Mother & 2 Daughters In North Carolina Indicted For Allegedly Embezzling More Than $100K From Healthcare Concern

From the New Bern Sun Journal on 5.23.13:


A mother and her two daughters have been indicted for embezzlement from a medical practice in New Bern.

Lisa Moore Norton, 53, and her two daughters, Katherine Norton Cannon, 21, and Courtney Norton, 19, all of New Bern face charges of systematic theft of more than $100,000 from Carolina Craniospinal Neurosurgery PLLC, a practice on Neuse Boulevard.

...

Lisa Norton was office manager at Craniospinal Neurosurgery for several years.

Thomas said Lisa Norton was in charge of handling the income and expense payments for the physicians employed there. Katherine Cannon and Courtney Norton were occasional employees of the practice in the past, but had not been employed for many months when the theft was discovered.
Warrants state the alleged offense occurred between July 10, 2009, and Jan. 4 of this year.

...

New York Woman Accused Of Embezzling $800K From Healthcare Concern

Bonnie Simson, 41, of Manlius, New York, has been accused of embezzling some $800,000 from St. Joseph's Hospital Health Center where she had been employed as manager of the patient telephone and television services program.  Prosecutors allege that Simson's scheme, which spanned more than 10 years, beginning in December 2000 and continuing through March 2011, involved simply pilfering the envelopes of cash from patients intended to pay for the telephone and television services.  Simson reportedly stole the funds to support a drug habit.

Read the story here & here.

Hat tip: FraudTalk reader Joe.

Texas Couple Indicted On Charges Of Embezzling More Than $220K From Non-Profit Health Care Program

Melanie Newman, 25, and Michael Anthony "Tony" Goodloe, Jr., 29, of Carrollton, Texas, have been indicted on charges they embezzled some $220,000 from the Medical Center of Louisiana Foundation in New Orleans where Newman had been employed as a bookkeeper. Prosecutors allege that Newman used her position to write unauthorized checks to pay for personal expenses, including automobiles, student loans and the couple's wedding in May 2009. It is believed that the thefts occurred over a two year period from 2007 until 2009. They have been indicted on 34 felony counts including conspiracy, health care fraud and uttering forged securities. On her LinkedIn page, Newman lists her current position as "Accounting" at Zion Oil & Gas, Inc. in the Dallas/Fort Worth area.

Read the story here and here.

I hope the good folks at Zion Oil & Gas know about this and check their own books...

Alabama Woman Pleads Guilty In $1.2 Million Embezzlement Case

Kimberly Lynn Perrin, 40, of Birmingham, Alabama, pleaded guilty to federal charges of health care fraud, wire fraud, and tax fraud in connection with her alleged embezzlement of some $1.2 million from the Simon-Williamson Clinic in Birmingham, where she had been employed as company controller. According to prosecutors, Perrin misappropriated the funds over a 3 year period between 2005 and 2008, by causing checks to be issued to her and others for her own personal use. She faces up to 35 years in prison.

Read the story here.

Read the DOJ announcement here.

Update (3/11/10): Perrin, now 41, was sentenced yesterday to 30 months in prison for embezzling $1,197,074 from the the Simon-Williamson Clinic where she had been employed as controller.

Four Florida Medical Workers Plead Guilty In $10 Million Medicare Fraud

Dr. Roberto Rodriguez, 54; Dr. Carlos Garrido, 69; Gonzalo Nodarse, 38; and Alexis Carrazana, 41, all residents of the Miami, Florida area and executives or employees of the Miami-based Midway Medical Center, pleaded guilty yesterday to one count each of conspiracy to commit health care fraud. Rodriguez and Garrido are owners of Midway Medical and, along with the other defendants, admitted they defrauded the Medicare program by receiving $10 million in reimbursements for unnecessary or non-performed medical procedures, specifically HIV infusion services. The scheme lasted from at least October 2003 to February 2005. Rodriguez is the founder of five clinics in and around Miami that have been the subject of criminal probes for Medicare fraud. Nodarse and Carrazana, who were employed at Midway as medical assistants, admitted to making false entries in medical records. We note that these physicians and medical assistants are simply the latest in a long list of Medicare fraudsters in South Florida who engaged in the HIV infusion fraud.

