Medicare Hotline and the website stopmedicarefraud.gov.

Authorities recommend that seniors pay close attention, if they spot unfamiliar provider names or get billed for office visits that they didn’t go to.

When a Medicare beneficiary discovers a problem, he or she should call the healthcare provider, who should then report it to Medicare, if the discrepancy can’t be explained. This simple system has helped the government recover nearly $15 billion in the past few years. The Senior Medicare Patrol — a volunteer group of around 5,000 people — helps seniors understand their benefits and avoid fraud.

Unfortunately, well meaning providers can easily get caught up in this dragnet and wind up facing devastating charges, like Beverly Hills Medicare fraud or Beverly Hills insurance fraud. These can lead to criminal penalties as well as to license suspension. As a national program manager for Senior Medicare Patrol, Rebecca Kinney, put it: “Most [cases] are mistakes or misunderstandings. Very rarely do we come across something that looks like fraud.”

If you stand falsely accused of Southern California Medicare fraud – or if you did do something wrong, and you’re not sure what to do next — trust the experienced, compassionate, and results-driven team here at the Kraut Criminal & DUI Lawyers to provide insight and advice. Call attorney Kraut today to schedule a free consultation and begin the process of clearing your name.

Published on: October 1, 2013

Southern California Healthcare Fraud Nets “Dr. J” Wijegunaratne 27 Months in Jail

by Michael Kraut

A Southern California healthcare scam involving wheelchair fraud has netted 58-year-old Dr. Sri J. Wijegunaratne 27 months behind bars. health-care-fraud-wheelchair-los-angeles.doc

“Dr. J” was found guilty of Medicare fraud back in April. Our blog reported on Dr. J’s co-defendant, Godwin Onyeabor, who recently got sentenced to 51 months behind bars for his role in billing Medicare fraudulently and giving kickbacks to physicians. The Anaheim doctors lured patients to a local clinic by them promising juice, vitamins, and other freebies. When they got to the clinics, the patients got more than they bargained for – motorized wheelchairs and other unneeded equipment. The department plans to bring charges against two other co-defendants, Victoria Onyeabor and Heidi Morishita, in late September and early October.

As far as Southern California healthcare fraud schemes go, the one allegedly perpetrated by Onyeabor, Dr. J, and the coconspirators was pretty small and controlled (“just” $1.5 million). The truly titanic Medicare fraud schemes often involve tens of millions or hundreds of millions of dollars.

The Obama Administration’s Department of Justice has been highly active in pursuing Los Angeles healthcare and insurance fraud charges. Why? Two main reasons:

1. By certain objective standards, health care fraud has reached epidemic levels.
2. Healthcare costs have grown so out of control that the government wants to do anything it can to rein in the burden.

How much jail time will you get for your Los Angeles Medicare fraud charge, if you’re convicted?

Sentencing for fraud charges in Southern California (and elsewhere) is a complicated business. Your punishments will depend on:

• The nature of the crime you allegedly committed;
• Whether you were charged with a federal crime or California crime;
• Whether you might be able to strike a plea deal with prosecutors;
• Whether you have a criminal history;
• Whether you conspired with other people to carry out the healthcare fraud
Given the complexity of your legal situation, it may behoove you to find an experienced Los Angeles criminal defense lawyer who has handled similarly sophisticated cases before. Mr. Michael Kraut of the Kraut Criminal & DUI Lawyers has spent nearly decade-and-a-half as a prosecutor for Los Angeles, during which time he’s handled many very complex fraud cases from the prosecutorial side. The Harvard Law School educated Mr. Kraut can help you come to terms with the charges that you’re up against and build a stiff and vigorous defense.

Published on: September 11, 2013

What Laws, Exactly, Did Your Los Angeles Health Care Fraud Violate?

by Michael Kraut

Whether you’re just being investigated for healthcare fraud in Los Angeles, or whether police already raided your facility and booked you under some very scary sounding charges, you’re feeling out of control and out of the loop.

What crimes, exactly, might prosecutors charge you with? And what can you do about your impending serious legal battle?

The vast majority of Southern California healthcare crimes are charged according to Insurance Code Section 1871.4. Many cases also include a charge per Penal Code Section 550. That section covers when people make false insurance claims to collect or deny insurance benefits. If you used a false statement to make an insurance claim, prosecutors might also slam you with a charge per Penal Code Section 118, which deals with perjury.

If you’re a doctor, chiropractor or dentist who committed Southern California healthcare fraud, you may also face charges per Labor Code Section 3700. This misdemeanor has to do with falsely representing an employee’s workers’ compensation coverage.

Doctor Fraud in Los Angeles

If you’re a caregiver who practices medicine (or any therapy) in Southern California, you’re well aware that insurance companies are paying less and less for services. So many doctors “push the envelope” with their billing – either by billing more than they should or by making up services never provided. You can read in the news about the million and one variations on this kind of scheme. But the law takes them all very seriously. Not only can you risk a major jail sentence, but the California Medical Board may also strip you of your license.

If federal or CA investigators have already collected patient records and other vital paperwork from your office – or you have other urgent questions concerning your rights, responsibilities, potential punishments, possible defenses, etc – please get in touch with an experienced Southern California Medicare fraud defense attorney at the Kraut Criminal & DUI Lawyers now for sound, effective guidance regarding your legal options.

Published on: August 13, 2013

Southern California Medicare Fraud News: Son Blows Whistle on Dad’s Company, Could Get Slice of $1 Million Settlement

by Michael Kraut

What makes a Los Angeles Medicare fraud story newsworthy?

