Tag Archives: Health and Human Services

Miami couple faces lengthy sentence for Medicare fraud

Lawrence Duran was a Miami healthcare executive who regularly lobbied Congress in favor of legislation to boost government subsidies for his industry: community mental health centers. He visited with U.S. Rep. Ileana Ros-Lehtinen in Washington to drum up support. He, his girlfriend and other members of his lobbying organization threw a fundraiser for another Miami congressman, Rep. Kendrick Meek, when he ran for the U.S. Senate.

But Justice Department officials paint a far more sinister portrait of Duran and his girlfriend, Marianella Valera. They say the lobbying work was all a front to help them steal more money from the taxpayer-funded Medicare program.

Now Duran and Valera, who each pleaded guilty this year to Medicare fraud charges of running the biggest mental-health racket in the nation, face the prospect of spending the rest of their lives in prison for orchestrating the $205 million scam.

Dozens arrested in Medicare mental health fraud

Federal agents have arrested dozens of suspects charged with bilking Medicare of hundreds of millions of dollars in bogus services for mental health therapy and other types of healthcare.

Agents with Health and Human Services and the FBI have fanned out across three South Florida counties, arresting clinic owners, healthcare employees, patient recruiters and assisted living facility owners who allegedly supplied hundreds of patients to the mental health clinics.

Feds to start directly targeting drug company execs in health care fraud schemes

The days of drug companies simply settling out of court every time they break the law may soon be coming to an end. In a move that represents a significant shift toward punishing individuals for crimes rather than faceless corporations, federal officials say they will begin personally going after CEOs and other company executives whose companies fraudulently bilk Medicare, Medicaid, and other federal programs out of millions of dollars, or that falsely market dangerous drugs.

Texas Doctors Prescribe $47 Million Worth of Antipsychotic & Anti-Anixety Drugs, Primarily for Kids—One Child Psychiatrist Alone Wrote 27,000 Prescriptions For Xanax

With little oversight and apparent carte blanche, a relative handful of Texas physicians wrote $47 million worth of Medicaid prescriptions for powerful antipsychotic and anti-anxiety drugs over the past two years, according to a Star-Telegram analysis. The top five doctors alone wrote $18 million worth. Grassley asked Texas and other states for the top 10 prescribers who billed Medicaid for certain drugs. The Star-Telegram used prescriber numbers to identify the doctors, then sorted and tallied the drugs they were prescribing. Also reviewed was information on other mental-health drugs that have cost taxpayers about $1.3 billion during the past five years.

Most of the drugs have gone to children and adolescents, although prescribing the drugs to children, such as a toddler, is considered “off-label” — uses not approved by the federal Food and Drug Administration. Now the state’s Medicaid program is among others under scrutiny, after Sen. Charles Grassley, R-Iowa, began investigating the use of mental-health drugs this year.

Drug-firm executives under new scrutiny in Medicare fraud

Federal inspectors want to prevent drug-company executives from doing business with the U.S. government when their companies are convicted of Medicare fraud.
Under guidelines from the Department of Health and Human Services’ Office of Inspector General, executives can be barred from contracting with federal health programs when they knew, or if the inspector general concludes they should have known, about fraud at their firms. The guidelines were posted Oct. 20 on the office’s Web site. Authorities have been spurred by large settlements, said Robert DeConti, chief of the administrative and civil remedies branch in the inspector general’s Office of Counsel. GlaxoSmithKline was ordered to pay $750 million on Oct. 26 for sale of defective drugs, and Pfizer agreed to pay $2.3 billion in September 2009 for fraudulent marketing of medicine.