Read the story here, here and here.

Read the DOJ announcement here.

Second Executive Pleads Guilty In California "Skid Row" Healthcare Fraud Case

Dante Nicholson, 51, of Palmdale, California and the former Senior Vice President of the City of Angels Medical Center, pleaded guilty last Wednesday to a scheme whereby he and others paid an agent to recruit homeless people to come to the hospital for unnecessary medical procedures fraudulently charged to Medicare and Medi-Cal. Dr. Rudra Sabaratnam, 64, of the former CEO of the hospital, previously pleaded guilty in this case and was ordered to pay a $4.1 million fine. The fraud occurred between August 2004 and October 2007, according to prosecutors. The recruiter, Estill Mitts, 64, was arrested with Dr. Sabaratnam last August. He is alleged to have received more than $500,000 from the hospital as part of the scheme. Nicholson faces up to 10 years in prison and was also ordered to pay a $4.1 million fine.

Read FraudTalk's original post on this story here.

Read the story here and here.

Read the DOJ's announcement here.

California Woman Pleads Guilty In Largest Medical Insurance Fraud Case In US

Sue Nanda, 40, of Costa Mesa, California pleaded guilty Friday to felony charges of conspiracy, recruiting patients for fraudulent surgeries, failing to file tax returns, filing fraudulent tax returns and grand theft "with an enhancement for white-collar crime," for her role in what is being described as the largest medical insurance fraud case in US history. Nanda is one of 19 defendants charged with bilking some $154 million from medical insurance companies in California by performing unnecessary surgeries on patients. Nanda has been described as a "capper" or recruiter, of patients who she would then arranged to travel to and receive the fraudulent procedures from the Unity Outpatient Surgery Center in Buena Park, California. The purported mastermind of the scheme, Tam Vu Pham, pictured here, has been sentenced to 12 years in prison.

Read the story here, here and here.

Read the Orange County District Attorney's press release here.

Illinois Man Pleads Guilty To $800K Healthcare Fraud

Rickey Weir, 61, of Springfield, Illinois, pleaded guilty today to felony healthcare fraud charges. Weir who was originally charged on 16 counts of mail fraud, plead guilty to a single count, admitting that he conspired to bilk the government, insurance plans and patients out of more than $800,000. Weir, the business manager for Cardinal Respiratory, Inc. in Springfield, IL, double billed for medical supplies over a 10 year period, according to prosecutors. Weir was also suspected of transferring at least $300,000 to overseas accounts. He faces up to 10 years in prison plus a fine of $250,000. Cardinal Respiratory is owned by Weir's estranged wife, Dr. Janet Despot, an allergist. She previously pleaded guilty to a misdemeanor charge of "balance-billing" Medicare patients and agreed to pay $2.8 million in fines and restitution.

Read the story here, here and here.

Mississippi Woman Convicted Of Healthcare Fraud

Pamela Hull, of Moss Point, Mississippi, and co-owner of Rehabilicare Inc., and a principal of Mississippi Care Partners, Inc., was convicted Thursday on multiple counts of healthcare fraud for falsely billing Medicare $23 million. Specifically, Hull was convicted by a jury on one count of conspiracy to commit health care fraud, three counts of health care fraud and 12 counts of making false statements relating to health care, according to prosecutors. She faces up to 95 years in prison and $4 million in fines. Hull was arrested in October 2007 along with Jim Davis Hull, Janis Kayer Dunn of Gulfport; Evelyn Marshell of Cleveland; Jacquline Crawley of North Carolina and Cheniqua G. Ellis of Franklin, Tennessee, according to reports.

Read the story here, here and here.

Southern California Physician To Pay $2.2 Million To Settle Medicare Fraud Charges

Paul Arnold Lessler, 70, of Corona del Mar, California, will pay the government $2.18 million as part of a settlement over healthcare fraud charges. Lessler plead guilty to criminal conspiracy and healthcare fraud last year for filing false claims of giving patients respiratory treatments between 2002 and 2006, according to prosecutors. Lessler, an anesthesiologist and pain management specialist who was the owner of University Pain Specialists, allegedly paid kickbacks to others who referred patients to his practice. He was also stripped of his medical license by the California Medical Board after his guilty plea.

