Friday, December 31, 2010

Happy New Year!

Wishing all of you a very happy 2011 with lots of new opportunities!

Posted by Tracy Green

Wednesday, December 29, 2010

L.A. Times Article On Illinois Physician Program For Sexual Misconduct Treatment Comes Under Attack. What Do We Do In California For Licensees With Substance Abuse And Sexual Boundary Issues?

In California, if there is a complaint made about a physician that alleges any type of "sexual misconduct," the California Medical Board handles those cases with a presumption that the physician is guilty until proven innocent. The incendiary nature of such an allegation makes it difficult for the Board to refuse to file unproven allegations and often physicians are forced into disciplinary hearings since the Board is reluctant to dismiss weak charges on its own.

The Los Angeles Times ran an article on December 29, 2010 entitled "Doctor misconduct cases monitored in secrecy" regarding a program in Illinois. The article writes about criticisms of the Illinois Professionals Health Program which operates a diversion program for physicians involving alcohol and drug abuse and now sexual misconduct allegations. The article quotes certain opinions that such programs shield physicians and that patients should know about these allegations.

California Does Not Have A Diversion Program
In California, physicians have not been eligible for diversion in lieu of discipline where there are substance abuse allegations since 2008. California does not have any program for the diversion or monitoring of physicians with sexual misconduct allegations where there is also no discipline filed against the physician.

Physicians Can Enroll In Treatment Programs Confidentially Before Disciplinary Charges Are Filed
In California, if a physician has a substance abuse or sexual boundary issue, he or she is free to participate in any treatment program on their own which will remain completely confidential. There is no duty to report the enrollment to the Medical Board. However, if the Board received a complaint that the physician has a substance abuse or sexual boundary problem, the Board investigates the matter to determine if sufficient evidence is found to proceed to disciplinary action.

Most Disciplinary Charges Arising From Substance Abuse Arise From Arrests And Convictions
In our practice, we see most discipline filings relating to substance abuse arising from misdemeanor convictions (such as driving under the influence or wet reckless) and felony arrests and convictions. Physicians (and other health care providers) are required upon renewal to disclose their misdemeanor and felony convictions.

As for arrests, physicians are not required to report a misdemeanor arrest but as for a felony arrest, they must report a felony indictment or a felony information (meaning that in a state criminal case the case has gone through preliminary hearing and the physician has been held to answer).  This means that if a doctor in California is arrested on felony charges, he or she does not need to report until held to answer after a preliminary hearing and an "Information" is filed. We have had cases where a physician was arrested on felony charges and we were able to have the charges dismissed before or at preliminary hearing which did not trigger any self-reporting requirements. Failure to report can be an additional ground for discipline.

Even though self-reporting is not required in felony cases until the Information is filed after a preliminary hearing, there is the risk that the city attorney or deputy district attorneys' office could notify the Board.  Prosecutors in criminal cases are required to notify the Medical Board (and Chiropractic, Osteopathic, Podiatric and "other allied health board") of any felony filings against a licensee upon obtaining information that the defendant is a licensee of that board.   California Business and Profession Code Sections 803.1. Thus, licensee must always be prepared for Board scrutiny where there has been an arrest. 

Reporting also occurs since court clerks are required to report misdemeanor and felony convictions of any persons licensed by the Medical Board and other Boards (Chiropractic, Dental, Osteopathic, Acupuncture, Nursing, Vocational Nursing, Optometry, Veterinary, Pharmacy, Speech-Audiology, Hearing Aid Dispensers, Respiratory Care, Behavioral Science).  California Business and Profession Code Sections 803.1 and 803.5.

Conclusion
Physicians and other licensees can expect that in California, disciplinary charges will be filed in lieu of any type of diversion program. Even where diversion programs exist (such as in nursing), the trend is to file disciplinary charges, place the licensee on probation and then require diversion. The Boards are very attuned to the political climate that they not be perceived as protecting physicians or other licensees and that the process be open to the public.

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Any questions or comments  should be directed to Tracy Green, a very experienced California health care attorney, administrative attorney, and California Medical Board attorney.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers in California and throughout the country. Their website is: http://www.greenassoc.com/

Tuesday, December 28, 2010

California Court of Appeal Allows Dentist To Sue Writers Of Negative Yelp Review For Libel

A common question we receive from our professional clients such as doctors and health care providers is what they can do when there is a negative review online -- whether it be Google, Yelp or other websites.  

Often common sense applies, contacting the patient or customer, offering to address the issue or solve the problem, posting a response on the website outlining those attempts, and other tactics that will not alienate the readers of these sites.


Suing the Internet host is not an option under the facts of most cases since the federal communications Decency Act immunizes Yelp and other Internet sites from libel lawsuits stemming from user comments. 

A recent case in California upheld dentist Yvonne Wong's right to sue the man who posted a negative review on Yelp for libel and his wife.  The Court held in Wong v. Jing that the lower court properly dismissed claims for intentional and negligent infliction of emotional distress filed by Dr. Wong.

Dr. Wong alleged that she properly advised the couple, prior to filling their son’s cavity in 2006, that she would use a silver amalgam filling containing mercury, and that she examined the child again in 2008 and found more cavities. But after consulting another dentist, she alleged, the couple published “slanderous complaints” on Yelp.com and other websites, false claiming that she did not tell them about the mercury, misdiagnosed the son’s case, and improperly used a general anesthetic. 

Dr. Wong alleged the couple knew those claims were false. The Yelp review, a copy of which was attached to the complaint, suggesting that Wong should be avoided “like a disease;” that she worked “really fast” and caused the son to be “light headed for several hours;” that the new dentist discovered seven cavities; that Wong used laughing gas, “which was the cause of my son’s dizziness” and “harms a kid’s nerve system” and that she used “silver amalgams” containing a trace of mercury. 

As for Dr. Wong's defamation claim, the Court held that the dentist showed a prima facie case based on her sworn statements that she disclosed that the amalgam contained mercury, that she properly diagnosed the case, and that she did not use a general anesthetic or otherwise engage in unprofessional conduct, all contrary to Jing’s assertions. 

