Ex-MetroHealth COO sentenced to 15 years for defrauding hospital

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-metrohealth-coo-sentenced-to-15-years-for-defrauding-hospital.html?origin=cfoe&utm_source=cfoe

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The former chief operating officer of Cleveland-based MetroHealth System was sentenced to more than 15 years in prison for his role in a conspiracy to defraud the health system through a series of bribes and kickbacks, according to the Department of Justice.

Five things to know:

1. The sentencing came after former COO Edward Hills, DDS, and three co-defendants — all dentists at MetroHealth — were found guilty of criminal charges in July 2018. The four men were indicted for the crimes in October 2016.

2. According to court documents presented by the Justice Department during the trial, Dr. Hills and two of his co-defendants engaged in a racketeering conspiracy from 2008 through 2016 that involved a series of bribes, witness tampering and other crimes.

3. Federal prosecutors alleged Dr. Hills solicited cash, checks and expensive gifts from the two co-defendants beginning in 2009, and in return took actions on their behalf allowing them to operate their individual private dental clinics during regular business hours while receiving full-time salaries from MetroHealth.

4. Dr. Hills, who also served as interim president and CEO of MetroHealth from December 2012 through July 2013, allowed the co-defendants to hire MetroHealth dental residents to work at their private clinics during regular business hours and did not require them to pay wages or salaries to residents. He allowed the three individuals and others to solicit bribes from prospective dental school residents, which amounted to at least $75,000 between 2008 and 2014.

5. Dr. Hills’ co-defendants are scheduled to be sentenced later this month.

 

 

Ex-revenue cycle director gets prison time for embezzling from Delaware hospital

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-revenue-cycle-director-gets-prison-time-for-embezzling-from-delaware-hospital.html?origin=cfoe&utm_source=cfoe

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Hope Abram, a former revenue cycle director at Lewes, Del.-based Beebe Healthcare, has been sentenced to prison for embezzling more than $100,000 from Beebe Healthcare, according to the Salisbury Daily Times.

Ms. Abram was arrested earlier this year after Beebe Healthcare officials alerted police of a potential internal embezzlement. A standard audit of receivables and payments pointed to several irregularities tied to Ms. Abram. She recently pleaded guilty to theft of greater than $100,000 in connection with the incidents.

Between February and May of 2017, Ms. Abram requested refund checks for fictitious people. When the checks were returned, she deposited them into her personal account.

Ms. Abram was sentenced to 25 years in prison, but much of it was suspended. She will serve two years in federal prison followed by home confinement. In addition to the prison term, Ms. Abram was ordered to pay $201,451 in restitution, according to the report.

Healthcare CEO gets prison time for role in $19.4M kickback scheme

https://www.beckershospitalreview.com/legal-regulatory-issues/healthcare-ceo-gets-prison-time-for-role-in-19-4m-kickback-scheme.html

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The former CEO of American Senior Communities, an Indianapolis-based skilled nursing and rehabilitation provider, was sentenced June 29 to nine and a half years in prison for his role in a fraud, kickback and money laundering conspiracy, according to the Department of Justice.

Federal agents began their investigation into James Burkhart three years ago. In September 2015, agents executed search warrants of his residence and ASC office. About a year later, Mr. Burkhart and three others — Daniel Benson, the former COO of American Senior Communities; Steven Ganote, an associate; and Joshua Burkhart, Mr. Burkhart’s younger brother — were indicted by a federal grand jury. All of the defendants, including Mr. Burkhart, had pleaded guilty to federal felony charges by January 2018.

Mr. Burkhart and his co-conspirators were accused of creating shell companies that would inflate vendors’ bills and submit them to ASC as if the shell companies were the real vendors. He also caused vendors or shell companies to submit false bills to ASC for fictitious services that were never provided, and, in some cases, demanded vendors pay him kickbacks in exchange for allowing them to service ASC’s large number of facilities.

In addition, Mr. Burkhart had vendors inflate their bills to ASC, which he would pay with money from Health & Hospital Corp. of Marion County, the public health department that operates several Indianapolis hospitals. The vendors would allegedly kick the overage back to Mr. Burkhart and his co-conspirators.

According to the DOJ, Mr. Burkhart and his co-conspirators funneled nearly $19.4 million to themselves through the scheme. The majority of the funds came from Health & Hospital Corp. of Marion County.

Mr. Burkhart was sentenced to prison after pleading guilty to three felony offenses: conspiracy to commit fraud, conspiracy to violate the healthcare Anti-Kickback Statute and money laundering.

 

 

Ex-CFO, 3 surgeons charged in $950M kickback scheme in California

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-cfo-3-surgeons-charged-in-950m-kickback-scheme-in-california.html

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Federal prosecutors unsealed charges this week against nine new defendants for their alleged roles in a kickback scheme that resulted in the submission of more than $950 million in fraudulent claims, mostly to California’s worker compensation system, according to the Department of Justice.

The nine defendants were charged in relation to the government’s investigation into kickbacks physicians received for patient referrals for spinal surgeries performed at Pacific Hospital in Long Beach, Calif. They are among the dozens of physicians and other medical professionals allegedly involved in the scheme.

Of the nine defendants recently charged, three are orthopedic surgeons. Daniel Capen, MD, agreed to plead guilty to conspiracy and illegal kickback charges. He allegedly accounted for about $142 million of Pacific Hospital’s claims to insurers. Timothy Hunt, MD, who allegedly referred spinal surgery patients to Dr. Capen and other physicians, agreed to plead guilty to a conspiracy charge involving his receipt of illegal kickbacks. Tiffany Rogers, MD, allegedly received illegal kickbacks to refer patients for spinal surgeries to Pacific Hospital.

