NEWARK—A pain management doctor with a practice based in Red Bank, New Jersey admitted today that he embezzled more than $1.1 million from a medical practice, U.S. Attorney Paul J. Fishman announced.
Robert Muscio, 40, a resident of Colts Neck, New Jersey, pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark federal court to one count of committing mail fraud to embezzle those monies.
According to documents filed in this case and statements made in court:
Between 2007 and 2008, Muscio misused his position as medical director of a practice—with which he is no longer associated—to write checks on the practice’s bank account to pay his personal expenses. To conceal this misconduct from his partners, Muscio falsely described the payments as business expenses of the practice.
The mail fraud count to which Muscio pleaded guilty is punishable by a maximum potential penalty of 20 years in prison and a $250,000 fine. Sentencing is scheduled for May 21, 2014.
U.S. Attorney Fishman credited special agents of the U.S. Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Thomas O’Donnell, and the FBI, under the direction of Special Agent in Charge Aaron T. Ford, with the investigation leading to today’s guilty plea.
The government is represented by Senior Litigation Counsel Andrew Leven of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.
U.S. Attorney Paul J. Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $520 million in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act; the Food, Drug; and Cosmetic Act; and other statutes.
Defense counsel: Joseph J. Benedict Esq., New Brunswick, New Jersey
Showing posts with label Monmouth county. Show all posts
Showing posts with label Monmouth county. Show all posts
Thursday, February 20, 2014
Monday, January 13, 2014
Brotherly Love Ambulance EMT Charged in Health Care Fraud Scheme
PHILADELPHIA—Neel Jackson, 35, of Philadelphia, Pennsylvania, was charged today by information with health care fraud and aiding and abetting health care fraud, announced United States Attorney Zane David Memeger.
In July 2010, Feda Kuran, who is charged elsewhere and has pleaded guilty, began operating Brotherly Love Ambulance Inc. with a co-schemer. According to the information, Jackson, an Emergency Medical Technician (EMT) employed by Brotherly Love, transported patients by ambulance when those patients could have been transported safely by other means and were, therefore, not eligible for ambulance service under Medicare and Medicaid requirements. It is further alleged that Jackson and others completed paperwork, including “run sheets,” representing that patients needed ambulance services, when he knew that they were able to walk or to be transported by public transportation or para-transit van. In addition, it is alleged that Jackson gave envelopes he understood to contain cash or other payments to induce patients to allow Brotherly Love to transport them and/or to induce them to remain with Brotherly Love. Finally, it is alleged that Jackson received payments for referring patients to Feda Kuran and/or Brotherly Love. According to the information, as a result of Jackson’s actions, the Medicare program paid more than $200,000 in inappropriate bills. As a result of the overall scheme at Brotherly Love, it is alleged that the Medicare program paid more than $2 million in inappropriate bills.
If convicted, the defendant faces a maximum possible sentence of 10 years of in prison, three years of supervised release, a $250,000 fine, a $100 special assessment, and an order of restitution and forfeiture.
The case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General, the Federal Bureau of Investigation, and the U.S. Department of Labor Office of the Inspector General. It is being prosecuted by Assistant United States Attorneys Matthew J.D. Hogan and Paul W. Kaufman.
An Information is an accusation. A defendant is presumed innocent unless and until proven guilty.
In July 2010, Feda Kuran, who is charged elsewhere and has pleaded guilty, began operating Brotherly Love Ambulance Inc. with a co-schemer. According to the information, Jackson, an Emergency Medical Technician (EMT) employed by Brotherly Love, transported patients by ambulance when those patients could have been transported safely by other means and were, therefore, not eligible for ambulance service under Medicare and Medicaid requirements. It is further alleged that Jackson and others completed paperwork, including “run sheets,” representing that patients needed ambulance services, when he knew that they were able to walk or to be transported by public transportation or para-transit van. In addition, it is alleged that Jackson gave envelopes he understood to contain cash or other payments to induce patients to allow Brotherly Love to transport them and/or to induce them to remain with Brotherly Love. Finally, it is alleged that Jackson received payments for referring patients to Feda Kuran and/or Brotherly Love. According to the information, as a result of Jackson’s actions, the Medicare program paid more than $200,000 in inappropriate bills. As a result of the overall scheme at Brotherly Love, it is alleged that the Medicare program paid more than $2 million in inappropriate bills.