With respect to the emotional distress claims, however, the Court of Appeal upheld their dismissal. The Opinion stated that Jing’s statements, he said, fall short of the “high bar” that California sets on such claims, and could not have caused Dr. Wong to suffer “severe, lasting, or enduring” mental harm. 

Attorney Notes:  What happens now to this case? It gets sent back to the Santa Clara Superior Court and discovery and litigation proceeds. Litigation is one tool that a professional or business owner can use with respect to reviews that rise to the level of libel. However, filing a lawsuit and going through the extensive motion and appeal process which happened in this case can be costly.

We have guided clients through this process since licensed professionals need to act cautiously since disputes with patients or clients can lead to Board complaints. Anything that is written or spoken to a client or patient needs to be viewed through that lens. An analysis of the cost benefit analysis is also helpful. The Internet has turned everyone into a potential instant critic.

We refer some of our clients to "reputation management" consultants who understand the best way to drive negative reviews and encourage our clients to deal intelligently with social media and the Internet. The funds are often best spent there and on marketing rather than on litigation against reviewers. It is very frustrating especially when some of the "reviews" are false by competitors. 

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation or to discuss this post.  

The firm focuses its practice on the representation of licensed professionals (including dentists), individuals and businesses in civil, business, administrative and criminal proceedings. Our website is: http://www.greenassoc.com/

Sunday, December 26, 2010

Woman Sentenced To 10 Years In Los Angeles Welfare Fraud Case With Alleged $1.3 Million Loss


In a state welfare fraud case that has been pending in Los Angeles County Superior Court for 3 years, Sakina Myles (aka Sakina Johnson), was sentenced to 10 years in state prison on December 20, 2010.  Ms. Myles was also ordered to make full restitution to the agencies in the amount of $1.3 million by Los Angeles Superior Court Judge William Pounders in Case No. BA317830.

Ms. Myles sentencing came after a no contest guilty plea to 12 counts of grand theft and 27 counts of perjury in two separate cases.  At the sentencing, Judge Pounders said he "was shocked by the monstrous greed" demonstrated by her.  The agencies who were alleged victims are: DPSS, Crystal Stairs, Drew Child Development Corporation, and the Center for Community and Family Services.

Ms. Myles was accused of leading a ring of 19 people who falsely supplied employment records and billed state and federal agencies for childcare services never rendered. The complex child care fraud scheme allegedly operated for almost 6 1/2 years, from June 2000 through October 2006. Ms. Myles allegedly claimed to operate the Johnson Family Daycare center at 438 E. 140th St. in Los Angeles, even though government authorities said records show she stopped providing childcare at that location in April 2002.   However, she allegedly continued receiving government funding even though she no longer provided childcare services. As part of the charges, she also allegedly provided phony employment records so 14 parents could qualify for childcare payments from the government’s welfare-to-work program.

Attorney Comments: The sentences continue to get longer in state court cases even where there is a plea agreement. It does not appear that Ms. Myles had a prior criminal record. However, the length of the sentence appears to indicate that there was no or little payment of restitution prior to the sentencing. In fraud cases, restitution is important to the prosecutors and the victims. Thus, successful mitigation of these cases focuses significantly on restitution.

Restitution is made by the judge and does not consider ability to pay. Where restitution is not possible due to financial reasons, it is important to show that all efforts have been made to pay something even if the amount is overwhelmingly large. Many clients find it difficult to pay the $250 a month even if the loss is in the million dollar range but they do not understand that it is important to pay what you can. I encourage clients to take second jobs devoted solely to restitution, selling assets, holding yard sales and showing the efforts to pay restitution. This is part of taking responsibility where there has been a plea agreement. The more creative I can be in showing that my client is working harder than anyone else -- the easier it is to obtain a fairer sentence.

Years ago, the state Department of Corrections had a restitution center halfway house program, but that program has been eliminated. To the extent we can create our own program where there will be a greater likelihood of restitution payment, we can present that as an alternative to state prison. It requires, however, a significant commitment by the client and depends on the assets available and whether there is a realistic ability to earn restitution instead of state prison. Every case is different and depends on the amount of the loss, the sentencing judge, the prosecutors on the case and the individual's past history.

Posted by Tracy Green, Esq.  Any questions regarding your own situation should be directed to Tracy Green, a very experienced welfare fraud attorney and white collar crime attorney. You can email her at tgreen@greenassoc.com or call her at 213-233-2261.  

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing individuals and small businesses in fraud and overbilling allegations in California and throughout the country. Their website is: http://www.greenassoc.com/

Monday, December 20, 2010

Medical and Physician Marketing: Los Angeles Times Article On "Scrutiny Of Lap Band Enterprise Is Overdue"


On March 4, 2010, I posted an article regarding the Los Angeles Times' articles on Top Surgeons' marketing of lap bands entitled "L.A. Times Article On Lap Band Surgery Centers: What Other Legal And Consumer Issues Are Raised Here?"

The Los Angeles Times recently wrote another article on December 19, 2010 stating that "Scrutiny of Lap Band Enterprise Is Overdue." 

According to the L.A. Times, the 1-800-GET-THIN billboards which pepper the Los Angeles and Orange County freeways have caught the attention of the Los Angeles County Department of Public Health and it has asked the U.S. Food and Drug Administration to investigate the ad campaign.  Here is a link of the letter that was sent to the FDA


The referral to the FDA was probably made since the Medical Board does not have jurisdiction over advertising by non-physicians and there were some issues over who has jurisdiction over the surgery centers operated by non-physicians. The success of this type of marketing to patients comes with its pitfalls and level of scrutiny. 

For health care providers, this article is a reminder that they need to ensure that their advertising and referral arrangements with surgery centers and companies that advertise (on the Internet and elsewhere) comply with California and federal laws prohibiting false advertising and the giving of any consideration (money or other things of value) for the referral of a patient.

