Medicare Fraud and Medical Malpractice - Essay Example

Medicare Fraud 16 Metro Detroiters linked to huge Medicare fraud sweep Tom Greenwood, The Detroit News1:43 p.m. EDT June 18, 2015 As part of what federal officials are calling the “largest national Medicare fraud takedown in history,” they announced the apprehension of 16 Metro Detroit health care officials allegedly involved in fraud and kickback schemes totaling over $122 million. The arrests were part of a nationwide sweep that resulted in charges against 243 individuals, including 46 doctors, nurses and other license medical professionals, accused of bilking the government with $712 million in false billings. In Metro Detroit, the arrested included six doctors, a social worker, a pharmacist and two physical therapists. According to officials, the schemes involved medical services that were unnecessary or never rendered, including hospice and home health care plus the billing, but not dispersal, of drugs. “Health care fraud has been pervasive throughout Metro Detroit in recent years at great cost to the American taxpayer,” U.S. Attorney Barbara McQuade said. “We hope that cases like these will alert doctors, pharmacists and other providers that criminal investigators are now scrutinizing billing records so that we can detect fraud and hold wrongdoers accountable.” Authorities said the owners of home health care and hospice companies in Metro Detroit, two of whom are physical therapists, allegedly paid kickbacks to doctors and recruiters for referring patients to them, then billed Medicare for unnecessary services. Federal officials said two physicians — Dr. Waseem Alam, 59, of Troy and Dr. Hatem Ataya, 47, of Flushing —solicited kickbacks and submitted false claims to Medicare through their company, Woodward Urgent Care, in Bloomfield Hills. The physicians who allegedly solicited and received kickback also submitted claims to Medicare for medically unnecessary physician services through their companies, identified as A Plus Hospice and Palliative Care, At Home Hospice and At Home Network, Inc., all of which are located in Livonia. Along with Alam and Ataya, the other defendants charged in the indictment are Shahid Tahir, 45, of Bloomfield Township, Muhammad Tariq, 60, of West Bloomfield Township, Manawar Javed, 40, of West Bloomfield Township. The government has also charged four people, including a physician and three owners of home health care companies, with wire fraud and conspiracy to pay or receive health care kickbacks. Federal officials identified them as Dr. William Bind, 58, Muhammad Zafar, 43, of Brownstown Township, Tariq Khan, 47, of Woodhaven, and Ghulam Shakir, 43. The government has also charged Dr. Gerald Daneshvar, 39, of West Bloomfield, for his alleged part in a more than $5 million conspiracy to commit health care fraud by referring non-homebound patients for health care services as well as billing for physicians through Lake MI Mobile Doctors, P.C. Dr. Laran Lerner, 59, of Northville, and Mohamad Bazzi, 42, of Dearborn, a licensed pharmacist and pharmacy owner, have been charged in a $24 million health care fraud scheme. Federal officials said Lerner provided medically unnecessary prescriptions for expensive pharmaceuticals for which Bazzi’s pharmacy, Advanced Pharmacy Services in Oak Park, which would then bill Medicare but not dispense the drugs. Lerner is also accused of billing for unnecessary physician visits and referred beneficiaries for medically unnecessary home health care services through his clinic Greater Detroit Physical Therapy & Rehabilitation in Westland. Dr. Rizwan Qadir, 52, of Bloomfield Hills was charged with conspiracy to commit health care fraud and to pay or received kickbacks in a $19 million Medicare fraud scheme. Johnny Younan, 52, of Centerline, was charged as a recruiter within a conspiracy to pay or receive health care kickbacks to a physician, who would also prescribe Medicare beneficiaries controlled substances as an inducement to provide their Medicare information for billing. Licensed social worker Celestine Brown, 50, of Ypsilanti has been charged with one count of health care fraud and one count of structuring in connection with her role in a $3.8 million scheme to defraud Medicare through the submission of false claims for psychotherapy services that were never rendered. Tamara Brown, 42, of Southfield has been charged for her alleged participation in a $1.3 million kickback conspiracy. The complaint alleges that Brown solicited and received kickbacks from two Detroit area home health care agencies, Cherish Home Health Services, LLC, in Sterling Heights, Wayne and Inkster, and Empirical Home Health Care, Inc., in Farmington Hills, in return for providing patient referrals from a physician. http://www.detroitnews.com/story/news/local/michigan/2015/06/18/metro-detroiters-linked-huge-medicare-fraud-sweep/28929043/ Summary Federal officials have apprehended 16 Metro Detroit heath care officials for being involved in kickback schemes and fraud that amounts to $122 million. The apprehension has been termed as the largest takedown associated with Medicare fraud. A social worker, two physical therapists, pharmacist, and six doctors were among the people arrested in Metro Detroit. Federal official says that all nabbed individuals were part of schemes to bill the government for services that were not rendered. The schemes included both home and hospice health care with the exception of the drug dispersion. All this was happening at the cost of taxpayers’ money. According to the U.S. Attorney Barbara McQuade, healthcare fraud has been high in Metro Detroit. A massive takedown of this nature can help in alerting health care professionals that the government is using advanced criminal investigators to analyze all billing records. Any form of discrepancy can result in prosecution. The owners of hospice and home health care organizations gave doctors and recruiters for referring new patients to them. The companies then billed Medicare for services that were not given. The physicians who received kickbacks submitted false claims to Medicare through the companies Palliative Care and A Plus Hospice. On the same note, other four people were charged with conspiracy to receive and pay kickbacks. They also committed wire fraud. Another physician has been charged for sending non-homebound patients to healthcare services. He also used Lake MI, Mobile Doctors to bill physician. The doctor was involved in a fraud that involves around $5million. The arrests made in Metro Detroit are part of nationwide operation that led to the arrest of 243 people who were involved in fraud that reaches $712 million. The investigations show that 46 doctors, nurses and other licensed medical providers were all part of the large scale fraud. The sweep is part of a renewed passion to eliminate Medicare fraud. Comment to Student Summary The student selected an interesting story on medical malpractice. It tells the compelling story of a woman who went through hell because of a cancer misdiagnosis. The summary has been well done. The student focuses on the main points of the article while eliminating the non-essential parts of the story. The effectiveness of the summary is supported by the fact that one can read the summary and get the whole story. Read More