If convicted, the defendant faces a maximum possible sentence of 10 years of in prison, three years of supervised release, a $250,000 fine, a $100 special assessment, and an order of restitution and forfeiture.
The case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General, the Federal Bureau of Investigation, and the U.S. Department of Labor Office of the Inspector General. It is being prosecuted by Assistant United States Attorneys Matthew J.D. Hogan and Paul W. Kaufman.
An Information is an accusation. A defendant is presumed innocent unless and until proven guilty.
Southern California Doctor Sentenced to More Than Three Years in Prison for Role in Medicare Fraud Scheme
SACRAMENTO, CA—Dr. Emilio Louis Cruz, III, 61, of Carson, California, was sentenced today by United States District Judge Morrison C. England, Jr. to three years and two months in prison and ordered to pay $601,581 in restitution for his role in a conspiracy to commit Medicare fraud, United States Attorney Benjamin B. Wagner announced.
According to court documents, Cruz earned an undergraduate degree from Johns Hopkins University and his medical degree from Yale University. He held medical licenses in three states and was board certified in neurology. According to his plea agreement and the testimony heard at the trial of Cruz’s co-defendants, doctors Ramanathan Prakash, Alexander Popov, and Lana LeChabrier, and a man named Vardges Egiazarian owned and controlled three health care clinics in Sacramento, Richmond, and Carmichael from February 2006 through August 2008. Over this time period, Cruz ran the practice at the Carmichael clinic on 3609 Mission Avenue. He established a Medicare provider number for the clinic and established a bank account into which Medicare funds were deposited. Hundreds of claims were submitted to Medicare seeking reimbursement for services allegedly performed at the Carmichael clinic under Cruz’s care. Cruz, however, never treated a single patient. Indeed, during the majority of the time that the Carmichael clinic operated, he was living and practicing in North Dakota. A similar pattern was followed at the other two clinics operated by Egiazarian, and not one of the physicians submitting bills to Medicare ever treated a single patient.
According to evidence at trial, the clinic’s patients were primarily elderly and non-English speaking. They were recruited and transported to the clinics by individuals who were paid according to the number of patients they brought to the facilities. Rather than being charged a co-payment, the patients were paid for their time and the use of their Medicare eligibility, generally $100 per visit. False charts were created stating that each patient received comprehensive exams and a broad array of diagnostic tests. Few of these tests were ever performed, none were performed based on any medical need, and clinic employees filled out other portions of the charts using preprinted templates. Some clinic employees admitted to performing various tests on themselves, and placing the results in patient files.
In all, the three clinics submitted more than $5 million worth of fraudulent claims to Medicare, $1.7 million of which was actually paid. With respect to claims submitted for services purportedly provided by Cruz at the Carmichael clinic, Medicare paid $601,581.
The only defendants to go to trial, doctors Prakash, Popov, and LeChabrier, were found guilty by a jury on July 8, 2011, of conspiracy to commit healthcare fraud and various counts of health care fraud.
This case is the product of an investigation by the Office of the Inspector General for the Department of Health and Human Services and the Federal Bureau of Investigation. Assistant United States Attorneys Philip Ferrari and Jean M. Hobler are prosecuting the case.
Others who were charged in this matter include:
According to court documents, Cruz earned an undergraduate degree from Johns Hopkins University and his medical degree from Yale University. He held medical licenses in three states and was board certified in neurology. According to his plea agreement and the testimony heard at the trial of Cruz’s co-defendants, doctors Ramanathan Prakash, Alexander Popov, and Lana LeChabrier, and a man named Vardges Egiazarian owned and controlled three health care clinics in Sacramento, Richmond, and Carmichael from February 2006 through August 2008. Over this time period, Cruz ran the practice at the Carmichael clinic on 3609 Mission Avenue. He established a Medicare provider number for the clinic and established a bank account into which Medicare funds were deposited. Hundreds of claims were submitted to Medicare seeking reimbursement for services allegedly performed at the Carmichael clinic under Cruz’s care. Cruz, however, never treated a single patient. Indeed, during the majority of the time that the Carmichael clinic operated, he was living and practicing in North Dakota. A similar pattern was followed at the other two clinics operated by Egiazarian, and not one of the physicians submitting bills to Medicare ever treated a single patient.