Should you have any questions regarding your own situation or this post, you can email physician attorney Tracy Green at tgreen@greenassoc.com. Green and Associates is located in downtown Los Angeles, California and focuses their practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a long-standing specialty in representing health care providers. Ms. Green is presently a member of the Board of Directors of the California Naturopathic Doctors Association. The firm website is: http://www.greenassoc.com/

Thursday, December 9, 2010

Elderly New York Doctor Arrested On Charges Of Distributing Painkillers

 
The DEA is taking an active stance across the country on physicians who prescribe painkillers to patients without medical necessity.  On November 16, 2010, Dr. Felix Lanting, age 83, was arrested on a charge of conspiracy to distribute oxycodone in Grant City, New York. At the time he was arrested, the federal agents also conducted a search warrant.  Charges were filed in the Eastern District of New York.

Dr. Lanting garnered some unwanted attention when he was interviewed in August 2010 by the press  for a story on a state-run database of patients who have had prescriptions filled from multiple sources.
Of his approach with dealing with patients seeking prescriptions, he said: "We take their word and we depend on the pharmacists' computers."

Obviously, that quote is not the standard for physicians in today's world.  Although Dr. Lanting may have been quoted out of context, this was not a great quote for public viewing. We can expect to see an increase in filings against physicians for subscribing painkillers. 


Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.
Any questions or comments  should be directed to Tracy Green, a very experienced California health care fraud attorney, prescription fraud attorney, California DEA lawyer, and California Medical Board attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers in California and throughout the country. Their website is: http://www.greenassoc.com/

Saturday, November 13, 2010

Tracy Green Interviewed On NPR Station On "Use Of Unappoved Birth Control Devices Common In U.S." National Issues With Physicians Using IUDs Manufactured In Other Countries.

Tracy Green was interviewed by radio station WRNI (Rhode Island's NPR Station) in a program entitled "Use Of Unappoved Birth Control Devices Common In U.S."

This is a program on OB-GYNs using IUDs from Canada. In the U.S. only IUDs from two companies are "FDA approved" even if the IUD is the same as ones purchased from other countries.

In the article and program, Green was quoted as follows:

"They just thought, wow, this is a great deal," said lawyer Tracy Green. " Don't be a knucklehead and over pay."   Green practices in Los Angeles, and she represented five doctors who did the same thing three years ago in California. She says the practice was pretty widespread.

"One of my doctors, it was another OBGYN who called him and said, Boy, my office, we found a great price.' And you know, they're all board certified OB-GYNs," Green said. "They just thought this was a great deal."

Green says the IUDs appeared to be identical to the ones the doctors usually prescribed. They even had the same packaging. The lawyer representing the Rhode Island doctors who bought the UN-approved IUDs declined to speak on tape for this story, but he's argued the same thing: There was nothing different about these devices; they were just cheaper because they came from Canada.


Attorney Commentary:  I have represented numerous physicians on this particular issue in California over the past three years.  The issue for physicians who bill Medicare or Medicaid (Medi-Cal) for non-FDA approved devices is that they cannot bill the programs and will be liable for repaying any claims submitted.  Whether a case proceeds to criminal prosecution will depend on whether there was criminal intent and if the physician knew it was a non-FDA approved device. It has been my experience that often the physicians are not buying the supplies, the non-FDA supplies were sold by pharmacies or other supply companies, and that just because the price was lower does not trigger a suspicion that it is non-FDA approved.

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.  

Any questions or comments  should be directed to Tracy Green, a very experienced California FDA attorney, Medical Board attorney, Medi-Cal fraud attorney and physician attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/

Sunday, November 7, 2010

Two Los Angeles Rookie Police Officers Charged With Auto Insurance Fraud

A Los Angeles police officer accused of making arrangements for his vehicle to be set ablaze and a fellow officer were charged on October 18, 2010 with automobile insurance fraud. The Los Angeles County District Attorney's Office, Auto Insurance Fraud Division, filed the complaint in Los Angeles County Superior Court, Case No. BA376806.  California Department of Insurance is the investigating agency.

Anthony Robert Villanueva, 24, is charged with one count each of insurance fraud, arson of one’s own property and false report of a criminal offense. Co-defendant Ricardo Rebolledo, 27, faces one count of insurance fraud.  Both defendants are presumed innocent and a criminal complaint is not evidence. 

Prosecutors allege that in April 2010, Mr. Villanueva arranged for his 2001 Lexus sedan to be taken to the desert and set on fire, resulting in a total loss. Mr. Villanueva then purportedly filed a stolen vehicle report with the Los Angeles Police Department (LAPD) and submitted a claim for damages to his automobile insurance company.

Co-defendant Mr. Rebolledo allegedly provided a fraudulent statement to Mr. Villanueva’s insurance company in support of the claim vouching for his friend’s whereabouts on the day of the supposed vehicle theft.Each defendant has been employed by the LAPD since September 2009. The recommended bail for Mr. Villanueva was $75,000 and $25,000 for Rebolledo.

If convicted as charged, Mr. Villanueva faces a maximum state prison term of six years, two months and a fine of up to $50,000. Mr. Rebolledo faces a maximum term of five years in state prison.

Attorney Commentary: Although it is surprising to see two police officers charged with such an offense, they are young and were officers for less than a year before the alleged offense was committed.  The speed with which this case was investigated and charged was unusual (6 months) especially in a fraud case. The case may have been expedited due to the suspects being police officers.  A case like this will be harmful in more ways than one since both men will face investigation and potential disciplinary charges from LAPD due to the filing of this case. 

Any questions or comments should be directed to: tgreen@greenassoc.com. Tracy Green is a principal at Green and Associates in Los Angeles, California. The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing individuals and companies in fraud investigations and federal and state cases, including auto insurance fraud. Their website is: http://www.greenassoc.com/

Monday, November 1, 2010

Two Los Angeles Physicians, Alleged Clinic Owner And Four Clinic Workers Arrested For Performing Unnecessary Tests And Illegal Referral Fees



On October 30, 2010, seven people (including two physicians) were arrested and charged with seven counts relating to the operation of a medical clinic in North Hollywood. The criminal counts charged were: conspiracy, making fraudulent claims for healthcare benefits, making illegal referrals, and receiving illegal kickbacks.