• Is it the sheer amount of fraud involved?
• Is it the number of people allegedly harmed by deception?
• Is it the stress that the case puts both on the Medicare system and on the court system?
• Is it the elaborateness of the Rube Goldberg machinations that doctors, caregivers, and other collaborators use to bend or break the system’s rules?

These elements surely help determine what’s “intriguing” or not about Southern California Medicare fraud cases.

But there’s another key element: DRAMA.

After all, we live in the heart of the entertainment industry. Angelinos appreciate compelling, emotionally riveting stories.

In that context, consider a Medicare fraud case just settled up in White Plains, New York. It concerns a company called Park Avenue Medical Associates. At the heart of the case is a family feud between a father and son.

Michael Wolfson, a founder of Park Avenue and its Chief Medical Officer, must have been devastated when he learned that his son, Zachary Wolfson, blew the whistle on him and his associates. The crime, allegedly? Submitting an enormous number of bogus claims for reimbursement.

For instance, the company charged Medicare for psychiatric services for patients with advanced dementia – who could never have benefited from the services! According to Zachary’s accusations – which were supported by the Manhattan U.S. Attorney – the company often failed to adhere to Medicare rules and also billed for unnecessary services.

Since Zachary Wolfson blew the whistle under the False Claims Act, he will be entitled to a sum of the cash settlement that Park Avenue offered to end the legal drama.

News reports have speculated on the intriguing dynamic between Zachary and his father. What went wrong in the company and why? The internal family and company politics may be forever opaque to news sources – and perhaps it should be.

This bring up an important point: the psychological and financial motivations that compel people to commit healthcare fraud, insurance fraud, or other Southern California white collar crimes often are complex. The news likes to paint certain defendants as “bad guys” and talk about them in black and white terms.

Here’s the reality.

People who get involved in fraud schemes are not inherently evil. Rather, their motivations often come from needs not met, such as needs for fair compensation, autonomy, power, and so forth.

The point is that, if you or someone you love stands accused of a similar crime, you need a thorough defense. Trust attorney Michael Kraut of Los Angeles’s Kraut Criminal & DUI Lawyers, to provide a free and thorough consultation about your options. Mr. Kraut is a Harvard Law School educated ex-prosecutor who wracked up a very impressive 99+% rate at jury trials as a prosecutor.

Published on: August 6, 2013

Fascinating Medicare Fraud Case: Cincinnati Doctor Sued For $11 Million in Unnecessary Surgery, but Dr. Durrani Vigorously Denies Charges

by Michael Kraut

Medicare fraud cases in Southern California (and elsewhere) can start to sound pretty similar to one another, especially if you report on these crimes month after month, year after year, as we’ve done on this blog.

But every once in a while, a riveting, different kind of story bursts through and merits extended commentary.

Recently, prosecutors charged Dr. Atiq Durrani with unfairly billing Medicare to the tune of $11 million for surgeries he performed between February 2010 and January 2013. Prosecutors say that these surgeries were not medically necessary for patients. They also hit him with healthcare fraud charges and charges for making false statements.

Published on: July 31, 2013

Los Angeles Healthcare Fraud Scheme Was Big, But Strike Force Took Him Down

by Michael Kraut

The annals of Los Angeles healthcare fraud are filled with astonishing tales. As an expose in Los Angeles Weekly recently described in vivid detail, con artists, tricksters and “good doctors turned to bad” have engaged in diverse shenanigans to pilfer funds from the federal government’s coffers.

But few schemes hold a candle to an operation developed by Dr. Jacques Roy, a physician who operated a “boiler room” in Dallas, Texas that prosecutors say amounted to a $375 million scam.

According to Assistant Attorney General, Lanny Breuer, the 54-year-old Dr. Roy and his coconspirators, for years, ran a well oiled fraudulent enterprise in the Dallas area. They made their millions by recruiting thousands of patients for unnecessary services and then billing Medicare for those services.

Published on: July 29, 2013

Yet Another Guilty Verdict in a Major Los Angeles Medicare Fraud Case (This Time, for $1.5 Million)

by Michael Kraut

A federal jury just convicted 49-year-old Godwin Onyeabor and two confederates of scheming to defraud Medicare in Los Angeles to the tune of $1.5 million.

Onyeabor, who had been working for a San Bernardino company, Fendih Medical Supply Inc., paid kickbacks to another doctor and healthcare professional to write fake prescriptions for power wheelchairs and other medical equipment.

Onyeabor’s scheme lasted from 2007 to 2012; he billed Medicare for fraudulent claims totaling $1.5 million. Medicare paid out almost $1 million of that money.

Published on: July 15, 2013

Journaling to Understand Your Los Angeles Medicare Fraud Charges

by Michael Kraut

Ever since Federal investigators got on your case (and potentially even charged you) for healthcare fraud in Los Angeles, news commentators and observers have been calling you things like “mastermind” and “criminal conspirator.” You certainly don’t think of yourself in those terms. In fact, you’re feeling pretty scared, bewildered, and out of control right now – anything but the master of your mind.

This lack of clarity and sense of dis-ease can cause problems for your defense. To the degree that you are unclear about what you did, what charges you face, and what you can do to respond is the degree that you’ll feel out of control.

There are two main tools that you can use to regain a coherent perspective.

Published on: July 3, 2013

Healthcare Fraud in Los Angeles: Why Did You Do It? (No, Really, Why Did You Do It?)

by Michael Kraut

Why did you commit healthcare fraud in Southern California?

Now that you’ve been investigated (or, perhaps, arrested), your life path certainly doesn’t seem fully rational. After all, you now face massive jail time, thousands (or millions) of dollars in forced restitution, public humiliation, the loss of your medical, dental, or chiropractic license (or other professional credentials), and problems with your relationships and self-esteem.

So… why did you do it?