Local Oncologist Charged with Medicare Fraud

Mark Mandell, Esq.

Yet another Michigan doctor has been brought up by the FBI on charges of Medicare fraud this past Tuesday. Although this seems like an unfortunate regular occurrence nowadays, this specific case is one of the worst our state has seen.

Dr. Farid Fata, a 48-year-old oncologist from Oakland Township, was arrested Tuesday morning for submitting over $35 million worth of false claims to Medicare. Despite this large fraud, however, the FBI are alleging even worse crimes than cheating Medicare.  In their criminal complaint against Fata, the FBI states he “administered unnecessary chemotherapy to patients in remission.” As shocking as it sounds, not only was Fata fraudulently billing Medicare for his own benefit, but he was abusing the trust and confidence of his cancer patients.

The FBI said that Fata deliberately misdiagnosed patients with cancer so he could bill them for chemotherapy and that he told cancer-free patients who had entered remission that they were still in need of chemotherapy medications. While it is unclear whether Fata’s actions resulted in any severe medical issues or deaths at this point, the FBI is not ruling out the possibilities.

With over $14 million in liquid assets and a house in Lebanon, the FBI considers Fata a flight risk and are holding him until his hearing date arrives. For his current charges he faces up to 20 years behind bars if he is convicted.

If you or someone you know is the target of a fraud investigation, or if you have already been indicted, contact the experienced team of fraud attorneys at Fausone Bohn, LLP, at (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

 

To learn more or see the original article, please visit: http://www.wxyz.com/dpp/news/region/oakland_county/doctor-arrested-offices-raided-by-fbi-in-connection-to-healthcare-fraud-charges

Former VA Secretary Calls for VA Disability Benefits Reform

According to former VA Secretary Anthony J. Principi, the VA backlog of disability claims is in large part due to the more recent policy decisions and laws have burdened the system. 
 

Principi argued that current eligibility requirements are far more liberal than, as President Lincoln once charged, "To care for him who shall have borne the battle and for his widow and his orphan." He said that the 50,000 veterans wounded in Iraq and Afghanistan who have filed for disability claims are not the reason the system is clogged, but that the system was already overwhelmed by veterans who were filing claims from long-ago service.  

"While every benefits system may face the occasional questionable filing, the focus of the VA disability benefits system needs to support the servicemen and servicewomen who need those benefits to which they are entitled," commented veterans disability attorney James Fausone.

Principi called for the restoration of the "integrity" of the Veterans Administration claims system in a keynote address this June at forum on the VA. The forum, co-hosted by Concerned Veterans for America The Weekly Standard magazine, featured Principi's keynote, where he stated that Congress, vet service organizations and the VA must address the expansion of disability pay eligibility. Principi has called for a "rebalancing" of priorities or the VA system will be at risk, he said. His remarks were in sharp contrast to other speakers, who urged the VA to work more efficiently and faster on the backlog of disability claims still pending.

More than one million claims are filed each year; an estimated 80 percent of these are filed from veterans who served prior to 2001, Principi said. A vet who served a single day in Vietnam can file for medical conditions typically seen in aging men, Principi said, such as prostate cancer, lung cancer, Parkinson's disease, and Type II diabetes.

It has been 40 years since the end of the Vietnam War, and 37 percent of VA claims have been filed by Vietnam vets, twice as many as those filed by recently discharged vet, according to Principi. And, says Principi, as much as 11 percent of claims, 100,000 or more, have been filed by veterans who never saw conflict. Vietnam-era vet claims increased, posited Principi, due to assumptions that "ailments of aging" such as some heart diseases and Type II diabetes, were added to the list the VA accepted as caused by exposure to Agent Orange.

The VA paid out $26.6 billion in 2005 in disability compensation. By the end of 2013, it will pay out more than $60 billion.

Source
http://www.military.com/benefits/2013/07/03/principi-eligibility-explosion-behind-va-backlog.html?comp=1198882887570&rank=6

Detroit Area Man Pleads Guilty to Health Care Fraud

Mark Mandell, Esq.

 

According to the U.S. Justice Department, a Detroit-area Physical Therapist Assistant, Syed Shah, has pleaded guilty to participating in a $22 million home health care fraud.

Prosecutors say that the 51 year old West Bloomfield man acknowledged that he conspired to bill Medicare for home health services that weren’t performed or were not medically necessary.  These actions occurred between 2008 and 2012.

Mr. Shah will be sentenced on November 19th and he faces a maximum penalty of 10 years in prison. 

Long prison sentences such as this are further evidence of the Federal government’s crackdown on health care fraud.  The Federal government is ramping up its investigation and prosecution efforts in an effort to combat the billions of dollars lost annually to Medicare and Medicaid fraud.

If you or someone you know is the target of a fraud investigation, or if you have already been indicted, contact the experienced team of fraud attorneys at Fausone Bohn, LLP, at (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

Military Renews Focus On Drinking In Wake of Sexual Assaults

Incidents of binge drinking and sexual assaults involving military personnel have highlighted an ongoing concern for the service. The Army's Surgeon General, Lt. Gen. Patricia Horoho, notes that while there are many different treatment programs for servicemen and servicewomen who grapple with drinking problems, there is now a concerted effort on prevention, before drinking gets out of hand.

