Articles Tagged with whistleblowers’ attorney

pill$As consumers of health services, we rely on medical professionals to help us protect our own health and the health of others.  The vast majority of medical professionals are dedicated to providing the best care possible.  Sadly, however, there are some people who abuse the public’s trust, often risking the health and welfare of others for personal gain.  Today’s post will focus on pharmacies and pharmacy fraud, a category that includes pill restocking schemes.  These schemes may include Medicare fraud, Medicaid fraud, and/or fraud on private insurance providers.  People who become aware of such schemes, including patients, pharmacy employees, and other medical professionals, can help fight back.  As a pharmacy fraud law firm, we work with concerned citizens to stop these crimes and protect the health of innocent Americans.

Restitution Order in Alleged Pill Restocking Case

Last week, according to WZZM13, a federal judge handed down an order for restitution in a case that has already let to more than a dozen arrests.  WZZM reports that, according to this ruling, the drug restocking scheme cost Medicare over $64 million and cost Medicaid $18.2 million with an additional $4.7 million lost by Blue Cross Blue Shield of Michigan.  The ruling decrees that the CEO and six others must collectively pay $8.8 million, 10% of the total amount lost by public and private insurers due to the fraud.

Identity theft is a common fear and a common problem.  Readers of this blog know that identity theft is a problem that reaches beyond the financial sphere.  Quite often, health care fraud cases involve an element of medical identity theft.  In a previous post, our medical identity theft lawyer discussed the problem of scammers stealing consumers’ medical identities and using the information to submit and collect on false claims.  However, consumers are not the only targets of medical identity theft.  Provider identity theft is also a component of many health care fraud scams, criminal enterprises that divert critically needed health care dollars and endanger the health and well-being of countless Americans.

Clinic Owner Allegedly Filed Claims Using Former Owner’s Provider Information

In late August 2012, NBC New York reported on the arrest of a man who operated a radiology practice in Queens on charges that he engaged in health care fraud.  According to the article, a 34 year-old man by the name of Ting Huan Tai was taken into custody by federal agents who arrested him at his luxury apartment in a Lower Manhattan high-prescriptionrise.  In May 2010, as alleged in court filings, Tai took over operations at United Medical Diagnosis (“UMD”), a radiology clinic in Flushing, New York.  From May 2010 through May 2012, Tai and his staff allegedly used the identity of the clinic’s prior owner, a radiologist, to submit more than $30 million in claims to Medicare and Medicaid.  The claimed services were not actually performed and the bills were submitted without the knowledge or consent of the former UMD owner.  United States Attorney Loretta Lynch explained, “The defendant sought to enrich himself and fund his lifestyle first by stealing a doctor’s identity and then using that stolen identity to steal Medicare and Medicaid funds…While the documentation provided was a sham, the money stolen was very real.”