According to evidence at trial, the clinic’s patients were primarily elderly and non-English speaking. They were recruited and transported to the clinics by individuals who were paid according to the number of patients they brought to the facilities. Rather than being charged a co-payment, the patients were paid for their time and the use of their Medicare eligibility, generally $100 per visit. False charts were created stating that each patient received comprehensive exams and a broad array of diagnostic tests. Few of these tests were ever performed, none were performed based on any medical need, and clinic employees filled out other portions of the charts using preprinted templates. Some clinic employees admitted to performing various tests on themselves, and placing the results in patient files.
In all, the three clinics submitted more than $5 million worth of fraudulent claims to Medicare, $1.7 million of which was actually paid. With respect to claims submitted for services purportedly provided by Cruz at the Carmichael clinic, Medicare paid $601,581.
The only defendants to go to trial, doctors Prakash, Popov, and LeChabrier, were found guilty by a jury on July 8, 2011, of conspiracy to commit healthcare fraud and various counts of health care fraud.
This case is the product of an investigation by the Office of the Inspector General for the Department of Health and Human Services and the Federal Bureau of Investigation. Assistant United States Attorneys Philip Ferrari and Jean M. Hobler are prosecuting the case.
Others who were charged in this matter include:
- Ramanathan Prakash, a doctor involved with the Sacramento clinic, is currently serving 10 years in prison.
- Lana LeChabrier, a doctor involved with the Richmond clinic, is currently serving six and a half years in prison.
- Vardges Egiazarian pleaded guilty early in the case and has served his six-and-a-half years' sentence.
- Alexander Popov, a doctor involved with the Sacramento clinic, is currently serving eight years and one month in prison.
- Nazaret Salmanyan, an unlicensed ultrasound technician who worked at all three clinics, pleaded guilty and on November 14, 2013, was sentenced to 20 months in prison.
- Derrick Johnson, a doctor involved with the Richmond clinic, pleaded guilty and is awaiting sentencing.
- Zoya Belov, a nurse licensed in Russia but not the United States who worked at all three clinics, pleaded guilty and is awaiting sentencing.
- Liw Jiaw Saechao, aka Jenny Saechao, recruited patients, pleaded guilty and is awaiting sentencing.
- Migran Petrosyan, a co-owner of the Richmond clinic, pleaded guilty, and on December 5, 2013, was sentenced to 27 months in prison.
- Shushanik Martirosyan, a medical biller who submitted claims to Medicare for all three clinics, pleaded guilty and on October 24, 2013, was sentenced to 18 months in prison.
Tuesday, January 7, 2014
Suspect Allegedly Caught Coaching How to Fake Depression
Court documents released today include a transcript of a suspect in an alleged multi-million dollar fraud coaching a New York City employee on how to fake depression and anxiety.
The call allegedly recorded Joseph Esposito, 70, advising the person to "pretend" to have "panic attacks."
He also "coaches" the employee on how to behave when faced with a medical panel considering the application for disability benefits:
"Okay. When you get there, usually the first question they ask you is "How did you get here?" You're gonna say "My sister drove me." The next question they generally ask is "Who does the cooking, cleaning, shopping in your house?" You're gonna say "My mother" and your sister. They, they drove [U/I] for you. When you get to see the doctor, he's gonna ask you questions. He's not trying to trick you. He, uh, they ask these questions, different variations for everybody. They just want to see if you can concentrate. They'll say to you, "But what do you do with yourself all day? How do you spend your day?" You're gonna tell 'em "I don't sleep well at night. I'm up three, four times. Usually, I, I nap on and off during the day. I put the television on, you know, I keep changing channels 'cause I, I can't concentrate on the television. Just, just to hear a voice in the house." And they're liable to say, "From the word—spell the word "world," so you go "W-R-L-D." Then they're gonna say "Spell it backwards." You think about it, and you can't spell it backwards. Then they're liable to say "From a hundred, subtract seven." You know, a hundred, ninety-three, and then you're trying to concentrate, and make it to eighty-six or eighty-five, you know. You're not too sure. Then they might tell you, uh—"I'm going to tell you three things to remember. A spoon, a fork, and a dish," and they're going to ask you later on in the conversation to remember them. You remember one of them. No jewelry, no cellphone – uh, when you're talking to the guy, don't look directly at him. You know, put your head down now and then, don't answer right away. You know, pause for a second. You're just trying to show that, you know, you're depressed. You, you can't, you, you don't have any desire for anything, and if can, you pretend you have panic attacks?
