Tag: medicare fraud

WASHINGTON - CMS says its aggressive corrective actions have led to an estimated $15 billion reduction in Medicare fee-for-service improper payments since 2016. The Medicare fee-for-service estimated improper rate decreased to 6.27% in fiscal year 2020, compared to 7.25% in FY 2019, the fourth consecutive year the rate has been below the 10% threshold for compliance established in the Payment Integrity Information Act of 2019. “We must ensure that fraud and abuse doesn't rob the program of...

WASHINGTON - CMS has issued a final rule that creates several new revocation and denial authorities to bolster the agency's efforts to stop waste, fraud and abuse in Medicare, Medicaid and CHIP.The Program Integrity Enhancements to the Provider Enrollment Process, CMS-6058-FC, contains a new “affiliations” authority that allows CMS to identify individuals and organizations that pose an undue risk of fraud, waste and abuse based on their relationships with other previously sanctioned entities....

HOUSTON- Angel Mirabal, of Miami, was arrested Sept. 26 on charges of scheming to defraud Medicare. From April 2013 to July 2013, Mirabal allegedly conspired to bill Medicare $24 million in fraudulent claims for reimbursement through Quick Solutions Medical Supplies. According to the indictment said Mirabal and his co-conspirators used fraudulent shell companies to launder and disburse the proceeds from the health care fraud scheme.

LOS ANGELES - Vahe Tahmasian has been sentenced to 121 months in prison after being convicted of conspiracy to commit health care fraud, six counts of health care fraud and six counts of aggravated identity theft, according to a press release from the U.S. Department of Justice. Between April 2009 and February 2011, Tahmasian and co-conspirator Erik Mkhitarian, owners of Orthomed Appliance, a DME supply company in West Hollywood, allegedly stole the identity of beneficiaries and doctors from patient...

BATON ROUGE, La. - A federal court jury has found Ahaoma Boniface Ohia, owner of All-Star Medical Supplies, guilty of wire fraud, it was announced June 12. Ohia was accused of billing Medicare for durable medical equipment that was less expensive than what was provided or that wasn't provided at all, according to a press release. Ohia, who was taken into custody after the verdict, faces up to 140 years in prison, fines of up to $1.75 million, and restitution to victims.

WASHINGTON - The Medicare Fraud Strike Force has charged 90 individuals with $260 million in false billings, according to a May 13 release from the Department of Justice. Those charged include physicians, nurses and other medical professionals.“The crimes charged represent the face of health care fraud today—doctors billing for services that were never rendered, supply companies providing motorized wheelchairs that were never needed, recruiters paying kickbacks to get Medicare billing...

WASHINGTON - Jacob Kilgore, former co-owner of Salt Lake City-based Orbit Medical, has been indicted for his role in a $20 million Medicare fraud scheme, justice department officials have announced. The government alleges that between September 2008 and June 2011, Orbit Medical submitted false and fraudulent power wheelchair claims to Medicare. The company made $20 million in false claims; Medicare paid $15 million. Former Orbit sales representatives Morgan Workman, David Evans and Hunter Hartman...

I am being stalked by a company that wants to give me a free Senior Benefits medical alert system. The first two calls, I thought, were amusing. But the calls keep coming. I can't block them: they come from different numbers and different area codes. Every time my phone rings, I am alternately annoyed/resigned/trepidatious. "Senior Benefits is recommended by the American Diabetes Association. To receive your free system press 1 now, press 5 to be removed but press 1 now." Over and over again. I keep...

LOS ANGELES - A district judge has sentenced a Carson, Calif., woman to 13 years in federal prison for her role in an $8 million Medicare fraud case involving illegal kickbacks to marketers and doctors who wrote fraudulent prescriptions, according to a press release from the FBI. Uben Ogbu Rush, who owned or controlled six companies that ostensibly sold home medical equipment, took part in a scheme in which she paid marketers to recruit Medicare beneficiaries who would allow their identities and...

WASHINGTON - NAIMES has scheduled a virtual fly-in for Dec. 5 to build support for H.R. 6490, a bill that would replace the current competitive bidding program with a market-pricing program (MPP). In what its calling “Operation STOP NCB,” NAIMES staff and board members will be in Washington, D.C., on Dec. 4 and 5 to visit the offices of key lawmakers. The association asks that providers follow up those visits with calls to their lawmakers on Dec. 5 from 8 a.m. to 5 p.m. “Let's make...