Articles Posted in FRAUD & CRIMINAL TAX

negron-150x150melgen-150x150bernadett-150x150President Trump’s term ended with a spree of executive clemency to health care crooks who ripped off taxpayers and harmed patients.

His last-minute actions infuriated advocates for health care reform and patient protection, as well as federal prosecutors. They were aghast by the inexplicable largess shown to Medicare and medical miscreants included in Trump’s last-minute, public pardons of 73 people and commutations for 70 others. 

The white collar crooks not only got get-out-of-jail-free cards from Trump, but also saw their debts to the government canceled to the tune of millions of dollars.

countylahospicegrafic-300x139With coronavirus infections and deaths rising anew in worrisome fashion from coast to coast, matters could not get worse with the nation’s long-term care, right? Guess again. Profit-mongering and “audacious, widespread fraud” apparently has run amok in hospice care in the Golden State.

Because California, alas, too often serves as a trend-setting locale, patients, their loved ones, clinicians, regulators, and politicians may wish to take heed of an investigation published by the Los Angeles Times. The newspaper reported that too many older, sick, and injured patients have been gulled into signing up for unneeded and undelivered services meant for folks at the end of their lives:

“[M]any [hospice patients] are unwitting recruits [of] unscrupulous providers who bill Medicare for hospice services and equipment for ‘terminally ill’ patients who aren’t dying. Intense competition for new patients — who generate $154 to $1,432 a day each in Medicare payments — has spawned a cottage industry of illegal practices, including kickbacks to crooked doctors and recruiters who zero in on prospective patients at retirement homes and other venues … The exponential boom in providers has transformed end-of-life care that was once the realm of charities and religious groups into a multibillion-dollar business dominated by profit-driven operators. Nowhere has that growth been more explosive, and its harmful side effects more evident, than in Los Angeles County. The county’s hospices have multiplied sixfold in the last decade and now account for more than half of the state’s roughly 1,200 Medicare-certified providers, according to a Times analysis of federal health care data.”

oighhslogo-150x150Buh-bye? Arrivederci? Sayonara? Can it be that the coronavirus pandemic puts an end to one of the disgraceful ways that Big Pharma and medical device makers push their wares on all-too malleable doctors — with big-money speaker programs?

The inspector general’s office of the giant federal Health and Human Services (HHS) agency has warned drug- and medical device-makers that these pandemic-paused marketing shams should not resume. The $2 billion that industry players have forked out for the in-person gab fests in the last three years looks sketchy at best to federal watchdogs and prosecutors, the HHS inspector general warned in a rarely issued “special fraud alert.” It reported this:

“The Office of Inspector General (OIG) and Department of Justice (DOJ) have investigated and resolved numerous fraud cases involving allegations that remuneration offered and paid in connection with speaker programs violated the anti-kickback statute. The Federal government has pursued civil and criminal cases against companies and individual [health care providers] involving speaker programs … Our enforcement experience demonstrates that some companies expend significant resources on speaker programs and that some [health care providers] receive substantial remuneration from companies. This Special Fraud Alert highlights some of the inherent fraud and abuse risks associated with the offer, payment, solicitation, or receipt of remuneration related to company-sponsored speaker programs.”

Here’s another story with a satisfying ending and the take-home lesson that it’s a bad idea to cheat taxpayers and abuse medical resources.

A chain of hospices agreed to settle a lawsuit over its overbilling of Medicare, and driving up payments by providing care to patients for whom it wasn’t appropriate. St. Joseph Hospice, which operates in four states will pay $5.9 million, reported Associated Press (AP).

Hospice care is for people with terminal illnesses, and generally provides palliative services, which address symptoms, not curative care. Hospice patients usually receive the care in their homes, enabling them to die where they are most comfortable, instead of in a hospital or other care facility. Doctors prescribe hospice care only for people who are not expected to live longer than six months.

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