Quick Cases: “Too Many [Health Care Fraud Cases] To Shake A Stick At”

July 25, 2013

By: Sara Kropf

This is the one of my recurring posts that offer quick summaries of similar cases. Think of them as the Kay and Peele version of my blog posts, though not nearly as funny and always safe for work.

The Beastie Boys bemoaned that there are “too many rappers to shake a stick at.” Sometimes I feel that way about health care fraud cases. There are a lot of them. Many are straightforward prosecutions of doctors who illegal prescribe narcotics but there are also many prosecutions for more complex health care fraud schemes.

Here’s a sample of some of the latest and greatest in health care fraud prosecutions against corporate executives from around the country:

United States v. Christopher Keegan (W.D. Ky.).  Mr. Keegan was the owner of a Louisville Pharmaceutical company called National Respiratory Services LLC. He pleaded guilty to sending patients medications that were “sub-potent, super-potent, non-sterile, and therefore adulterated and misbranded in violation of the Food, Drug and Cosmetic Act.” His company would submit reimbursement claims to Medicare that these medications were FDA-approved when they were not.

United States v. Frank Santangelo (D.N.J.).  Dr. Santangelo pleaded guilty to accepting $1.8 million in bribes to refer business to a lab in New Jersey. In return for the bribes, he referred approximately $6 million in business to the lab. The bribes were paid through sham leases and service agreements as well as though payments to him by a third party. In one text message obtained by the government, he said that the “testing is 90 percent legit.” Dr. Santangelo pleaded guilty to violating the Travel Act, money laundering and failing to file tax returns.

  • See also United States v. Aponte, Dicovsky and Fortunato (D.N.J.) (three doctors plead guilty in same scheme as Dr. Santangelo)
  • See also United States v. Agarwal (D.N.J.) (cardiologist sentenced to 30 months in prison for accepting kickbacks for referring patients to diagnostic facility).

United States v. Obiageli Agbu (C.D. Cal.).  Ms. Agbu, the former owner of a California durable medical equipment (DME) company was found guilty by a jury of an $11 million Medicare scheme. Agbu owned a company called Ibon, Inc. and her father (a pastor) owned a DME company called Bonfee, Inc. from the same office as Ibon. Her father pleaded guilty to health care fraud in December 2012. At trial, the evidence showed that Ms. Agbu and her father would buy powered wheelchairs wholesale for $900 and then bill Medicare for $4000 to $5000. They would also find senior citizens to accept DME even though they did not need it.  The seniors were directed by Ms. Abgu’s co-conspirators to visit doctors who would receive kickbacks from Ms. Agbu for writing prescriptions for the unnecessary equipment.

  • See also United States v. Kenny Msiakii (S.D. Tex.) (owner of DME company sentenced to 97 months in prison after being found guilty by a jury of submitting $6.7 million in claims for equipment that was medically unnecessary or not provided by the company at all).
  • See also United States v. Kim Ricks (C.D. Cal.) (owner of DME company pleaded guilty to conspiracy to commit Medicare fraud of approximately $650,000, including submitting false claims for powered wheelchairs).

United States v. Javed Rehman (E.D. Mich.). Mr. Rehman was the owner of Quantum Home Health Care, Inc. Quantum would pay kickbacks to recruiters to obtain Medicare information. That information would be used by Quantum to then bill Medicare for home health care services that Quantum never provided. Mr. Rehman pleaded guilty to participating in this scheme which totaled approximately $13.8 million.

United States v. John R. Reynolds (S.D.N.Y.).  Mr. Reynolds is the former CEO of Hospital for Special Surgery. He pleaded guilty to accepting nearly $300,000 in payments from a subordinate employee at the hospital in return for negotiating favorable bonuses for that employee. He did not inform the hospital’s board of his conflict of interest in voting for the bonuses. He pleaded guilty to one count of wire fraud and one count of making a false statement.

United States v. Kallen-Zury, Miller, Petrie and Coloma (S.D. Fla.). Four executives of a Miami hospital were found guilty by a jury for participating in a Medicare fraud scheme that involved nearly $70 million in fraudulent billings. The defendant would submit false claims to Medicare through Hollywood Pavilion, a mental health care hospital. They paid bribes to recruiters to find Medicare beneficiaries who did not need psychiatric treatment and would use those individuals to submit false claims.

  • See also United States v. Roger Rousseau (S.D. Fla.) (indictment of medical director of Health Care Solutions Network for $63 million Medicare fraud scheme in which defendant would allegedly submit false claims for mental health treatment that was unnecessary or not actually provided).

If that’s not enough health care fraud cases for you, let me know. I have about 20 more press releases about other cases. Plus, you should consider that there is something wrong with you if you really want to read more about this subject today.

Published by Kropf Moseley

Whether you need to take a case to trial, negotiate a resolution without ever setting foot in the courtroom, or navigate a complex public relations problem, we can help. View all posts by Kropf Moseley.