Healthcare Fraud Lawyer Blog

December 29, 2017

California DWC Suspends 37 Medical Providers for Fraud

hush-naidoo-382152-copy-300x200 In December, California’s Division of Workers’ Compensation (DWC) announced it suspended 37 medical providers’ from being part of the state’s workers’ compensation system due to fraud. 21 suspensions were announced on December 4 and 16 additional suspensions were announced on December 21, bringing to the total suspensions for the year to 131. Many of these suspensions arise after being convicted of health care fraud or after a physician loses their medical license.

Suspended Medical Providers

The DWC suspended the following physicians due to fraud or other illegal acts:

December 22, 2017

Two Saratoga Doctors Convicted of Health Care Fraud

by Gregory J. Brod

vladimir-kudinov-71455-copy-300x241 Physicians Vilasini Ganesh, 47, and Gregory Belcher, 56, were convicted in December of committing health care fraud and making false statements to health care programs. A federal jury found Ganesh guilty of five counts of health care fraud and five counts of making false statements relating to fraudulently submitted claims. Belcher was found guilty of one count of making a false statement regarding a health care benefit program. Both were acquitted of conspiracy and money laundering charges.

Health Care Fraud and False Statements

Evidence presented at trial showed Ganesh, who was the head of Campbell Medical Group, submitted false and fraudulent claims to several health benefit programs for services. She submitted claims for days when patients had not seen a health care provider and claims that patients had been seen by another physician who was no longer with her practice.

December 15, 2017

California Radiologist Found Guilty of Health Care Fraud

by Gregory J. Brod

hush-naidoo-382152-copy-300x200 In mid-December, a federal jury found Ronald Grusd and two corporations, California Imaging Network Medical Group and Willows Consulting Company, guilty of fraud and bribery related to a health care fraud scheme involving California’s Workers’ Compensation program. More specifically, the jury was found guilty of Conspiracy, Honest Services Mail and Wire Fraud, Health Care Fraud, and violations of the Travel Act. Grusd, the companies, and his administrator, Gonzalo Paredes, were indicted by a federal grand jury in November 2015. Grusd will return for sentencing in March 2018. Paredes is to return to court for a hearing regarding a retrial in January 2018.

Grusd’s Health Care Scheme

Grusd and his two companies paid kickbacks to multiple clinics in San Diego County and Imperial County for patient referrals. The purpose of these illegally obtained patient referrals was to fraudulently bill insurers more than $25 million in medical services.

December 8, 2017

Unnecessary Medical Tests Lead to $1.2 Million Settlement

by Gregory J. Brod

piron-guillaume-96228-copy-300x200 On November 28, the U.S. Department of Justice (DOJ) announced a $1.2 million settlement with Cardiovascular Consultants Heart Center, known as CVC Heart Center, and its shareholder physicians. CVC Health Center is a cardiology clinic with offices in Fresno and Clovis, California.

The CVC Heart Center along with Dr. Kevin Boran, Dr. Michael Gen, Dr. Rohit Sundrani, Dr. Donald Gregory, and Dr. William Hanks resolved state and federal False Claims Act (FCA) allegations based on their allegedly performing medically unnecessary tests and billing state and federal health care programs for them.

If you are aware of any medical false billing to a California or federal health care program like Medicare or Medi-Cal, contact the San Francisco health care fraud lawyers of Brod Law Firm right away. You may have information that would be important to the authorities. You may also have standing to bring a qui tam suit on behalf of a state and/or federal government.

December 1, 2017

Former Health Care Facility Employees Plead Guilty to Medicare Fraud

by Gregory J. Brod

osman-rana-193633-copy-300x169 The U.S. Department of Justice announced on November 28 that two former health care employees pleaded guilty to Medicare fraud. Aharon Aron Krkasharyan, 53, was employed as a quality improvement coordinator at Mauran Ambulance Inc., a Los Angeles area ambulance company that provided non-emergency services to Medicare patients. Maria Espinoza, 47, was an administrative assistant at DaVita Doctors Dialysis of East Los Angeles.

Both pleaded guilty to fraud charges for a scheme that caused $6.6 million in fraudulent claims to be submitted to Medicare. They are scheduled to be sentenced in the spring of 2018.

If you have any information regarding a similar Medicare or Medi-Cal kickback or fraudulent claim scheme, you should contact a San Francisco health care fraud attorney from Brod Law Firm right away. You may be able to bring this illegal activity to state and federal authorities’ attention or to file a False Claims Act (FCA) qui tam suit yourself, potentially benefiting from a jury award or settlement.