This case is being prosecuted by the Los Angeles City Attorney's Office which makes it unusual since this office only has the jurisdiction to prosecute misdemeanors. However, the complaint seeks restitution to Medi-Cal and Medicare of $5 million. It is therefore clear that all prosecuting agencies are putting health care fraud as a priority.

The persons charged were: (1) two physicians, Dr. Eleanor Santiago Arthur and Dr. Rodney Stephen Barron, who were held on $500,000 bail; (2) the alleged owner of the clinic Artur Vic Manasarian who has also been charged in a federal health care fraud case; and (3) four individuals who worked at or on behalf of the clinic. All individuals are presumed innocent and a criminal complaint is not evidence or proof of guilt.

The allegations in the criminal complaint were that "cappers" recruited Medicare and Medi-Cal enrollees (including mentally ill homeless people) by paying them $100 each and drove them to and from the clinic. The government deemed it suspicious that some patients were recruited from Long Beach to go to the North Hollywood clinic. The clinic then allegedly performed unnecessary tests (such as abdominal ultrasounds) and other procedures at the North Hollywood clinic. This is the basis for the allegation that fraudulent bills were submitted to government insurance programs for seniors, the poor and the disabled.

One allegation was that in some instances, the patients' blood was drained into unsanitary, open containers and the clinic submitted the blood for tests under multiple patients' names so they could bill multiple times.  After the visits, the cappers drove the patients back to where they picked them up. The City Attorney alleges that the clinic billed the government for up to $1,000 worth of medical care per patient, and each physician saw 30 to 50 patients a day. 


Attorney Commentary:  These cases are not usually prosecuted by the City Attorney's Office since a misdemeanor count has a maximum of a one year sentence. However, the City Attorney's Office contends that if any of the charged individuals are convicted of all seven counts, the counts would be consecutive and they could face up to seven years in prison. This is one way for the City Attorney's Office to make misdemeanor counts serious for those charged with healthcare fraud and illegal kickbacks.

The City Attorney alleges that "owner" of the clinic is a non-physician indicating that there is the issue of the corporate practice of medicine in this case and it would not be surprising if there were allegations that the clinic was in control of the billing in this case. However, since only physicians can bill and receive payment from Medicare and Medi-Cal in California, the billing would have been in the names of the physicians and the City Attorney's Office will seek to hold them responsible even if they did not receive all the money received from Medicare and Medi-Cal. 


Thus, the days where these physicians were treated as "victims" appears to be over and physicians who work at clinics where there is illegal marketing, kickbacks and unnecessary tests cannot stick their heads in the sand and act like an "employee" when the billing and ordering of tests is under their name. Physicians must be very careful where they work and it is our experience that physicians who are young, elderly or have problems (such as medical, psychological, alcohol/substance abuse, or legal) are targeted to work at these illegal clinics. Even if a physician has trouble getting employment or making a living, working at any clinic which does not follow the law will cause more problems for the physician in the long run. We often advise physicians to do due diligence and make sure that their license and UPIN number will not be jeopardized. The short term benefits are not worth it.

Any questions or comments  should be directed to Tracy Green, a very experienced California health care fraud and Medicare fraud attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/

Thursday, October 28, 2010

Los Angeles Patient Recruiter For L.A. Medical Clinics And DMEs Sentenced To 21 Months In Federal Prison By Judge Walter: Lesson On Due Diligence In Hiring Marketers For Your Practice


A recent federal heath care fraud case alerts clinics as to how some marketers could be recruiting patients by paying those patients to go to clinics or receive DME. Before any marketer is hired, it is critical that the marketing methods be known. If a marketer pays for a patient to go to a clinic, all billing by that clinic to Medicare could be deemed a false claim. Physicians and medical providers cannot hide behind the marketer any longer and due diligence is required by the provider hiring the marketing company or individual.

In this case, James Roland Fuquay, 49, a patient recruiter who sold the personal information of Medicare beneficiaries from San Diego and Los Angeles to Los Angeles medical clinics and durable medical equipment (DME) companies was sentenced on October 26, 2010 to 21 months in prison  by U.S. District Judge John F. Walter of the Central District of California. Mr. Fuquay was also ordered to pay $556,815 in restitution and serve three years of supervised release following his prison term.

The sentence follows Mr. Fuquay's guilty plea over a year ago (May 11, 2009) to conspiracy to commit health care fraud. According to court documents, Mr. Fuquay was a patient recruiter known as the “Red, White, and Blue Man,” which is a reference to the colors on a Medicare card. Mr. Fuquay admitted to  recruiting Medicare beneficiaries from homeless shelters in San Diego and Los Angeles using the sales pitch, “Red, white, and blue. Let’s make it do what it do.”

Mr. Fuquay then paid the beneficiaries to go with him to fraudulent medical clinics and DME supply companies to receive medical services, power wheelchairs, hospital beds and other medical equipment the beneficiaries did not want, need or receive. Mr. Fuquay’s network of Medicare beneficiaries and fraudulent DME supply companies was large enough for him to make approximately $220,000 in illegal recruiter fees.

According to court documents, one of the fraudulent DME supply companies that paid Mr. Fuquay to recruit beneficiaries was Airport Medical Supply, whose owner, Eli Gichon, pleaded guilty on Sept. 1, 2010, to health care fraud and tax charges. According to court documents, Airport Medical Supply operated out of a dry cleaning business where Gichon directed Mr. Fuquay and others to bring beneficiaries so that Gichon could take pictures of them sitting in power wheelchairs or standing next to empty hospital bed boxes. Gichon used these pictures to try to fraudulently prove to Medicare inspectors that he had in fact provided the beneficiaries with power wheelchairs and hospital beds. Gichon’s sentencing is scheduled for Jan. 10, 2011.

Posted by Tracy Green, Esq.
Green and Associates, www.greenassoc.com
Phone: 213-233-2260
Email: tgreen@greensasoc.com

Monday, October 25, 2010

Mental Health Community Clinic & Its Owners/Managers Indicted In Miami For Paying Kickbacks To Assisted Living Facilities & Halfway Houses And For Admitting Ineligible Patients To Partial Hospitalization Programs


On October 21, 2010, the Departments of Justice and Health and Human Services (HHS) announced that two Miami health care companies who provide mental health care services and four owners and senior managers of the companies were indicted in the Southern District of Florida.