Read the story here, here and here.

Former Iowa Insurance Claims Worker Sentenced To 2 Years In Prison For Fraud

Rachel Lenagh, 39, of Neola, Iowa, was sentenced Friday to 2 years in prison for defrauding her employer, Mutual of Omaha, out of $1.4 million in fraudulent insurance claims. Lenagh, who plead guilty to conspiracy to commit health care fraud in October, processed fraudulent health insurance claims for Sharon Johnson of West Dover, Vermont, who in return, paid Lenagh $95,600 in kickbacks, according to prosecutors. The scheme reportedly went on from 2001 to 2006. Johnson is awaiting her own trial.

Read the story here.

Tennessee Woman Pleads Guilty To Defrauding Texas Medical Center Of More Than $850K; Accomplice Expected To Plead Guilty Next Week

Sheri Lynn Mitchell, 48, of Cleveland, Tennessee, pleaded guilty today to her role in an embezzlement scheme involving Hendrick Medical Center, dba Hendrick Health Services, of Abilene, Texas. Mitchell was the owner/operator of Physician Source, a physician recruiting business. Her accomplice in the scheme, Laura Cullars Minor, 52, of Abilene, Texas is a former employee of the medical center and is expected to plead guilty next week, according to reports. The pair is accused of embezzling at least $850,000 from the company over a five year period. According to prosecutors, Mitchell would submit false invoices to Minor for services not performed, who would then approve the invoices and receive a kickback from Mitchell. Minor was employed as director of physician recruiting and received nearly $300,000 in kickbacks from Mitchell, according to prosecutors. The two were originally indicted in October 2008 on one count of conspiracy to commit mail fraud and health care fraud, eleven counts of mail fraud and aiding and abetting, and eleven counts of theft in connection with health care. Mitchell has several aliases, including Sheri Samuels and Sheri Dawes.

Read FraudTalk's original post on this story here.

Read the DOJ's announcement of the indictment here.

South Florida Man Sentenced In $7 Million Healthcare Fraud Case

Remberto Sarmiento, 47, of Miami, Florida, was sentenced to 8 years in prison for his role in a $7 million healthcare fraud scheme. Sarmiento was found guilty of 20 counts of healthcare fraud relating to making fraudulent billings to Medicare resulting from stolen patient information. According to prosecutors, Sarmiento purchased the two medical companies to receive the ill gotten gains, APR Medical Equipment and Super Medical Supply. Those funds were then transferred to a shell construction company.

Read the story here.

Read the original indictment here.

Alabama Hospice Pays $24.7 Million Fine To Settle Healthcare Fraud Charges

SouthernCare Inc., based in Birmingham, Alabama, has agreed to pay $24.7 million to settle charges it made false claims to the government concerning medicare reimbursements for patients who did not qualify. The case brought against SouthernCare was the result of two qui tam suits filed by two former SouthernCare employees, Tanya Rice and Nancy Romeo, both registered nurses, who will receive $4.9 million as their share in filing the cases. The prosecutor in the case, Alice H. Martin, U.S. Attorney for the Northern District of Alabama is quoted as saying, "Our investigation showed a pattern and practice to falsely admit patients to hospice care who did not qualify and to bill Medicare for that care.

Read the story here, here and here.

Read the DOJ's announcement here.

Georgia Chiropractor Sentenced To 3 Years For Defrauding Insurers $1.2 Million

Stephen Catterton, 39, of Norcross, Georgia, was sentenced yesterday to 3 years and one month in federal prison for defrauding insurers out of some $1.2 million. Catterton is the owner of two chiropractic businesses, Catterton Chiropractic and Citadel Healthcare Group. Prosecutors alleged that he had overbilled a number of health care insurance providers. He was also ordered to pay full restitution of $1.3 million and perform 300 hours of community service. An investigation, conducted by the FBI, found that from June 2001 and December 2006, Catterton's businesses had overbilled insurance programs by some $3 million.

