- Kentucky city called socialist for buying gas station, undercutting competitor fuel prices
- Israel hits five mosques, sports complex in overnight Gaza strikes
- Hillary Clinton dogged for refusing reporters’ questions on book tour
- EPA tweet baffles: ‘I’m now a C-List celebrity in Kim Kardashian: Hollywood’ iPhone game
- Australian P.M. Abbott: MH17 evidence tampered with on ‘industrial scale’
- Rep. Luis Gutierrez tells Hispanics to vote and ‘punish those’ who oppose amnesty
- Country singer Tim McGraw not sorry for slapping female fan: ‘Things happen’
- Iraq vet cited for owning 14 therapeutic pet ducks
- White House takes credit for drop in unaccompanied children at border
- International crises be damned, Obama’s fundraising trip must go on
Medicare fraud trial ends with 4 convictions
$70M in false billings
Question of the Day
A federal jury in Florida has convicted four people for their participation in a Medicare scheme involving nearly $70 million in fraudulent billings by a mental health care hospital, the Justice Department said.
Acting Assistant Attorney General Mythili Raman, who heads the Justice Department’s Criminal Division, said the defendants participated in a massive scheme that attempted to defraud the U.S government and take advantage of Medicare beneficiaries.
“By paying bribes to a network of patient recruiters and falsifying documents, the defendants created the illusion of providing intensive psychiatric care to qualifying patients, when in reality they provided no care of substance,” said Ms. Raman, adding that the guilty verdicts illustrated the “success of the interagency Medicare Fraud Strike Force, which is dedicated to stamping out Medicare fraud.”
Since its inception in March 2007, the Medicare Fraud Strike Force — now operating in nine cities across the country — has charged more than 1,500 defendants who collectively have billed the Medicare program for more than $5 billion.
In the Florida case, Karen Kallen-Zury, 59, of Lighthouse Point, Fla., and Daisy Miller, 44, of Hollywood, Fla., were each found guilty of one count of conspiracy to commit wire fraud and health care fraud, five counts of wire fraud and two substantive counts of health care fraud.
Michele Petrie, 64, of Fort Lauderdale, Fla., was found guilty of one count of conspiracy to commit wire fraud and health care fraud and three counts of wire fraud. Kallen-Zury, Miller, Petrie and a fourth defendant, Christian Coloma, 49, of Miami Beach, Fla., were also convicted of one count of conspiracy to pay bribes in connection with Medicare.
The defendants were charged in an indictment returned in October. Evidence at trial demonstrated that the defendants and their conspirators caused the submission of false and fraudulent claims to Medicare through Hollywood Pavilion (HP), a state-licensed psychiatric hospital that purportedly provided, among other things, inpatient psychiatric care and intensive outpatient psychiatric care. The defendants paid bribes and kickbacks to patient brokers in order to obtain Medicare beneficiaries as patients at HP who did not qualify for psychiatric treatment.
The evidence showed that the defendants then submitted claims to Medicare for those patients who were procured illegally.
Kallen-Zury, the CEO and registered agent of HP, attempted to conceal the payment of bribes and kickbacks by creating false documents to make it appear as if legitimate services were being rendered.
Evidence at trial established that Miller, the clinical director of HP’s inpatient facility, and Petrie, the head of HP’s intensive outpatient program, facilitated the payment of bribes to patient recruiters and oversaw the fraudulent admissions and treatment of unqualified patients.
Trial evidence also demonstrated that Coloma, the director of physical therapy for an entity associated with HP, facilitated the payment of bribes and kickbacks, and that he supervised the creation of false documents to conceal the scheme.
From at least 2003 through at least August 2012, HP billed Medicare nearly $70 million for services that were not properly rendered, for patients that did not qualify for the services being billed and for claims for patients who were procured through bribes and kickbacks.
© Copyright 2014 The Washington Times, LLC. Click here for reprint permission.
About the Author
- With bombs away, drug traffickers and illegal immigrants make their play
- Medical-device company exec admits to bilking shareholders of $400M
- Justice Dept: Florida's disabled children unnecessarily put in nursing facilities
- Philadelphia mobster sentenced to 11 years as city cleans up crime
- Man gets 11 years in Philadelphia mob crackdown
Latest Blog Entries
TWT Video Picks
U.S. appetite for drugs begets violence migrants are fleeing
- IRS seeks help destroying another 3,200 computer hard drives
- Jewish woman booted from JetBlue flight over fight with Palestinian
- YOUNG: A sinking presidency, deeper after November?
- PRUDEN: A deadly enemy within exacerbating immigration crisis
- Edward Snowden to work with Russia on anti-spy technology
- MERRY: Handicaps in Hillary's way
- U.S. scrambles as violence escalates in Israel-Hamas conflict
- Humanists seek support from Congress on military chaplains
- Rep. Jared Polis' anti-fracking crusade riles Colorado
- Big milestone for Britain's little prince
Obama's biggest White House 'fails'
Celebrities turned politicians
Athletes turned actors
20 gadgets that changed the world
Fighting in Iraq