At the time the indictment was unsealed, a related civil action was unsealed and a temporary restraining order was obtained to freeze the assets of the indicted companies and individuals. It is becoming more common for criminal indictments to be accompanied by civil actions to seize the assets of Medicare providers and their owners and managers. The government is concerned about recovering restitution for the Medicare program.

A 13-count indictment unsealed in U.S. District Court charges American Therapeutic Corporation (ATC) and Medlink Professional Management Group Inc. (Medlink), as well as Lawrence S. Duran, Marianella Valera, Judith Negron and Margarita Acevedo, aka Margarita De La Cruz, with one count of conspiracy to commit health care fraud.


Please note: An indictment contains allegations that a defendant has commtited a crime. Every defendant is presumed innocent until and unless proven guilty. 

ATC, Mr. Duran and Ms. Valera were also charged with 11 counts of health care fraud. ATC, Mr. Duran, Ms. Valera and Ms. Acevedo are charged with one count of conspiracy to defraud the United States, to receive health care kickbacks and to pay health care kickbacks. The individuals were all arrested in Miami and federal agents served search warrants at six ATC and Medlink locations on the date of the arrests.

The government argued at the detention hearing that Mr. Duran and Ms.Valera are romantically involved and that they should be held in custody pending trial on the ground that they are a flight risk. The government pointed to their international travels and alleged expensive lifestyle including luxury cars and other goods allegedly purchased with proceeds from the companies.

In a separate action, a civil complaint for injunctive relief was unsealed and a temporary restraining order was obtained to freeze the assets of Mr. Duran, Ms. Valera, Ms. Negron, Ms. Acevedo, ATC and Medlink. This will likely make it difficult for the individuals and corporations to use their assets to defend themselves and retain private counsel although there are ways in which counsel can move the court and the U.S. Attorney's Office for funds for their criminal defense.

According to the criminal and civil court documents, it is alleged that there was a scheme to defraud the Medicare program by submitting false claims for mental health services administered at ATC facilities that were medically unnecessary or were not provided. ATC, headquartered in Miami, operated purported partial hospitalization programs (PHPs) in seven different locations throughout Florida, from Homestead to Orlando. A PHP is a form of intensive treatment for mental illness.

Court documents allege that Mr. Duran, Ms. Valera, Ms. Acevedo and ATC paid kickbacks to owners and operators of assisted living facilities (ALFs) and halfway houses in exchange for the ALFs and halfway houses delivering patients from their facilities to ATC. According to the indictment, in many instances, the patients received a portion of the kickbacks from the owners and operators of the ALFs and halfway houses.

ATC allegedly billed Medicare for services purportedly provided to these recruited patients. According the indictment, the services were not medically necessary or were not provided at all. According to the civil complaint, ATC routinely admitted patients to the PHP program who suffered from Alzheimer’s and severe dementia and therefore were not eligible for the PHP program because their mental capacity did not allow them to benefit from group therapy.

Court documents allege that patient charts and notes from therapy sessions were routinely altered at ATC in order to make it appear that the patients being treated at ATC qualified for PHP treatments when, in fact, they did not. According to the indictment, Mr. Duran and Ms. Valera allegedly instructed employees and doctors at ATC to alter diagnoses and medication types and levels to falsely make it appear that the patients qualified for PHP treatments. Court documents also allege that Ms. Valera manipulated the length of patients’ stays in order to maximize the number of days Medicare would pay for the PHP services.

The civil complaint and temporary restraining order also name American Sleep Institute Inc. (ASI) and D and V Development Inc., as participants in the health care fraud. Civil court documents allege that ASI was owned and operated by Ms. Valera and Mr. Duran and that ASI submitted false claims to the Medicare program for sleep studies. According to the civil complaint, D and V Development was owned and operated by Ms. Valera and Mr. Duran and was established in an effort to divert funds received by ATC and ASI.


Attorney Commentary: We can expect to see an increase in the number of health care fraud indictments filed in the various federal districts in the U.S. Significant resources are being expended and these cases are a priority in the Justice Department. This case does not mention the fact that the individual defendants are of Cuban heritage but in Miami a number of the health care fraud cases filed have involved those of Cuban ethnicity. In each of the major U.S. cities, Medicare fraud is more preeminent among the ethnic communities. The allegations in this particular case also allege that the patients received kickbacks. In order to combat the fraud, the patients need to be educated and face some consequences if they allow their Medicare card to be used for fraud or agree to receive payment for medical services.

The alteration of patient record allegations are important in that such evidence is used to show "criminal intent" in that the defendants "knew" that there was no medical necessity and ordered the charts to be altered in order to establish the need and basis for payment. The owners of the clinic would normally be expected to argue that the doctors saw the patients and determined medical necessity. If there is credible evidence of ordering doctors and other staff to alter the charts, this could effect this particular defense.  

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Any questions or comments  should be directed to Tracy Green, a very experienced California health care and Medicare fraud attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/


Friday, October 22, 2010

Attorney Tracy Green Quoted By San Diego Union-Tribune On Medical Board Investigation Of Doctor For San Diego Chargers

Attorney Tracy Green was quoted in a December 19, 2009 article in the San Diego Union-Tribune about the longtime doctor for the San Diego Chargers entitled "Complaint Filed Against Chargers Doctor." Ms. Green was interviewed about the Medical Board investigation into Dr. Chao. Ms. Green was quoted as follows:

“All the boards are on high alert because of the scrutiny that’s been placed on the nursing board,” said Tracy Green, an attorney with expertise representing professionals in health care. “They are getting alert to anything with drugs or alcohol or any convictions. The boards are being more aggressive than they used to be.”

Green is not involved in this case but said she doubted it would result in serious punishment. She said the board’s intent is to “look at it and see if he has an alcohol problem.”

