Michigan doctor arrested for purposely misdiagnosing cancer
by Jen Hayden
Daily Kos
Aug 07, 2013
Greed knows no bounds. It pushes people to do unspeakable things. For Dr. Farid Fata, a Michigan oncologist, there were no limits:
Dr. Farid Fata, 48, of Oakland Township was arrested Tuesday and charged for allegedly submitting false claims to Medicare for services that were medically unnecessary, including chemotherapy treatments, Positron Emission Tomograph (PET) scans and a variety of cancer and hematology treatments for patients who did not need them. Dr. Fata owns and operates Michigan Hematology Oncology Centers (MHO) which has offices in Clarkston, Bloomfield Hills, Lapeer, Sterling Heights, Troy and Oak Park.
Dr. Fata was scamming Medicare to the tune of $35 million.
In the course of the scheme, prosecutors say Dr. Fata falsified and directed others to falsify documents. MHO billed Medicare for approximately $35 million dollars over a two-year period, approximately $25 of which is attributable to Dr. Fata, federal officials said.
The complaint further alleges that Dr. Fata directed the administration of unnecessary chemotherapy to patients in remission; deliberate misdiagnosis of patients as having cancer to justify unnecessary cancer treatment; administration of chemotherapy to end-of-life patients who will not benefit from the treatment; deliberate misdiagnosis of patients without cancer to justify expensive testing; fabrication of other diagnoses such as anemia and fatigue to justify unnecessary hematology treatments, and distribution of controlled substances to patients without medical necessity or are administered at dangerous levels.
Dr. Fata was prescribing painful and unnecessary treatments to patients:
The feds say he also deliberately misdiagnosed patients “as having cancer to justify unnecessary cancer treatment,” WXYZ reported.
Federal agents say Fata directed the “administration of chemotherapy to end-of-life patients who [would] not benefit from the treatment,” and deliberately misdiagnosed “patients without cancer to justify expensive testing.”
Thankfully, Dr. Fata isn't likely to get out of jail any time soon:
Dr. Fata faced a federal magistrate Tuesday afternoon. Assistant U. S. Attorneys assigned to the case argued Fata is a flight risk because he has access to about $14 million in liquid assets and a home in Lebanon. The magistrate is temporarily detaining Fata until another hearing can be held on Thursday. He faces up to 20 years behind bars if he’s convicted.
Twenty years? Not long enough. Not nearly long enough.
Showing posts with label medicare fraud. Show all posts
Showing posts with label medicare fraud. Show all posts
Monday, August 12, 2013
Wednesday, February 29, 2012
Jacques Roy, Charged With $375 Million In Health Care Fraud, Gave Money To Tea Party
Jacques Roy, Charged With $375 Million In Health Care Fraud, Gave Money To Tea Party
Jeffrey Young
Huff Post
02/29/2012
If Texas physician Jacques Roy turns out to be guilty of charges he conspired to defraud Medicare and Medicaid of almost $375 million, we'll know where at least $1,650 of that money went: to a political action committee affiliated with the Tea Party Express, a group opposed to the health reform law that helped nab him.
Between August 2009 and January 2010, Roy wrote five checks to the Our Country Deserves Better PAC, associated with the Tea Party Express, according to Federal Election Commission records. Roy also gave $300 to the PAC for the Texas Medical Association, which opposed the health reforms enacted in March 2010 by President Barack Obama and Democrats in Congress. Those contributions also are listed in FEC records.
The White House partially credits new anti-fraud measures from the health care reform law with the case announced yesterday.
Roy, who lives in Rockwall, Texas, gave the money during the most contentious months of the congressional debate over national health reform. His first donation was in August 2009, when Tea Party activists and other opponents of the legislation stormed congressional town hall meetings and captured the attention of the news media. The Tea Party Express organized a bus tour and a rally in Washington to protest the health reform bill in August 2009.
According to federal law enforcement agencies, Roy's financial support of Tea Party causes also took place in the middle of his nearly six-year campaign to bilk government health programs. Federal agents arrested Roy and six others Tuesday alleging they worked together to file $350 million in bogus claims to Medicare and another $24 million to Medicaid. Louise LaMarre, who shares a home and business address with Roy, donated $710 to the Republican National Committee in 2008 and 2009, records show. LaMarre was not charged in the fraud case.
