Medical Fraud

Published on: June 13, 2012

72 Year Prison Sentence for 50-Year-Old Guilty of Los Angeles Medicare Fraud?

Last Friday, 50-year-old David James Garrison was found guilty of perpetrating a Los Angeles Medicare fraud scam that bilked the federal program out of almost $19 million.

As a result of his convictions — fraud, conspiracy, and other Los Angeles white collar criminal charges — Garrison could face more than seven decades behind bars and a fine of up to $2 million. If he ends up having to serve that entire prison sentence, he would have to become the 2nd oldest person in the history of the world to ever see freedom again.

Garrison worked as a physician’s assistant at various bogus medical clinics. He pilfered the identities of patients and used those IDs to create false prescriptions and to place orders for (Medicare funded) equipment. He also stole the identities of doctors to write these fake scripts.

Published on: May 21, 2012

The Los Angeles Medicare Fraud News: The Sad Case of a Temple University Dean’s Fraud Charge

by Michael Kraut

Most people really do not understand what is likely to be a defendant in a Los Angeles Medicare fraud case. While the general public has some sympathy for people who commit crimes like petty theft or white color crimes or even some certain kinds of insurance fraud, most people have a bad picture in their minds of medical fraud defendants. They picture them as brilliant cold blooded schemers who have no conscience.

If you or someone you care about has been charged with a fraud crime, you obviously know this Doctor Evil like caricature does not hold water. Even if you did engage in a complex, illegal and even immoral scheme, odds are that you did not plan to be in your current position when you chose to become a doctor, chiropractor, dentist, or other care giver. You went into this business to provide care – not to wind up prosecuted for fraud.

In that light, let’s consider the case of 62-year old Dr. Joseph Kubacki, a former Assistant Dean at Temple University School of Medicine, who was sentenced last week for his role in running a fraudulent Medicare billing scheme. Kubacki, who once served as the chair of Temple’s ophthalmology department, had been billing the government for medical services that residents provided – even when he was not around. All told, the penalty for the scheme clocked in at over $676,000. Kubacki had worked for Temple for nearly 30 years, when school investigators discovered what was going on and confronted him in 2007.

Published on: May 9, 2012

Understanding Your Own Southern California Medical Fraud Scheme

by Michael Kraut

If you are under investigation for Southern California medical fraud – or if you have already been arrested and charged – your big concern is: What comes next?

How can you construct an effective, ethically coherent defense to the charges against you? Will you be able to save your business or practice? Will you have to serve jail time? Will you lose your license ? Etc.

Before you can even get a handle on these questions, you need to understand your current reality. Yes, you have gotten in trouble with the law – or you are on the verge of getting in trouble. And perhaps you also recognize that you have engaged in practices or activities that are illegal or, at the very least, legally and ethically ambiguous. At the same time, however, you may not even recognize the full extent of what you have done wrong – or what the prosecutors will say that you have done wrong. For instance:

Published on: April 18, 2012

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

by Michael Kraut

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: 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: January 2, 2012

When Someone You Love and Care About Commits Los Angeles Medicare Fraud

by Michael Kraut

On this blog, we talk a lot about why doctors, chiropractors, dentists, and others commit Los Angeles Medicare fraud. What drives them, psychologically, socially, and societally?

We also talk about what these defendants should do, how to grapple with the situation, etc. But let’s take time to change perspective and consider the role of family members. If you are the spouse or child of someone charged with any Southern California white crime, such as credit card fraud, insurance fraud, identity theft, etc., you may feel mixed emotions about what’s going on.

• On the one hand, perhaps you are shocked by the news of the arrest or investigation – you had no idea.

Published on: December 5, 2011

Why Do We Have Such a Severe Los Angeles Medicare Fraud Problem?

by Michael Kraut

This blog is not the only blog on the web to voice serious concerns over Los Angeles Medicare fraud investigative practices.

Indeed, it’s common knowledge that both state and federal efforts to identify, track, and thwart Southern California white collar crimes, like Los Angeles’ insurance fraud, credit card fraud, healthcare fraud and the like are stymied by bad processes and systems. It’s a fiasco: there are problems with method, investigators who are not incentivized correctly, evidentiary mistakes, etc. Outsiders introduced to the system often blanch at just how out of control things seem to be.

Last week, an AP article crystallized the frustrations many people out there in the Los Angeles criminal defense community have been feeling:

Published on: November 28, 2011

Being Accused of Los Angeles Medicare Fraud: Can Your Conscience Ever Be Cleared?

by Michael Kraut

If you or someone you care about was recently arrested or investigated for a crime like Southern California Medicare/Medi-Cal fraud, your life has been topsy-turvy.

The penalties associated with your charges could include substantial jail time and forced reparations. You could also lose your dental, medical, or chiropractic license. On top of that, a seemingly endless array of ripple effects could haunt you: e.g. loss of your professional reputation, loss of respect from your family members and peers, financial problems, etc.

Perhaps the most frustrating thing about being tagged for Los Angeles Medicare fraud (or Southern California credit card fraud, Los Angeles insurance fraud, or other so-called white-collar crimes) is the self-recrimination that often follows.