Bookmark this page on your mobile

QR Code image

What is this?

Daily Court Reporter - News National health care fraud takedown includes two Ohio companies and owners charged with false billing

 

National health care fraud takedown includes two Ohio companies and owners charged with false billing

(Columbus) A federal grand jury has returned separate indictments charging two central Ohio health care companies and the people who own them with health care fraud. One company allegedly billed government insurance programs for unnecessary medical procedures and the other is accused of billing government insurance programs for pain and scar creams that recipients said they never requested or wanted.

The two Ohio cases are part of a nationwide health care fraud takedown announced today by Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D.

Benjamin C. Glassman, United States Attorney for the Southern District of Ohio; Lamont Pugh III, Special Agent in Charge, U.S. Department of Health & Human Services; Office of Inspector General – Chicago Region; the Medicaid Fraud Control Unit in Ohio Attorney General Mike DeWine’s Office; Angela Byers, Special Agent in Charge, Federal Bureau of Investigation Cincinnati; Timothy J. Plancon, Special Agent in Charge, Drug Enforcement Administration (DEA); and Steven W. Schierholt, Executive Director of the Ohio Board of Pharmacy announced the indictments today as part of a nationwide crackdown on fraudulent health care providers.

One indictment alleges that Salim Dahdah who owns and operates the Ohio Institute of Cardiac Care (OICC) in Springfield, and his wife Cindy Dahdah who owns Accubil, a company that handles the billing for OICC, received more than $2 million from Medicare and Medicaid for medically unnecessary nuclear stress tests and medically unnecessary coronary interventions such as pacemaker insertion and stent procedures. The indictment charges them with conspiracy to commit health care fraud and health care fraud, crimes punishable by up to ten years in prison, and health care false statements a crime which carries a maximum sentence of five years in prison.

The grand jury also indicted Darrell Bryant and Gifty Kusi, a husband and wife who own and manage Health & Wellness Pharmacy in Dublin. Kusi and Dr. Jornel Rivera owned and operated Health & Wellness Medical Center, also in Dublin. The indictment alleges that they fraudulently received more than $3 million from the Ohio Department of Medicaid and Medicaid Managed Care Organizations (MCOs) through multiple schemes including billing for compound creams that were not provided or not requested by patients, billing for counseling services that were not provided or billing for group counseling sessions as individual counseling services. The indictment charges all three defendants with conspiracy to commit health care fraud and health care fraud.

“Health care fraud creates victims out of patients, providers, and taxpayers,” U.S. Attorney Glassman said. “It’s a crime that breaks the bonds of trust between doctor and patient, and between government and the people, just for the sake of personal greed.”

“The charges announced today should send a strong message to criminals that theft from vital health care programs will not be tolerated”, said SAC Pugh of HHS Office of Inspector General. “The OIG and our law enforcement partners will continue to be vigilant in our efforts to protect tax payer dollars that are intended to aid our most vulnerable citizens.”

“Both of these cases are egregious,” said Attorney General DeWine. “In the OICC case, the investigation found that patients underwent dangerous and completely unnecessary medical procedures, and in the Health and Wellness Pharmacy case, the investigation found that people who legitimately needed drug treatment and counseling weren’t getting it – even though the company charged for it. In the midst of the opioid epidemic in Ohio, it is critical that healthcare providers are rendering services that are meant to help Ohioans struggling with addiction.”

“Some of the charges described include medically unnecessary procedures performed which could cause patient harm. This is the most egregious form of health care fraud”, said SAC Byers of the FBI, adding that “Health care fraud contributes to rising health care costs for everyone.”

Today’s nationwide enforcement action is the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.

U.S. Attorney Glassman commended the investigation of this case by the HHS-OIG, Ohio Attorney General Mike DeWine’s Medicaid Fraud Control Unit and IRS Criminal Investigation, as well as Assistant United States Attorney Kenneth Affeldt and Special Assistant United States Attorney Maritsa Flaherty, who are representing the United States in this case.

An indictment merely contains allegations, and the defendant is presumed innocent unless proven guilty in a court of law.

Date Published: July 27, 2017

 

The United States Department of Justice for the Southern District of Ohio

 

Task force seizes 400 pounds of marijuana, two arrested

Ohio Attorney General Mike DeWine, Montgomery County Sheriff Phil Plummer, U.S. Department of Homeland Security Investigations Special Agent in Charge Steve Francis, and members of the Miami Valley Bulk Smuggling Task Force announced recently the seizure of approximately 400 pounds of marijuana in connection with an investigation into a large-scale marijuana distribution organization operating between Dayton and Columbus.

Ohio and U.S. Employment Situation (Seasonally Adjusted), June 2017

Ohio's unemployment rate was 5.0 percent in June 2017, up from 4.9 percent in May 2017. Ohio’s nonagricultural wage and salary employment increased 11,500 over the month, from a revised 5,517,300 in May to 5,528,800 in June 2017.