Spokespeople for the Tea Party Express, the Rockwall County TEA Party, the Dallas Tea Party, and the Rockwall County Republican Party did not respond to emails requesting comment.
The Department of Justice said Roy and his alleged conspirators charged taxpayers for home-health care services that were either unnecessary or never provided, in some cases giving patients cash, groceries and food stamps, in exchange for their cooperation. The indictment charges home-health agency representatives recruited patients door-to-door and at locations including a homeless shelter and a church in Dallas. Authorities said Roy had employees forge his signature on forms approving medical services.
Roy, a 54-year-old native of Canada, runs Medistat Group Associates in DeSoto, Texas, and worked with nearby home-health agencies to produce the allegedly false claims. The owners of three home-health agencies also were arrested Tuesday and, because of their connections to Roy, 78 other agencies had their payments cut off by the government agency that administers Medicare and Medicaid.
Roy signed off on services by more than 500 home-health agencies for 11,000 patients from January 2006 through November 2010 and "had more purported patients than any other medical practice in the United States," according to a Department of Justice press release.
Public records from the Texas Medical Board show Roy has been in hot water before. The board suspended his medical license for 30 days in 2001 and placed unspecified conditions on his practice until August 2005. The Dallas Morning News reported that the sanctions against Roy stemmed from a 2005 incident when he was an emergency room physician. According to the report, Roy provided "dozens of prescriptions" for painkillers to a woman with whom he was having an affair. The woman died in a car crash and an autopsy revealed high levels of the drugs in her system. Roy subsequently took a job caring for Dallas County jail inmates but was fired after six months, the newspaper reported.
Federal agents said they raided Roy's home and office last June and seized what they claim is evidence he created a fake identity and is a flight risk. An illegitimate Texas drivers license, a Quebec identification card, and a Canadian birth certificate all under the name Michel Poulin along with applications for a passport and Social Security benefits from Canada were also found. Authorities also found books entitled Hide Your A$$ets and Disappear, A Step-By-Step Guide to Vanishing Without a Trace and The Offshore Money Manual, according to the indictment.
Jeffrey Young
Huff Post
02/29/2012
If Texas physician Jacques Roy turns out to be guilty of charges he conspired to defraud Medicare and Medicaid of almost $375 million, we'll know where at least $1,650 of that money went: to a political action committee affiliated with the Tea Party Express, a group opposed to the health reform law that helped nab him.
Between August 2009 and January 2010, Roy wrote five checks to the Our Country Deserves Better PAC, associated with the Tea Party Express, according to Federal Election Commission records. Roy also gave $300 to the PAC for the Texas Medical Association, which opposed the health reforms enacted in March 2010 by President Barack Obama and Democrats in Congress. Those contributions also are listed in FEC records.
The White House partially credits new anti-fraud measures from the health care reform law with the case announced yesterday.
Roy, who lives in Rockwall, Texas, gave the money during the most contentious months of the congressional debate over national health reform. His first donation was in August 2009, when Tea Party activists and other opponents of the legislation stormed congressional town hall meetings and captured the attention of the news media. The Tea Party Express organized a bus tour and a rally in Washington to protest the health reform bill in August 2009.
According to federal law enforcement agencies, Roy's financial support of Tea Party causes also took place in the middle of his nearly six-year campaign to bilk government health programs. Federal agents arrested Roy and six others Tuesday alleging they worked together to file $350 million in bogus claims to Medicare and another $24 million to Medicaid. Louise LaMarre, who shares a home and business address with Roy, donated $710 to the Republican National Committee in 2008 and 2009, records show. LaMarre was not charged in the fraud case.
Spokespeople for the Tea Party Express, the Rockwall County TEA Party, the Dallas Tea Party, and the Rockwall County Republican Party did not respond to emails requesting comment.
The Department of Justice said Roy and his alleged conspirators charged taxpayers for home-health care services that were either unnecessary or never provided, in some cases giving patients cash, groceries and food stamps, in exchange for their cooperation. The indictment charges home-health agency representatives recruited patients door-to-door and at locations including a homeless shelter and a church in Dallas. Authorities said Roy had employees forge his signature on forms approving medical services.