Read the story here and here.

Florida Bank Exec Sentenced To 3 Years For Money Laundering Role In Healthcare Fraud Scheme

Javier J. Ortiz, 36, of Miami, Florida and a former vice president of Wachovia Bank branch in Miami's West Gables Financial Center, was sentenced yesterday to 3 years in prison for money laundering in connection with a $48 million Medicare fraud case in South Florida. According to prosecutors, Ortiz conspired with Angel Castillo Jr. in defrauding Medicare by opening bank accounts through which fraudulent Medicare reimbursements were deposited by Castillo. Some $400,000 was laundering in this way between 2005 and 2006. Ortiz had plead guilty in October to an information conspiracy to commit money laundering. Castillo was separately charged and was sentenced to 19 years in prison for orchestrating the Medicare fraud.

Read the story here and here.

Read the DOJ press release about Ortiz' guilty plea here.

Pennsylvania Chiropractor Sentenced To 4 Years For Healthcare Fraud

Douglas A. Henderson, 47, of Lower Burrell, Pennsylvania, was sentenced Friday to 4 years in prison and ordered to pay $12.1 million in restitution to Highmark Blue Cross/Blue Shield for fraudulent billings for services never performed. The sentencing had been delayed 10 times. In April 2006, Henderson pleaded guilty to separate felony counts of health care fraud, conspiracy and income tax evasion. According to prosecutors, between January 1995 through 2002, Henderson billed Highmark for services never performed on patients of the now-defunct Burrell Chiropractic Clinic. Fifteen other individuals have been charged in this case. Henderson's fraud allowed him to live lavishly with several homes, a fleet of luxury vehicles and a country club membership, among other things. He did cooperate in the prosecution of the other 15 individuals, who have all been convicted or plead guilty. Henderson, who masterminded the largest health care fraud in Western Pennsylvania history, is quoted as saying, "My actions are inexcusable." I agree.

The Pittsburgh Tribune Review has an excellent article chronicling the case here which includes this list of the other 15 defendants in the case:

• Robert Bates, 56, of Lower Burrell was sentenced to serve three years' probation, including 10 months of home detention. He cooperated with Henderson to submit more than $152,600 in false claims, for which he was paid $19,500.
• Brandon E. Burns, 31, of Murrysville was placed on probation for three years and ordered to pay restitution of $64,000 for false claims submitted in his name. He received about $17,000 for his participation.
• Robert Durcho, 51, Tarentum was sentenced to three years' probation and ordered to make restitution for 147,000 in false claims. He was paid about $51,000 in the scam.
• Marilyn Marshall, 56, Murrysville was placed on probation for three years and ordered to make $140,000 in restitution. She received around $58,000 from Henderson for her cooperation.
• Tina McCurdy, 42, of North Huntingdon was sentenced to three years' probation and ordered to pay $242,000 in restitution for her role in the scheme that paid her $73,992 in kickbacks.
• Eric Ribar, 37, of Apollo must serve three years' probation and pay $146,577 in restitution for claims submitted in his name. He received $49,230, prosecutors said.
• John Slimick, 49, of New Eagle in Washington County was placed on probation for three years and ordered to serve six months on house arrest. He must pay $156,000 in restitution for claims filed by Henderson, who paid him about $20,000.
• Phillip Swartzlander, 50, of New Kensington was sentenced to five months in prison followed by probation. He must make restitution totaling $138,000 for cooperating with Henderson, who paid him $30,000.
• Judith Williamson, 50, of Pittsburgh's South Side was placed on probation for three years and ordered to repay Highmark $316,611 for claims submitted in her name by Henderson, who paid her $46,500.
• Heather Layhew, 35, of Rural Valley in Armstrong County, and John Layhew, 40, of Lower Burrell will be sentenced Jan. 9. They admitted helping Henderson to obtain $210,000, for which they received $47,000.
• Linda McClafferty, 59, and William McClafferty, 54, of Allegheny Township will be sentenced Jan. 9. The couple said they helped Henderson to collect about $415,000, for which they received about $41,000.
• Susie Horning, 56, of Leechburg will be sentenced Jan. 23 for $250,000 in claims submitted in her name. Prosecutors said she received kickbacks of a least $26,000 and free use of a New Kensington residence.
• Kendra Huddleston, 45, of Littleton, N.C., will be sentenced Jan. 23 on guilty pleas to health care fraud, conspiracy and income tax evasion for submitting numerous fake medical bills to Highmark and filing a fraudulent tax return for 2000.