Man sentenced to 200 months in prison for role in cocaine trafficking conspiracy

Oscar Collado-Rivera, 32, of New Albany, Ohio, was sentenced in U.S. District Court to 200 months in prison for conspiring with others to distribute more than 150 kilograms of cocaine.

University of Cincinnati to study prevalence of human trafficking in Ohio

In collaboration with Gov. John R. Kasich’s Ohio Human Trafficking Task Force, the Office of Criminal Justice Services (OCJS) has awarded funding to the University of Cincinnati (UC) to assess the extent to which youth and children are exploited in Ohio.

Fact: Multiple 529 Plans work best for multiple kids

Families with more than one child may wonder if they need more than one 529 plan to save for their children’s future college costs. While it’s not necessary, the benefits of a 529 plan customarily can be amplified best if each child has their own 529 account. Why? Here are a few reasons.

When a loved one dies…who pays the bills?

Q: Who is responsible for paying the bills of a deceased person?

Attorney who misappropriated $363,000 permanently disbarred

A Columbus personal-injury attorney was permanently disbarred by the Ohio Supreme Court recently for misappropriating more than $363,000 in settlements funds, mostly by not paying parties, other than her clients, who were entitled to portions of the settlement.

OHFA announces 2017 Housing Tax Credit Program Recipients, awarding more than $25 million to create affordable housing options

At its July 19, 2017, meeting, the Ohio Housing Finance Agency (OHFA) Board announced the recipients of the 2017 Housing Tax Credit (HTC) program awards, used to fund the construction, acquisition and rehabilitation of affordable housing communities throughout Ohio. Over $27 million in federal housing tax credits was awarded to 33 developments to create 1,698 housing units serving families, seniors and individuals with disabilities:

5 investment strategies that can outlast market spikes

(BPT) You're familiar with the saying "If it seems too good to be true, it probably is"?

Staying healthy while traveling overseas

(BPT) Each year, travelers from the United States (U.S.) head to popular destinations. And while many have Zika on their mind while traveling, and are aware of the need to bring sunscreen, bug repellant and other travel necessities, many don't know that cholera may be a bigger threat than they thought and most don't take the necessary measures to protect themselves from it.

Survey: More Americans see less media bias — but why?

Attention you so-called "enemies of the people" and alleged purveyors of biased reporting: There's reason to think fewer people than last year might see you that way, despite the ongoing, politicized attacks from multiple quarters on the news media's credibility.

No rights warnings required to question intoxicated driver in police vehicle front seat

Placing a suspect in the front seat of a police cruiser during a traffic stop does not alone determine if the officer needs to read the suspect his rights before questioning, the Ohio Supreme Court ruled recently.

The PUCO answers your questions about budget billing

The Public Utilities Commission of Ohio (PUCO) would like to remind consumers that in addition to energy conservation and energy choice, budget billing is another way to manage your utility bills.

Seven men from Cuyahoga County indicted for firearms offenses

Seven men from Cuyahoga County were indicted on federal firearms charges, said Acting U.S. Attorney David Sierleja and Trevor Velinor, ATF Special Agent in Charge for the Columbus Field Division.

Proposal would allow medical first responders to carry firearms

A Cincinnati emergency room physician has joined first responders from around the Buckeye State to back a proposed bill that would provide for firearms training for tactical medical professionals, who would be allowed to carry a firearm in a concealed manner while on duty.

Applications now available for $3 million in Ohio law enforcement grants to address opioid epidemic

Ohio Attorney General Mike DeWine announced recently the application process is now open for Ohio law enforcement teams to apply for $3 million in new state grant money that will replicate or expand Drug Abuse Response Teams (DARTs) and Quick Response Teams (QRTs) to address the opioid epidemic in Ohio.

Simplify Your 529 Withdrawal Process

NOTE: This is the process for CollegeAdvantage Direct 529 Plan accounts only. The process is different for Guaranteed Plan accounts. Here is guidance for withdrawals from the Guaranteed Plan.

Proposal designed to shore up Ohio's school workers' health care fund

The annual 3 percent cost of living adjustment guaranteed to Ohio's retired public school workers through the School Employees Retirement System, or SERS, is at stake if current law and funding remain unchanged, according to a northwest Ohio lawmaker.

4 strategies to grow your finances in retirement

(BPT) Retirement is the time in your life when you can throw off the shackles of your daily responsibilities and truly enjoy the fruits of everything you spent years working toward. It's an empowering feeling and you've earned it. You've planned and you've saved, but now that you're here, don't make the mistake of believing your financial planning is over.

SCC baseball player named OCCAC Male Scholar-Athlete of the Year

Sinclair Community College and the Ohio Community College Athletic Conference (OCCAC) announced June 21 that freshman baseball player Blaze Glenn is this year’s 2016-17 OCCAC Male Scholar-Athlete of the Year.