The call allegedly recorded Joseph Esposito, 70, advising the person to "pretend" to have "panic attacks."
He also "coaches" the employee on how to behave when faced with a medical panel considering the application for disability benefits:
"Okay. When you get there, usually the first question they ask you is "How did you get here?" You're gonna say "My sister drove me." The next question they generally ask is "Who does the cooking, cleaning, shopping in your house?" You're gonna say "My mother" and your sister. They, they drove [U/I] for you. When you get to see the doctor, he's gonna ask you questions. He's not trying to trick you. He, uh, they ask these questions, different variations for everybody. They just want to see if you can concentrate. They'll say to you, "But what do you do with yourself all day? How do you spend your day?" You're gonna tell 'em "I don't sleep well at night. I'm up three, four times. Usually, I, I nap on and off during the day. I put the television on, you know, I keep changing channels 'cause I, I can't concentrate on the television. Just, just to hear a voice in the house." And they're liable to say, "From the word—spell the word "world," so you go "W-R-L-D." Then they're gonna say "Spell it backwards." You think about it, and you can't spell it backwards. Then they're liable to say "From a hundred, subtract seven." You know, a hundred, ninety-three, and then you're trying to concentrate, and make it to eighty-six or eighty-five, you know. You're not too sure. Then they might tell you, uh—"I'm going to tell you three things to remember. A spoon, a fork, and a dish," and they're going to ask you later on in the conversation to remember them. You remember one of them. No jewelry, no cellphone – uh, when you're talking to the guy, don't look directly at him. You know, put your head down now and then, don't answer right away. You know, pause for a second. You're just trying to show that, you know, you're depressed. You, you can't, you, you don't have any desire for anything, and if can, you pretend you have panic attacks?
More than 100 current, former NYC employees to be charged with disability scam
A law enforcement official says more than 100 current and former city workers, including dozens of police officers and firefighters, are being charged with faking psychiatric problems in order to get federal disability benefits.
Arrests in the sweeping case began early Tuesday morning. An afternoon news conference is planned at Manhattan District Attorney Cyrus R. Vance Jr.'s office. Arraignments are expected to begin Tuesday.
The official says the scam stretched back more than two decades, with the ex-officers and other workers claiming mental health problems so severe that they couldn't work at all.
The official wasn't authorized to discuss the case and spoke on condition of anonymity.
Huge 9/11 Fraud Case Accuses Retired New York Cops, Firefighters
Scores of retired New York City police, fire and corrections officers were arrested today in a crackdown on disability fraud stemming from the Sept. 11 terror attacks. The fraud cost taxpayers millions of dollars, prosecutors claim.
The Manhattan district attorney's office accuses the retired workers, along with their lawyers and doctors, of faking work-related stress, including feigned psychiatric disorders related to 9/11.
Among those busted today was John Minerva, the disability consultant for the Detectives Endowment Association, officials said.
Today's arrests cap a two year investigation, aided by federal investigators, the city's Department of Investigation and the NYPD's Internal Affairs Bureau.
The alleged fraud cost taxpayers hundreds of millions of dollars in improper Social Security benefits.
None of the accused actually suffered from debilitating stress, officials claim. Many were caught working after retirement, a violation of disability benefits.
And some of the retired officers retained their gun permits. Retired officers cannot possess guns if they are being treated for stress.