Roy, a 54-year-old native of Canada, runs Medistat Group Associates in DeSoto, Texas, and worked with nearby home-health agencies to produce the allegedly false claims. The owners of three home-health agencies also were arrested Tuesday and, because of their connections to Roy, 78 other agencies had their payments cut off by the government agency that administers Medicare and Medicaid.
Roy signed off on services by more than 500 home-health agencies for 11,000 patients from January 2006 through November 2010 and "had more purported patients than any other medical practice in the United States," according to a Department of Justice press release.
Public records from the Texas Medical Board show Roy has been in hot water before. The board suspended his medical license for 30 days in 2001 and placed unspecified conditions on his practice until August 2005. The Dallas Morning News reported that the sanctions against Roy stemmed from a 2005 incident when he was an emergency room physician. According to the report, Roy provided "dozens of prescriptions" for painkillers to a woman with whom he was having an affair. The woman died in a car crash and an autopsy revealed high levels of the drugs in her system. Roy subsequently took a job caring for Dallas County jail inmates but was fired after six months, the newspaper reported.
Federal agents said they raided Roy's home and office last June and seized what they claim is evidence he created a fake identity and is a flight risk. An illegitimate Texas drivers license, a Quebec identification card, and a Canadian birth certificate all under the name Michel Poulin along with applications for a passport and Social Security benefits from Canada were also found. Authorities also found books entitled Hide Your A$$ets and Disappear, A Step-By-Step Guide to Vanishing Without a Trace and The Offshore Money Manual, according to the indictment.
Sunday, May 15, 2011
We pay hospitals more if they injure patients
Hospitals to get cash boost for better care
Apr 29, 2011
Reuters
Hospitals that improve medical care for elderly patients, and reduce deadly errors, will get millions of dollars under an incentive program launched on Friday that aims to cut overall Medicare costs.
The government healthcare program for seniors spent about $4.4 billion in 2009 to care for patients who were harmed in the hospital, according to the Centers for Medicare and Medicaid Services (CMS)...
Apr 29, 2011
Reuters
Hospitals that improve medical care for elderly patients, and reduce deadly errors, will get millions of dollars under an incentive program launched on Friday that aims to cut overall Medicare costs.
The government healthcare program for seniors spent about $4.4 billion in 2009 to care for patients who were harmed in the hospital, according to the Centers for Medicare and Medicaid Services (CMS)...
Friday, February 18, 2011
Health-Care Fraud Sweep Nets 114
FEBRUARY 17, 2011
Health-Care Fraud Sweep Nets 114
By MARK SCHOOFS, MAURICE TAMMAN And BRENT KENDALL
Wall Street Journal
A health-care crime sweep Thursday morning netted 114 defendants on charges related to Medicare fraud, in what Attorney General Eric Holder called the largest such takedown in U.S. history.
The defendants—charged in nine metropolitan areas including Los Angeles, Brooklyn, Detroit and Miami—were allegedly involved in more than 40 schemes, almost all of which were unrelated to one another, officials said. Altogether, the schemes attempted to defraud the government of more than $240 million, according to law enforcement officials.
Several of the cases appear to involve doctors or other health-care practitioners acting alone or with few alleged co-conspirators. One of these, Brooklyn physical therapist Aleksandr Kharkover, had been featured in a December Wall Street Journal article on possible financial abuse involving physical therapy, a growing area of Medicare fraud.
Mr. Kharkover, accused of being involved in one of at least three separate alleged physical-therapy rings broken up this morning, billed Medicare about $11.9 million from January 2005 through July 2010, according to the indictment. During that time period, Medicare paid out $7.3 million, according to a person familiar with the investigation. He is accused of having billed for physical-therapy services that were never performed and weren't medically necessary.
Mr. Kharkover's lawyer, Montell Figgins, said his client "looks forward to his day in court where he'll be able to set the record straight. Mr. Kharkover is a good man and a well-respected doctor."
The publisher of The Wall Street Journal, Dow Jones & Co., filed court papers last month to overturn a court injunction that blocks the public from seeing the Medicare billing records of individual doctors.
In 1979, citing privacy rights, the American Medical Association won a suit against the government to keep secret the amounts of money individual doctors get paid by Medicare. The AMA argued that releasing the information would violate physicians' rights to privacy. The court's ruling still stands...