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Wednesday, October 13, 2010

Operation “Diagnosis Dollars” -- 10 Individuals Indicted In Los Angeles & 28 Charged In New York Indictment - Allegations Of Medicare Fraud Where Services Never Provided At Phony Clinics & Armenian Organized Crime

L.A Times Photo
The Los Angeles Times and New York Times (44 Charged In Huge Medicare Fraud Scheme) reported on a number of federal criminal indictments in New York,  Los Angeles, New Mexico, Cleveland and Atlanta arising from an alleged scheme to defraud Medicare allegedly involving phony clinics, no patients (just Medicare cards), and physician identity theft. The above-referenced New York Times article has a copy of the Southern District New York Indictment embedded in it in which there were 28 defendants (including some from Los Angeles). The New York Indictment included RICO crime charges involving alleged Armenian organized crime. This nationwide investigation was called  Operation “Diagnosis Dollars.”

Three Los Angeles Indictments.  According to the indictments returned under seal by a federal grand jury in Los Angeles on October 7, the defendants (many of whom are related) played roles in the operation of at least eight fraudulent medical clinics and sought reimbursement from the Medicare health care benefit program for services that were never delivered to patients with coverage under that program, The defendants are also charged with laundering the money derived from the fraudulent scheme. In addition, 12 search warrants were executed in Los Angeles to seek evidence.

The Los Angeles indictments alleges crimes including Conspiracy to Commit Bank Fraud; Conspiracy to Launder Monetary Instruments; Money Laundering; Bank Fraud; Aggravated Identity Theft; and Criminal Forfeiture. The defendants charged in three separate Los Angeles indictments unsealed this morning are:
Pogos Satamyan, of Glendale
Vachagan Dishchian, 34, of Van Nuys
Vahe Dischian, 36, of Van Nuys
Andranik Satamyan, 20, of Glendale
Haroutyoun Dischian, 62, of Van Nuys
Nicolae Candu, 24 (not arrested or surrendered yet)
Vitalina Shcherbyak, 24 (not arrested or surrendered yet)
Nikolay Agishev, 24 (not arrested or surrendered yet)
Grisha Sayadyan, 59, of Glendale
Allen Sayadyan, 30, of Glendale

According to the main eight-defendant indictment, the scheme worked in the following way: individuals would obtain the stolen identities of physicians to enroll as providers in the Medicare program, which requires a medical doctor's name, Social Security number and date of birth. Using the stolen physician identities, applications to become providers were submitted applications to Medicare. The defendants would then open clinics by leasing office space or by renting a post office box. Other defendants would then open fraudulent bank accounts into which Medicare could transfer fraudulent claims. These bank accounts were opened in either the name of the physician whose identity had been stolen, a business, or in the name of a co-conspirator.

Once the application was approved and the Medicare provider account was opened, the defendants allegedly began to bill Medicare utilizing stolen beneficiary identifications. In reality, the Medicare beneficiaries were never seen or treated.

Medicare would then pay the fraudulent claims and transmit the funds directly into the fraudulent bank accounts. As the Medicare funds were received, they were withdrawn immediately and laundered. Some of the defendants laundered the funds by forging signatures of the alleged account holder, and then delivered the signed checks to a third party, who was actually a confidential informant working for the FBI. The confidential informant would then cash the checks and return the proceeds in cash to the defendants, less a fee.
Eight fraudulent clinics are specifically identified in the Los Angeles case, and investigators estimate the defendants submitted more than $17 million in fraudulent claims for which Medicare paid approximately $8 million.

Attorney Comments:  In my experience, one way that physician identities are obtained for fraudulent billing is through advertisements for physician employees at clinics. Physicians must be very careful not to place their physician number, UPIN number, Social Security number or other identifying information on blind resumes or CVs sent in response to advertisements.If physicians do not guard this information, the fraudulent use of their information for billing can cause huge problems with Medicare that can take years to unwind including overpayment demands, tax issues and related problems.

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Any questions or comments  should be directed to Tracy Green, a very experienced Medicare fraud attorney  and health care fraud attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/

Saturday, October 9, 2010

Attorney Tracy Green quoted in L.A. Times Article: "Medical workers in California were allowed to keep practicing despite failing drug, alcohol tests"

Attorney Tracy Green was quoted in the Los Angeles Times on October 8, 2010 regarding the errors by Maximus in administering drug and alcohol tests to nurses in California diversion program. The article can be found at:

Medical workers in California were allowed to keep practicing despite failing drug, alcohol tests - latimes.com

Los Angeles Medical Equipment Supplier Sentenced to 46 Months in Prison for Role in Billing Power Wheelchairs to Medicare

Another sentence has been imposed in the power wheelchair Medicare fraud cases. On October 4, 2010, Sylvester Ijewere, 49,  the owner and operator of Los Angeles durable medical equipment (DME) company Maydads Medical Supply, was sentenced to 46 months in prison by U.S. District Judge Dale S. Fischer of the Central District of California. Mr. Ijewere was also ordered to pay $211,755 in restitution. In addition, Mr. Ijewere was ordered to serve three years of supervised release following his prison term.

This sentence came after a guilty plea. Mr. Ijewere pleaded guilty on April 12, 2010, to health care fraud. Mr. Ijewere admitted that between June 2007 and October 2009, he conspired with others to purchase fraudulent prescriptions and medical documents which he used to submit false claims to Medicare for expensive, high-end power wheelchairs, and other DME.

Mr. Ijewere's company received approximately $4,000 in reimbursement payments for each power wheelchair claim he submitted to Medicare. Approximately 50 percent of the Medicare beneficiaries to whom Mr. Ijewere claimed Maydads had supplied power wheelchairs and other equipment lived more than 100 miles from Maydads’ Los Angeles-area offices in Central and Northern California. When patients are brought in from long distances it is a red flag to Medicare that there is patient marketing or fraudulent prescriptions. 

Mr. Ijewere admitted in his plea that he submitted or caused the submission of approximately $471,345 in false and fraudulent claims to Medicare through Maydads.

Mr. Ijewere’s alleged co-conspirator, Donna Wells, a patient recruiter, was charged for her role in the scheme in October 2009, and is scheduled to begin trial on November 9, 2010.

