Fraud Roundup: LA Hospital Workers Investigated; Guilty Pleas In Texas And N.J. Cases; Fla. Candidate Defends His Actions

Main Category: Litigation / Medical Malpractice
Also Included In: Public Health;  Medicare / Medicaid / SCHIP;  Caregivers / Homecare
Article Date: 03 Jun 2010 - 3:00 PDT

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News outlets report on health fraud investigations.

The Los Angeles Times: "Los Angeles County officials are investigating allegations that Olive View-UCLA Medical Center staff accepted gifts from nursing home employees in exchange for placing Medi-Cal and Medicare patients at their facilities, a possible violation of the county's code of ethics, as well as state and federal anti-kickback laws. Three staff members at the county hospital in Sylmar - a clinical social worker and two medical case workers - have been accused of receiving gifts in exchange for referring Medi-Cal and Medicare patients to at least three local nursing homes, according to three county employees who asked not to be identified for fear of retaliation" (Hennessy-Fiske, 6/2).

The Associated Press/Houston Chronicle: "A 51-year-old Houston man has pleaded guilty to receiving nearly $1 million in payments from the federal government for counseling services prosecutors say he was not licensed or qualified to provide. Edward Birts, owner of the Courage to Change center, admitted in U.S. District Court on Tuesday that he billed Medicaid and Medicare for nearly $1.3 million in services from 2003 to 2006" (6/1).

New Jersey Newsroom: Babak Bamdad, a pharmacist in Hoboken, pleaded guilty Tuesday to a charge of third-degree Medicaid fraud and "admitted that between Jan. 1 and Oct. 9 of last year, he submitted claims to the Medicaid program for prescription drugs allegedly dispensed to Medicaid beneficiaries, even though the drugs were never dispensed. The claims were subsequently paid out by the Medicaid program. ... Since October, more than 32 people, including doctors and pharmacists, have been arrested in [a state] investigation, which uncovered a major criminal narcotics network based in Hudson County that distributed thousands of black market prescription pain pills such as OxyContin and Percocet" (Hester, 6/1).

Meanwhile, The Tampa Tribune reports: "Gubernatorial candidate Rick Scott is not shrinking away from attacks on him for having headed a company that committed Medicare fraud. His campaign has launched a new, 60-second ad that responds directly to a negative campaign against Scott, the former CEO of Hospital Corporation of America, which was fined $1.7 billion in the largest Medicaid fraud case on record. Scott, a multi-millionaire from Naples, is pouring his own money into challenging state Attorney General Bill McCollum for the GOP nomination for governor. Scott's latest TV spot, part of an $8-million ad campaign, began airing statewide last Friday." In the ad, Scott notes that "he was never charged or questioned personally in the case" but "takes responsibility for his company's mistakes and that he has learned from them" (Whittenburg, 6/1).

The Palm Beach Post also reports on the ads: "Scott, the former chief executive officer of Columbia/HCA, acknowledges the hospital chain 'was fined by the government for Medicare fraud,' though he doesn't mention the dollar figure - more than $1.7 billion in fines and settlements after Scott's 1997 departure. ... The Scott campaign has also launched a Truth About Rick Scott website to counter criticism" (Bennett, 6/1).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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