Health-Care Fraud Sweep Nets 114
By MARK SCHOOFS, MAURICE TAMMAN And BRENT KENDALL
Wall Street Journal
A health-care crime sweep Thursday morning netted 114 defendants on charges related to Medicare fraud, in what Attorney General Eric Holder called the largest such takedown in U.S. history.
The defendants—charged in nine metropolitan areas including Los Angeles, Brooklyn, Detroit and Miami—were allegedly involved in more than 40 schemes, almost all of which were unrelated to one another, officials said. Altogether, the schemes attempted to defraud the government of more than $240 million, according to law enforcement officials.
Several of the cases appear to involve doctors or other health-care practitioners acting alone or with few alleged co-conspirators. One of these, Brooklyn physical therapist Aleksandr Kharkover, had been featured in a December Wall Street Journal article on possible financial abuse involving physical therapy, a growing area of Medicare fraud.
Mr. Kharkover, accused of being involved in one of at least three separate alleged physical-therapy rings broken up this morning, billed Medicare about $11.9 million from January 2005 through July 2010, according to the indictment. During that time period, Medicare paid out $7.3 million, according to a person familiar with the investigation. He is accused of having billed for physical-therapy services that were never performed and weren't medically necessary.
Mr. Kharkover's lawyer, Montell Figgins, said his client "looks forward to his day in court where he'll be able to set the record straight. Mr. Kharkover is a good man and a well-respected doctor."
The publisher of The Wall Street Journal, Dow Jones & Co., filed court papers last month to overturn a court injunction that blocks the public from seeing the Medicare billing records of individual doctors.
In 1979, citing privacy rights, the American Medical Association won a suit against the government to keep secret the amounts of money individual doctors get paid by Medicare. The AMA argued that releasing the information would violate physicians' rights to privacy. The court's ruling still stands...
Monday, February 14, 2011
8 Miami-Dade County nurses prison-bound for fraud
02.05.11
8 Miami-Dade County nurses prison-bound for fraud
The Miami Herald
The Associated Press
Eight Miami-Dade County nurses have been sentenced to prison and ordered to pay restitution for helping two agencies fleece millions from Medicare.
The nurses worked for two home health care agencies, ABC Home Health and Florida Home Health Care Provider.
According to the Justice Department, each of the eight nurses pleaded guilty last year to one count of conspiracy to commit health care fraud. The nurses admitted falsifying patient records for Medicare beneficiaries to make it seem like they qualified for services from the two agencies.
The nurses' prison sentences range from five months to 2 1/2 years. Each has been ordered to pay restitution. Those amounts range from roughly $66,000 up to $699,000.
8 Miami-Dade County nurses prison-bound for fraud
The Miami Herald
The Associated Press
Eight Miami-Dade County nurses have been sentenced to prison and ordered to pay restitution for helping two agencies fleece millions from Medicare.
The nurses worked for two home health care agencies, ABC Home Health and Florida Home Health Care Provider.
According to the Justice Department, each of the eight nurses pleaded guilty last year to one count of conspiracy to commit health care fraud. The nurses admitted falsifying patient records for Medicare beneficiaries to make it seem like they qualified for services from the two agencies.
The nurses' prison sentences range from five months to 2 1/2 years. Each has been ordered to pay restitution. Those amounts range from roughly $66,000 up to $699,000.
Tuesday, May 12, 2009
Richard L. Scott: Healthcare Enemy #1?
Richard L. Scott: Healthcare Enemy Number One
The Rag Blog
By Christopher Hayes
March 11, 2009
...for my money, Rick Scott is the man who best embodies the spirit of the current conservative opposition... Politico recently reported that the millionaire Republican would be heading up Conservatives for Patients' Rights (CPR), a new group that plans to spend around $20 million to kill President Obama's efforts at healthcare reform.
Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation...the for-profit hospital chain Scott helped found--the one he ran and built his entire reputation on--was discovered to be in the habit of defrauding the government out of hundreds of millions of dollars.
This is the man who will be delivering what Politico called the "pro-free-market message."
A Texas lawyer who shared a business partner with George W. Bush, Scott started his health company, Columbia Hospital Corporation, in 1987. Its growth was meteoric, expanding from just a few hospitals to more than 1,000 facilities in thirty-eight states and three other countries in 1997. As his firm gobbled up chains, like the Frist family's Hospital Corporation of America (HCA), it became the largest for-profit hospital chain in the country. By 1994, Columbia/HCA was one of the forty largest corporations in America, and Scott had acquired a reputation as the Gordon Gecko of the healthcare world. "Whose patients are you stealing?" he would ask employees at his newly acquired hospitals.
