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.  Ms. Green's office at Green and Associates is located at 801 South Figueroa Street #1200, Los Angeles, CA 90017.

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 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/

Media Links To Press Or Past Cases

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