The 9/11 attacks took a heavy toll on the city's cops, called "New York's Finest," and firefighters, dubbed "New York's Bravest." The casualty count from the terror attacks included 23 police officers and 343 firefighters.
Most of the arrests in the fraud sweep took place in the city, with others being busted in Florida and elsewhere in New York State.
It was the second 9/11 scam to be revealed this week. On Monday, two New Jersey men pleaded guilty to raising and keeping $50,000 for a Sept. 11 charity that was supposed to help families who lost loved one in the catastrophe.
Thomas Scalgione and Mark Niemczyk never gave any of the more than $50,000 in proceeds to the victims' families or to charities as promised, they told the court.
The Manhattan district attorney's office accuses the retired workers, along with their lawyers and doctors, of faking work-related stress, including feigned psychiatric disorders related to 9/11.
Among those busted today was John Minerva, the disability consultant for the Detectives Endowment Association, officials said.
Today's arrests cap a two year investigation, aided by federal investigators, the city's Department of Investigation and the NYPD's Internal Affairs Bureau.
The alleged fraud cost taxpayers hundreds of millions of dollars in improper Social Security benefits.
None of the accused actually suffered from debilitating stress, officials claim. Many were caught working after retirement, a violation of disability benefits.
And some of the retired officers retained their gun permits. Retired officers cannot possess guns if they are being treated for stress.
The 9/11 attacks took a heavy toll on the city's cops, called "New York's Finest," and firefighters, dubbed "New York's Bravest." The casualty count from the terror attacks included 23 police officers and 343 firefighters.
Most of the arrests in the fraud sweep took place in the city, with others being busted in Florida and elsewhere in New York State.
It was the second 9/11 scam to be revealed this week. On Monday, two New Jersey men pleaded guilty to raising and keeping $50,000 for a Sept. 11 charity that was supposed to help families who lost loved one in the catastrophe.
Thomas Scalgione and Mark Niemczyk never gave any of the more than $50,000 in proceeds to the victims' families or to charities as promised, they told the court.
Monday, December 30, 2013
Boyfriend Charged in Pregnant Teen's Killing
The suburban Chicago boyfriend of a pregnant teenager fatally shot on Christmas Day and his brother were denied bail Sunday and will remain in jail after being charged with first-degree murder in the death.
Eva Casara, whose baby survived and remains hospitalized, wasn't an intended target when an apparent robbery spiraled out of control, the Chicago Sun-Times ( http://bit.ly/KeoXnB ) reported.
Charged are her boyfriend, Anthony Lee, 16, and his brother, Diante Lamont Coakley, 21, both from Dolton, a suburb south of Chicago. It wasn't immediately clear if either Lee or Coakley had lawyers.
The 17-year-old Casara was "just in the wrong place at the wrong time with the wrong company," Dolton Police Chief John Franklin told the Sun-Times on Saturday. Franklin said it appeared to be part of a drug deal or robbery gone wrong.
A message left with Franklin by The Associated Press was not immediately returned. It wasn't immediately clear whether Lee would be tried as an adult.
On Sunday, Assistant State's Attorney Christina Kye offered more detail, saying that Lee, Coakley and a third brother headed out to rob someone — and Casara went along. At some point, Casara ended up in the car of the robbery target — and shots were fired at the car as it sped off, Kye said.
Kye said the intended robbery victim only understood Casara was in the car when he heard gurgling sounds behind him, then pulled over and left her. A passerby later came across Casara's body, she said.
Casara, who was 5 1/2 months pregnant, was pronounced dead early on Thursday — several hours after the Wednesday shooting. But doctors were able to save the Calumet City teen's baby.
While Casara was not the intended target in the shooting, the police chief stopped short of calling her death an accident.
"It's hard to call it an accident when you're firing a gun in the direction of people," he said.
Casara's aunt, Melody Vargas, told the Sun-Times, "She was just a victim of their stupidity, and they need to pay for it."
Suspect in 3 Colorado Slayings Captured in Okla.
A month long hunt for a man accused of killing three people in Colorado and then setting a house on fire to cover it up has ended with his capture in Oklahoma.