Read the story here and here.

Read the plea agreement here.

Read the information here.

Miami Physician's Assistant Sentenced To 14 Years For $119 Million Healthcare Fraud

Thomas McKenzie, 53, of Miami, Florida, a physicians assistant, was sentenced today to 14 years in prison for his role in an HIV infusion fraud. McKenzie, a Nicaraguan native, was working in cahoots with the three masterminds, Carlos, Luis and Jose Benitez, along with a number of other conspirators, in orchestrating the fraudulent reimbursement for HIV infusions and other procedures not conducted or needed. McKenzie taught the others how to prescribe ''medically unnecessary'' HIV infusion treatments. In September, McKenzie pleaded guilty to one count of healthcare fraud conspiracy and one count of submitting false Medicare claims. He also became an informant for the authorities and a witness for the prosecution against the other co-defendants. The Benitez brothers owned a number of front HIV infusion clinics, including: AH Medical Office; Advanced Medical Rehabilitation Center; Best Medi Corp.; Physician's Health Med-Care; Physician's Med-Care; Saint Jude Rehab Center; Global Med-Care Corp.; CNC Medical Corp.; G&S Medical Centers; Karla Medical Services; and Best Medicare.

FraudTalk has covered this case before here, here and here.

Read the story here, here and here.

2 So-Cal Medical Company Execs Charged With Healthcare Fraud

Kim Jeanette Shittu, 45, and Adekunle Rafiu Shittu, aka "Cooley," 54, were indicted yesterday on charges of defrauding the Medicare program out of some $2.5 million. The pair are alleged to be part of a ring that has defrauded Medicare by recruiting patients for wheelchairs who do not need them and getting reimbursed by the program fraudulently. 18 others have been arrested in the Los Angeles area in connection with this and similar cases. The Shittus operated two entities, Kimco Medical Supply Inc. and K&K Medical Supply Inc., both operating from San Bernardino, California, which billed Medicare over $3.5 million and were fraudulently reimbursed in the amount of $2,517,076. FraudTalk has reported on a similar case in Texas here. The indictments are part of an ongoing prosecutorial effort made by the multi-agency composed Medicare Fraud Strike Force.

Read the story here, here and here.

Read the DOJ press release here.

Miami Doctor Sentenced To 30 Years For Heathcare Fraud

Dr. Ana Alvarez-Jacinto, 54, of Miami, Florida, was sentenced today to 30 years in prison for her role in a massive healthcare fraud scheme involving fraudulent AIDS/HIV Medicare reimbursements. It is one of the stiffest sentences for a Medicare fraud to date. FraudTalk has chronicled the ongoing prosecution of this type of healthcare fraud in Florida here and here. According to prosecutors, Dr. Alvarez-Jacinto was the front person at the Saint Jude Rehab Center Inc., an AIDS clinic in Miami, who conspired with Carlos Benitez and Luis Benitez, Cuban immigrant brothers and others, who succeeded in bilking the Medicare program out of some $119 million in total. She was convicted in October on one count of conspiracy to defraud the United States, to submit false claims and to pay healthcare kickbacks, one count of conspiracy to commit health care fraud, and three counts of the submission of false claims to the Medicare program. Her part in the fraud amounted to some $11 million. Another conspirator in the scheme and co-defendant, Sandra Mateos, 44, who was a nurse at the clinic, was convicted on two conspiracy counts and sentenced to 7 years in prison. Saint Jude Rehab Center was managed by Aisa Perera and Mariela Rodriguez, who have also been prosecuted and convicted on similar charges in this case as conspirators in the overall fraud. The Benitez brothers remain fugitives from the US, but are being held in jail in Cuba on immigration violations, according to authorities.

Read the story here, here and here.

Read the DOJ announcement of her conviction here.