The other defendants recently charged in the scheme include the former CFO of Pacific Hospital’s physician management arm, George Hammer. He agreed to plead guilty to tax charges based on the fraudulent classification of illegal kickbacks in hospital-related corporate tax filings. Two chiropractors as well as two companies and an individual associated with one of the chiropractors were also charged for their alleged involvement in the scheme, according to the DOJ.

Michael Drobot, former owner and CEO of Pacific Hospital, ran the 15-year-long kickback scheme. He was sentenced to more than five years in prison in January.

 

 

Victims Seek Payments As ‘Dr. Death’ Declares Innocence

http://khn.org/news/victims-seek-payments-as-dr-death-declares-innocence/

Farid Fata

Victims of “Dr. Death” had until this week to submit receipts for unnecessary chemotherapy, medical bills for liver damage and funeral expenses for their loved ones. By an initial count on Tuesday, 517 former patients and their families had filed claims against Farid Fata, the Detroit-area cancer doctor convicted of raking in over $17 million by poisoning patients with chemotherapy and other drugs they did not need.

Fata was branded by prosecutors as “the most egregious fraudster” in U.S. history for scamming Medicare and private insurers by giving at least 553 patients, some of whom did not have cancer, thousands of doses of unnecessary and expensive drugs. Now he insists he did nothing wrong. Breaking his silence in a jailhouse interview, Fata said victims claiming he killed loved ones or ruined their lives are misguided and that those who died were “going to die anyhow because of the nature of the diseases.”

Fata, nicknamed “Dr. Death” by his victims, is serving a 45-year sentence in a federal prison in South Carolina after pleading guilty to 13 counts of health care fraud, one count of conspiracy to pay or receive kickbacks and two counts of money laundering. He ran one of Michigan’s largest private cancer practices, with a network of clinics outside of Detroit, from 2005 to 2013.

The 51-year-old prisoner told Kaiser Health News he plans to speak in court at a Jan. 17 restitution hearing and declare his innocence. Fata said his guilty plea in 2014 came under duress, and he is preparing to seek freedom through a habeas corpus petition, by which a judge would determine if his detention is lawful.

http://www.beckershospitalreview.com/legal-regulatory-issues/physician-claims-innocence-after-admitting-he-administered-unnecessary-chemotherapy-to-patients.html

 

Former Non-Profit Health Clinics CEO Sentenced to 18 Years for Funneling Millions in Grant Money to Private Companies

https://www.justice.gov/usao-ndal/pr/former-non-profit-health-clinics-ceo-sentenced-18-years-funneling-millions-grant-money

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The former CEO of two Alabama health clinics has been sentenced to 18 years in prison for his role in a fraud scheme, according to the Department of Justice.

According to the DOJ, 53-year-old Jonathan Dunning left his post as CEO of Birmingham (Ala.) Health Care and Central Alabama Comprehensive Health in Tuskegee in 2008. However, he continued to exercise control over the two nonprofit health clinics and diverted government funds meant for the clinics to his own for-profit companies, according to the DOJ.

In June, a federal jury convicted Mr. Dunning of 62 counts of wire fraud, 33 counts of money laundering and two counts of bank fraud. A jury also found him guilty of one count of conspiracy, finding that he conspired with another person to commit wire fraud, bank fraud and money laundering.

Over a seven-year period, Mr. Dunning defrauded HHS, the Health Resources and Service Administration, the two clinics, a credit union and others out of more than $16 million, according to the government’s sentencing memorandum.

Pasadena doctor who falsely claimed patients were terminally ill is sentenced to four years for fraud

http://www.latimes.com/local/lanow/la-me-ln-pasadena-doctor-prison-20160824-snap-story.html?utm_campaign=CHL%3A+Daily+Edition&utm_source=hs_email&utm_medium=email&utm_content=33409508&_hsenc=p2ANqtz–KDKuU4PH1yztKbkXarPsY58B6-80M433Uz-u6qd86BDE6zJ4zbv5sPgwskL5rfPSDgOeUJw0jeuHlEK79jrfz4jh2Jg&_hsmi=33409508

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A Pasadena doctor convicted of falsely certifying that more than 79 patients were terminally ill as part of a scheme to bilk Medicare and Medi-Cal was sentenced by a federal judge to four years in prison.

U.S. District Judge S. James Otero also ordered Boyao Huang, 43, to pay $1,344,204 in restitution last week. In May, Huang was found guilty of four counts of healthcare fraud at the conclusion of a two-week trial that centered on a ploy to defraud the government of $8.8 million by making it pay for hospice-related services. Huang could have received up to 10 years in prison for each of the counts.

Former Sacred Heart physician gets 2 years for role in kickback scheme

http://www.chicagotribune.com/news/ct-sacred-heart-hospital-sentencing-met-20160812-story.html

Sacred Heart sentence

Venkateswara Kuchipudi, right, walks with his lawyer Theodore Poulos outside the Dirksen U.S Courthouse on Aug. 12, 2016, after Kuchipudi was sentenced to two years in prison for his part in a fraud scheme at the now-shuttered Sacred Heart Hospital.

http://www.beckershospitalreview.com/legal-regulatory-issues/former-sacred-heart-physician-gets-2-years-for-role-in-kickback-scheme.html