Attorney Comments:  In 1997, total billings to Medicare for power wheelchairs was $150 million. By 2003, this grew to $1.1 billion. The number has increased since 2003.  In addition, there was an OIG study indicating that sixty percent (60%) of all prescriptions for power wheelchairs did not meet documentation requirements imposed by Medicare. Many of the current federal and state investigations commence with documentation issues that are triggered when the physician who writes the prescription has seen the patient only one or two times and when the patient resides more than 30 miles from the DME or physician. 

In addition to documentation and medical necessity, there has been considerable concern raised about improper marketing of power wheelchairs. There were allegations that minority neighborhoods were targeted, using door-to-door solicitation, and that fully ambulatory older residents were offered kickbacks for participating and bounties for recruiting others. These individuals were then directed to specific physicians, some of whom also received kickbacks from the power wheelchair distributors. One factor contributing to the abuse was the large profit margin for suppliers of power wheelchairs. Medicare was paying more than $5,000 per power wheelchair claim in 2003, while the Veteran’s Administration paid closer to $3,000 per chair, which suggests that there was substantial profit in power wheelchairs reimbursed by Medicare.

The federal and state governments works on "projects."  The power wheelchair is a longstanding project by federal and state authorities. The first phase of prosecutions targeted those DMEs where wheelchairs were not delivered or where there was identity theft of Medicare beneficiaries. The second phase is for those DMEs where there was illegal marketing and a lack of medical necessity. I expect to see more prosecutions in the Central District of California over the next two years.

Posted by Tracy Green, Esq.
Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country.
Their website is: http://www.greenassoc.com/

Sunday, October 3, 2010

Workers Comp Premium Insurance Fraud: Two Painting Contractors Sentenced To 6 Months' Jail And 3 Years' Probation After Paying Over $500,000 In Restitution In Ventura County

On September 8, I posted an article about Two Painting Contractors Plead Guilty To Workers' Compensation Insurance Premium Fraud in Ventura County.  Now for the follow-up post on their sentence.

At the time they plead they were not sentenced and had no firm agreement on sentencing from what I understand.  There probably was a "lid" or cap on what the sentence would be with the judge to have discretion on the amount of jail time imposed.

Last week, the two painting contractors, Michael Nuciforo and James Nuciforo were sentenced to 36 months formal probation and ordered to serve 180 days in the Ventura County jail as a result of their convictions for felony workers' compensation premium fraud. Ventura County is known as a tough county in sentencing defendants. In order to obtain the 6 months' sentence (for which they will have to serve 3 months), the Nuciforos paid $517,433 in restitution before sentencing. In Los Angeles County, they may have received a different result showing that venue is important in your case. It also shows that payment of restitution is key to getting an excellent result. 
 
In this case, the allegations were that Michael and James Nuciforo, owners of D and J Drywall Painting, Inc., in Newbury Park, lied to their workers' compensation insurance carriers over a period of nine years in order to lower their workers' compensation insurance premiums. The Nuciforos allegedly earned an extra $50,000 a year by underreporting their workers' compensation premiums.  
 
Attorney Commentary: The government views this case and other premium workers' compensation fraud cases as indicative of an epidemic of workers' compensation premium fraud in California . A comprehensive study out of U.C. Berkeley by researchers Frank Neuhauser and Colleen Donovan indicated the losses caused by premium fraud in California during 2005 (the most recent year reflected in the study's statistics) were as much as $2.8 billion. 

According to the study, this $2.8 billion loss translates to approximately $75 for every person in California per year. According to the study, insurance companies do not suffer a net loss; they simply pass on the losses to businesses in the form of higher workers' compensation premiums. The businesses, in turn, increase their costs of goods and services to the consumer. In the end, the belief is that the average citizen bears the brunt of this crime.
 
The other reason the government targets workers' compensation premium fraud is the belief that it creates an unlevel playing field for businesses, particularly contractors (where premiums are high). This occurs in the construction industry, garment industry, farm worker industry and any other industry where certain jobs are deemed "high risk."  Contractors who improperly classify workers at lower premium rates or underreport their payroll are able to keep the money they would be using to pay premiums and then can underbid the competition. Honest employers are disadvantaged by having to pay even higher premiums than they otherwise would, and then lose jobs to the other company who pays lower workers' compensation premiums.   

The workers' compensation carriers are conducting more audits and are now obtaining the records that the employers have filed with EDD (which previously were ruled confidential). Thus, there is now a greater likelihood of an audit and a criminal investigation.  If your company has engaged in premium workers' compensation misrepresentations, it is better to address these issues early and amend prior submissions or ensure that future submissions comply with the law.  


Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation. 

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing professionals in fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/


Tuesday, September 21, 2010

El Centro Regional Medical Center Settles Qui Tam Medicare Fraud Suit By Paying U.S. $2.2 Million and Entering Into A Corporate Integrity Agreement

On September 20, 2010, the El Centro Regional Medical Center in Imperial County, California (near the Mexico border) agreed to pay the United States $2.2 million, plus interest, to settle allegations that it defrauded Medicare. El Centro is a nonprofit community based hospital owned by the city of El Centro. It was formed in 1956.

The United States has agreed to dismiss the lawsuit as a result of the settlement announced today. In addition, as a condition of continued participation in federal health care programs, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG-HHS) has required El Centro Regional Medical Center to enter into a Corporate Integrity Agreement. The agreement subjects the hospital to strict policies and procedures to ensure future compliance with applicable statutes and regulations that govern the use of federal health care funds.

Smaller providers often do not get the opportunity to enter into Corporate Integrity Agreements but given the nonprofit status of this hospital and the fact that it has been around for 40 years, that probably made a difference. Smaller providers when faced with overpayments and fraud allegations, however, should work on creating their own compliance plans and present them to Medicare or Medi-Cal in order to show their commitment to following the rules and regulations.

The government alleges that the 165-bed acute care hospital fraudulently inflated its charges to Medicare patients to obtain larger reimbursements from the federal health care program. The settlement covers claims submitted by the hospital for short inpatient admissions, usually of one day or less, when the services should have been billed on an outpatient “observation” basis or as emergency room visits.