The Pentagon estimates that there may have been as many as 26,000 sexual assaults perpetrated against military members in 2012, a dramatic jump from the estimated 19,000 assaults which occurred in 2010. The numbers are difficult to correlate, as many assaults are never reported. According to both studies and surveys conducted by the military and by independent agencies, alcohol abuse was a factor in almost 50 percent of sex abuse incidents.

Horoho spoke at SHARP, the Sexual Harassment/Assault Response and Prevention conference at Andrews Air Force Base, Maryland last month. She reported that troops are routinely asked about their level of alcohol consumption at medical appointments, as are their family members.

 

Drinking issues have been dealt with previously by various means, from barrack sweeps for beer and liquor to random breathalyzer testing to therapeutic efforts. This new push, to prevent problem drinking before it starts, is a sea change. She stated that the new push is focusing on prevention of alcoholic abuse both in barracks and off-base. Army barracks will be swept more often for alcohol in personal spaces, while the Marine Corps is now performing random breathalyzers tests to base-based troops on base.

Alcoholic consumption and sexual assault are frequently linked behaviors; a significant number of the reported sexual assault occurred when service members had also been socializing in settings where alcohol was consumed, or the alleged sexual perpetrator was often reported to have been drinking prior to the assault. 

The Army is now pushing for increased confidentiality for members who request help for a drinking issue, Horoho added. The potential stigma involved in having a chain of command know that a service member is work gin on a drinking issue is likely keeping many troops from accessing treatment, Horoho said.

The public recognition that alcohol plays a major role in the number of sexual assaults and sexual abuse is a change; Defense Secretary Chuck Hagel recently stated that while sexual assaults and sexual abuse in the military was due to a complex number of issues, one of the largest factors was alcohol use.

Source

http://www.military.com/daily-news/2013/07/08/military-tries-to-sever-booze-sex-assault-link.html?comp=1198882887570&rank=1

That is Not Fair

Jim Fausone

Veterans Disability Lawyer

 

Veterans have to really prove up PTSD to VA rating officials to receive about $25,000 a year in disability payments.  But here is a report of a student locked up and forgotten by DEA for five days and he gets $4.1 million from the federal government.  This is not fair.

A UC San Diego student who was forgotten in a Drug Enforcement Administration interrogation room for five days without food or water described the incident as a "really, really bad, horrible accident."

Daniel Chong, 25, will receive $4.1 million from the government to settle his claim.  For reasons that remain unclear, Chong was left for five days in a 5-by-10-foot windowless room without food, water or toilet facilities after being swept up in a campus raid on April 20, 2012.

He claims his quick weight loss allowed him to slip out of a pair of handcuffs.  He also claims to have suffered hallucinations and having to drink his own urine to survive. He tried to break a fire sprinkler to get water but failed.  He screamed for help but soon became too weak.

DEA employees found him covered in his own feces and severely dehydrated.  

Veterans are stuck pursuing claims within an administrative system.  Maybe if they had the right to file a civil suit, they could settle for fair and large dollar amounts.

 

 

Joint Electronic Health Record Program Off

Jim Fausone
Veterans Disability Lawyer

 

We have written about this before, the need for VA and DOD to be able to communicate on the medical records front.  It seemed that DOD and VA recognized the importance of this issue and were working on a joint solution.  Now we learn the joint project is off.  Both departments, including an interagency program office created to oversee joint electronic health records initiatives, spent more than $1 billion on their most recent efforts to build a joint system.  The project costs have reportedly ballooned from an estimated $4 billion to $12 billion. 

 

DOD is going to look to a commercial solution to Electronic Health Records (HER).  The need to coordinate with VA still exists.  Will the commercial solution be able to communicate seamlessly with VA's system. We are told it will but the DOD system may cost $16 billion. We are not left with a great deal of confidence in the new direction.  The problem of lack of coordinated EHR may continue for years.

http://www.federaltimes.com/article/20130612/IT03/306120010/DoD-VA-spent-1B-trying-build-joint-health-records-system

 

VA Forms Challenge

Jim Fausone
Veteran Disability Lawyer
 

If you are a veteran navigating the VA disability process, you are amazed at the numerous forms that must be completed.  If you are like many vets, the DOD experience with forms did not train you for the VA collection of forms, some of which seem designed to confuse.  A recent article discussed the federal government’s desire to create a form for every event. "The American Action Forum found that paperwork needed for health benefits claims — in part the result of 31.2 million Veterans Affairs claims each year — takes federal employees roughly 43.3 million hours to process."

" Other findings in the study:

•   A disabled veteran seeking health and educational benefits could encounter up to 49 different forms, more than four hours of paperwork, and an aggregate cost of $125, assuming $31 per hour of compliance time.

•   One collection, “Income-Net Worth and Employment Statement,” contains 40 questions, takes one hour to complete, and VA receives more than 104,000 responses every year."

What do you think is the worst form in the VA universe of forms?

 

http://www.stripes.com/news/new-study-shows-complications-in-va-claims-process-1.228830