Harry Carl Mapps, 59, was arrested at a motel in Roland, Okla., on Saturday night, authorities said Sunday.
Mapps faces charges of first-degree murder and arson in the shooting deaths of Kim and Reggie Tuttle and their adult daughter, Dawn Roderick. Their bodies were found in the Tuttles' home in the southern Colorado town of Rye after it was damaged by fire on Nov. 27.
A booking photo showed Mapps with a swollen lip and large red patch on his right cheek, but authorities said there had been no struggle during his capture. No other details of his arrest were released.
Pueblo County, Colo., Sheriff Kirk Taylor said Mapps was found using information developed by the U.S. Marshals Service in Colorado, Oklahoma and Texas. Mapps had lived in Texas.
The Marshals Service had issued a fugitive warrant for Mapps and said authorities were searching for him nationwide.
It wasn't immediately clear if Mapps had an attorney, and authorities did not yet know if he would fight extradition to Colorado.
The fire at the Tuttles' house was ruled arson, and Taylor said it was meant to cover up the shootings.
Three days after the fire, deputies said Mapps was their primary suspect. Authorities said he had been living with the Tuttles and was working for a trucking company owned by Reggie Tuttle, 51.
Taylor said money appeared to be the motive for the shootings. Authorities claimed Mapps stole checks made out to one of the victims and cashed them on the day of the fire. He also faces theft, identity theft and forgery charges.
Pueblo County sheriff's investigators arrived in Oklahoma Sunday and hoped to speak to Mapps, said Lisa Shorter, the sheriff's spokeswoman.
Mapps wasn't armed when he was arrested, but investigators did not yet know whether there were any weapons in the motel room or Mapps' vehicle, said Charles Ahmad of the Marshals Service in Denver.
Ahmad said the firearm used to shoot the Tuttles and Roderick had not been recovered, and investigators believed Mapps still had it. Ahmad declined to identify the weapon.
Shorter and Ahmad said they did not yet know where Mapps had been while he was a fugitive. He once worked as a long-distance trucker, and authorities had said he was familiar with little-used back roads.
Friends called the Tuttles generous and caring.
"Kim and Reggie would help anyone who needed it," Winnie Owens, a friend and neighbor, told the Pueblo Chieftain. "The hearts of everyone in this valley go out to that family."
Kim Tuttle, 55, worked on the culinary staff at Parkview Medical Center in Pueblo.
Roderick, 33, lived in nearby Pueblo and had a husband and three children. Authorities haven't said why she was at her parents' home.
———
Time Running Short for Teen Declared Brain Dead
Without further court order, a California hospital could unhook a 13-year-old girl declared brain dead from a breathing machine.
Alameda County Superior Court Judge Evelio Grillo's current order allows Children's Hospital of Oakland to remove Jahi McMath from a ventilator at 5 p.m. Monday.
The family was pinning its hopes on a New York facility to care for the child after two California care homes withdrew offers to accept her.
Jahi underwent a tonsillectomy at the hospital on Dec. 9 to treat sleep apnea. After she awoke from the operation, her family said, she started bleeding heavily and went into cardiac arrest.
Doctors at Children's Hospital and an independent pediatric neurologist from Stanford University have concluded the girl is brain dead.
The hospital wants to remove her from life support, but the family said they believe she is still alive.
Chris Dolan, the family's attorney, said he was waiting to hear from the New York hospital after its facility director and medical director speak.
"The family is together, and today everybody is praying and being together," Dolan told the Associated Press Sunday. He said no decisions had been made about legal options for Monday, and would not comment on progress with the New York facility.
On Sunday, the hospital said it had not heard from the New York, or any other, facility about a transfer.
"We need to be able to talk to the other facility to understand what it is they are capable of doing," Cynthia Chiarappa, a hospital spokeswoman, said. "This is not transferring an individual in a vegetative state, but a dead body."
The hospital also said it would need to confirm there is "lawful transportation" included in any plan to transfer Jahi, and written permission from the coroner.
Dolan said previously that the family views the New York site as it's "last, last hope." He has also has said it was possible the family could ask Grillo for more time, or file a federal appeal.
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