The allegations arise from a lawsuit that was brought under the qui tam, or whistleblower, provisions of the False Claims Act (FCA), which permit private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery. The whistleblower in this case, Pietro Ingrande, a former employee of El Centro Regional Medical Center, will receive $375,000 as his share of the recovery.

Attorney Commentary:  The qui tam lawsuit shows the importance of having an operative compliance plan where employees are encouraged to report to the provider first before reporting to outside agencies. Exit interviews are also important to the process so former employees report any alleged wrongdoing that can be investigated by the provider to avoid qui tam lawsuits.  I encourage providers to adopt the saying "there is no such thing as a bad fact, only something I do not know." If an employee believes there is improper billing -- even if unfounded -- it is better for the provider to know it and address it internally before there is outside reporting.

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.  

Any questions or comments  should be directed to Tracy Green, a very experienced California health care fraud attorney and qui tam defense attorney who understands fraud and the Medi-Cal Medicare programs at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country.
Their website is: http://www.greenassoc.com/

Monday, September 20, 2010

Miami-Area HIV Injection and Infusion Clinic Owner Pleads Guilty To Conspiracy to Commit Health Care Fraud - Sentencing Set For November

In Florida, you do not need to be a physician to own a medical clinic. On September 9, 2010, non-physician clinic owner Flor Crisologo, 58, pleaded guilty before Magistrate Judge Barry L. Garber in U.S. District Court in Miami to one count of conspiracy to commit health care fraud. Ms. Crisologo owned and operated an HIV infusion clinic and was originally charged in a May 2010 indictment. This case involved kickbacks, medically unnecessary tests, and some tests that were not performed.

According to the plea documents, Ms. Crisologo was the owner and operator of J and F Community Medical Center Inc. Ms. Crisologo admitted that she submitted approximately $23 million in false and fraudulent claims to Medicare for HIV injection and infusion services purportedly provided through J and F. According to court documents, Ms. Crisologo hired a physician at J and F and conspired with the physician and others to order unnecessary tests, sign false medical analyses and diagnosis forms, and authorize treatments to make it appear that medical services were being provided to patients who were Medicare beneficiaries. The services included medically unnecessary injection and infusion therapies.

On the marketing and kickback side, Ms. Crisologo admitted that she and her conspirators paid Medicare beneficiaries kickbacks to induce the beneficiaries to claim they received legitimate services at the clinic when in fact the HIV infusion services were either not provided or were not medically necessary. The kickbacks make defense difficult in these cases since violation of the anti-kickback statute automatically makes a claim for a service that is provided a "false claim." The kickbacks also play into the medical necessity where the marketer encourages the beneficiary to falsely report symptoms in order to obtain services. 

The maximum sentence for conspiracy to commit health care fraud is 10 years in prison. This is a high loss amount and unless there is significant cooperation, it is expected that the sentence could be lengthy.  Ms. Crisologo also faces fines and forfeiture of any property or proceeds derived from the clinic.  Sentencing is scheduled for November 23, 2010.

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Any questions or comments  should be directed to Tracy Green, a very experienced California health care fraud attorney and California Medicare fraud attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers and in health care fraud related matters in California and throughout the country. Their website is: http://www.greenassoc.com/

Sunday, September 12, 2010

Physicians and Nine Others Indicted For Online Pharmacies & Charges Of Illegally Distributing Drugs In San Francisco Federal Court


On September 1, 2010, a San Francisco federal grand jury indicted 11 defendants including one physician for participating in three separate but related conspiracies to distribute controlled substances outside the scope of professional medical practice. It is Case Number CR 10 - 0642 RS. The United States Drug Enforcement Agency issued a press release summarizing this multi-defendant case. 

This indictment was obtained in connection with an international investigation of illegal Internet pharmacies that began in 2005. The investigation has resulted in the indictment of 37 federal defendants, the conviction of 26 individuals on federal criminal charges, and the dismantling of more than five Internet pharmacies. Please note: An indictment contains only allegations against an individual and, as with all defendants, the individuals listed in the government's press release must be presumed innocent unless and until proven guilty.

There are three related conspiracies in the Indictment. In the first alleged conspiracy, called the "Safescripts Online" conspiracy, eight individuals allegedly conspired to distribute in excess of $22.2 million worth of controlled substances outside the scope of professional medical practice and without establishing a legitimate medical purpose for the drugs from November 2004 and continued until December 2006. The second is the "Pitcairn conspiracy" which allegedly ran between May 2003 and April 2007.  The third one is the "United Mail Pharmacy Services" conspiracy, which allegedly began in January 2006 and ended in March 2008.

This case related to Internet pharmacy website selling Schedule III and IV drugs (a) phendimetrazine; (b) diazapam (Valium); (c) phentermine; and (d) clonazepam. In essence, the Indictment alleges that the defendants at the pharmacy reviewed online questionnaires which asked customers to briefly describe medical history. The doctor defendants allegedly did not examine the "customers" and did not obtain a complete medical history and there was no effort made to confirm the accuracy of the information provided.  The doctor defendant authorized the prescription and the owners/employees of fulfillment pharmacies filled and shipped the orders to the customers.

The individuals charged are from around the United States and outside the country and reflect the geographic spread of internet pharmacies. All of the defendants were charged with (1) conspiracy to distribute schedule III and IV controlled substances, in violation of 21 U.S.C. § 846, and (2)  conspiracy to launder money, in violation of 18 U.S.C. § 1956(h). In addition, all but one defendant were charged with distribution of the schedule IV controlled substance Phentermine, in violation of 21 U.S.C. § 841(a)(1), and all but another defendant were charged with conspiracy to launder money, in violation of 18 U.S.C. § 1956(h).

Posted by Tracy Green, Esq. Please email Ms. Green at tgreen@greenassoc.com or call her at 213-233-2260 to schedule a complimentary 30-minute consultation.

Any questions or comments  should be directed to Tracy Green, a very experienced California health care fraud attorney, prescription fraud attorney, California physician lawyer, and California Medical Board attorney at tgreen@greenassoc.com.

The firm focuses its practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers in California and throughout the country. Their website is: http://www.greenassoc.com/





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