He promised to put nonprofit hospitals--which he insisted on referring to as "nontaxpaying" hospitals--out of business and touted his company's single-minded pursuit of profit as a model for the nation's entire healthcare system. "What's happening in Washington is not healthcare reform," he told the New York Times in 1994. "Healthcare reform is happening in the marketplace."
The press portrayed Scott as a guru to be admired and feared, "a private capitalist dictator," in the words of one Princeton health economist. "Probably the lowest body fat of anybody I've been in business with," his partner told the Times.
"Other hospitals were intimidated," recalls John Schilling, who worked for Columbia/HCA in the 1990s. Scott was "like the bully that would come into town and if you didn't sell to him or partner with him, he would open up shop across the street from you and put you out of business."
Not long after joining the company in 1993 as the supervisor of reimbursement for the Fort Myers, Florida, office, Schilling noticed things weren't quite kosher. "They were looking for ways to maximize reimbursement...which ultimately would improve the bottom line."
One way they did this was to fudge the costs on their Medicare expense reports. They were "basically keeping two sets of books," says Schilling. The company would maintain an internal expense report, what it called a "reserve" report, which accurately tallied its expenses. "And then they would have a second report, which...they would file with the government, which was more aggressive." That report would "include inflated costs and expenses they knew weren't allowable or reimbursable. The one they filed with government might claim $5 million and the reserve would claim $4.5." Columbia/HCA would pocket the difference...
The Rag Blog
By Christopher Hayes
March 11, 2009
...for my money, Rick Scott is the man who best embodies the spirit of the current conservative opposition... Politico recently reported that the millionaire Republican would be heading up Conservatives for Patients' Rights (CPR), a new group that plans to spend around $20 million to kill President Obama's efforts at healthcare reform.
Having Scott lead the charge against healthcare reform is like tapping Bernie Madoff to campaign against tighter securities regulation...the for-profit hospital chain Scott helped found--the one he ran and built his entire reputation on--was discovered to be in the habit of defrauding the government out of hundreds of millions of dollars.
This is the man who will be delivering what Politico called the "pro-free-market message."
A Texas lawyer who shared a business partner with George W. Bush, Scott started his health company, Columbia Hospital Corporation, in 1987. Its growth was meteoric, expanding from just a few hospitals to more than 1,000 facilities in thirty-eight states and three other countries in 1997. As his firm gobbled up chains, like the Frist family's Hospital Corporation of America (HCA), it became the largest for-profit hospital chain in the country. By 1994, Columbia/HCA was one of the forty largest corporations in America, and Scott had acquired a reputation as the Gordon Gecko of the healthcare world. "Whose patients are you stealing?" he would ask employees at his newly acquired hospitals.
He promised to put nonprofit hospitals--which he insisted on referring to as "nontaxpaying" hospitals--out of business and touted his company's single-minded pursuit of profit as a model for the nation's entire healthcare system. "What's happening in Washington is not healthcare reform," he told the New York Times in 1994. "Healthcare reform is happening in the marketplace."
The press portrayed Scott as a guru to be admired and feared, "a private capitalist dictator," in the words of one Princeton health economist. "Probably the lowest body fat of anybody I've been in business with," his partner told the Times.
"Other hospitals were intimidated," recalls John Schilling, who worked for Columbia/HCA in the 1990s. Scott was "like the bully that would come into town and if you didn't sell to him or partner with him, he would open up shop across the street from you and put you out of business."
Not long after joining the company in 1993 as the supervisor of reimbursement for the Fort Myers, Florida, office, Schilling noticed things weren't quite kosher. "They were looking for ways to maximize reimbursement...which ultimately would improve the bottom line."
One way they did this was to fudge the costs on their Medicare expense reports. They were "basically keeping two sets of books," says Schilling. The company would maintain an internal expense report, what it called a "reserve" report, which accurately tallied its expenses. "And then they would have a second report, which...they would file with the government, which was more aggressive." That report would "include inflated costs and expenses they knew weren't allowable or reimbursable. The one they filed with government might claim $5 million and the reserve would claim $4.5." Columbia/HCA would pocket the difference...
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