November 24, 2017

San Diego Nursing Homes Pay $6.9 million for Health Care Fraud

by Gregory J. Brod

alex-boyd-260321-copy-300x200 Four San Diego nursing homes owned by Brius Management Co. have agreed with the federal and state governments to resolve civil allegations regarding illegal kickbacks and health care fraud by paying a $6.9 million settlement.

The investigation into the Point Loma Convalescent Hospital, Brighton Place located in San Diego, Brighton Place located in Spring Valley, and Amaya Springs Health Care Center in Spring Valley began through a qui tam lawsuit regarding false claims submitted to Medicare and Medi-Cal. The whistleblower’s allegations enabled the government to investigate the claim and eventually enter into Deferred Prosecution Agreements (DPAs) and a Corporate Integrity Agreement with these four facilities.

If you work for a nursing home, hospital, or other medical facility and you aware of an illegal kickback scheme or false claims being made to Medicare or Medi-Cal, contact a San Francisco health care fraud lawyer from Brod Law Firm right away.

November 17, 2017

Inland Empire Resident Pleads Guilty to Health Care Fraud

by Gregory J. Brod

ken-treloar-385255-copy-300x200 Elaine C. Lat, 47, of Fontana, California, owned and operated the Star Home Health Resources, Inc., a home health agency. As the chief operating officer, Lat implemented an illegal kickback scheme through which she would pay physicians, marketers, and other professionals in cash or checks from Star Home’s accounts for referrals of Medicare patients. Between May 2008 and May 2016, she paid more than $1.25 million in illegal kickbacks for these referrals. She then received more than $8.5 million in reimbursements from Medicare for services provided to patients the facility gained through the illegal kickback scheme.

Sentencing for Illegal Kickbacks

Lat pleaded guilty in May 2017 to one count of conspiracy and four counts of paying illegal kickbacks. She was sentenced in November 2017 to 30 months in federal prison and ordered to pay $41,930 in restitution to Medicare.

November 10, 2017

Four Californians Plead Guilty and are Sentenced for Health Care Fraud Conspiracy

by Gregory J. Brod

alex-boyd-260321-copy-300x200 Sentencing for four California residents who pleaded guilty to conspiracy to commit health fraud was recently handed down. Geoffrey Ricketts, 49, Marla Ricketts, 38, Samuel Kim, 41, and Sunyup Kim, 40, all pleaded guilty in late 2016 and early 2017 after being indicted in June 2015.

Glucose Meter Fraud Scheme

These individuals created a fraudulent scheme regarding the sale of “talking glucose meters,” which were not medically needed or requested by consumers. They did so through the operation of Care Concepts, LLC and Choice Home Medical Equipment and Supplies (“Care Concepts”). The main corporate business was based out of Louisiana, while Care Concepts had its principal place of business in Chatsworth, California.

November 3, 2017

Former Orange County Medical Device Provider Sentenced for Fraud

by Gregory J. Brod

daan-stevens-282446-copy-300x191 Michael Mirando, 40, previously a resident of Aliso Viejo, CA, was found guilty in May of 2017 on 15 counts of health care fraud. It took a federal jury less than half an hour to reach a verdict following the trial. At the end of October, Mirando was sentenced to eight years in prison and $3 million in restitution. Mirando’s current home in Portland is also being forfeited to the authorities since he admitted it was purchased by the financial proceeds of the fraud.

Medical Facility Owner Submits False Bills

Mirando owned Holter Labs, which offered patients cardiac monitoring services using what was called a Holter monitor. It is an ambulatory electrocardiography device, also known as an EKG device that can be used while a patient walks and performs normal activities. Holter Labs would provide these devices to physicians who then prescribed the devices to patients in order to monitor their heart rates for 24 to 48 hours. Mirando would bill the patients’ insurance companies for the day or two of use of the device. However, at the same time, he would tack on additional services that were not ordered or provided, like 30-day EKG tests, brain scans, and oxygen studies.

October 27, 2017

Two Fresno Health Care Fraud Cases Resolved in October

by Gregory J. Brod

how-soon-ngu-34-copy-199x300 The Department of Justice (DOJ) for the Eastern District of California announced in October that two individuals pleaded guilty to health care fraud charges. These announcements continue to prove that the DOJ is focused on prosecuting all forms of health care fraud throughout the state and federal levels.

If you have information regarding health care fraud, contact an experienced San Francisco health care fraud lawyer at Brod Law Firm to learn about your rights and options. You may be in the position to file a qui tam lawsuit on behalf of California or the federal government. Call us today at (800) 427-7020.

Fresno Podiatrist Pleads Guilty