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Medicare

Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes
Poor Conditions, Fraud: State Seizes Control Of 2 NJ Nursing Homes A pair of South Jersey nursing homes, riddled with poor conditions and alleged Medicaid fraud, have been turned over to the control of an independent receiver, authorities said. The state Comptroller previously suspended the owners of Deptford Center for Rehabilitation and Healthcare and Hammonton Center for Rehabilitation and Healthcare from New Jersey Medicaid. A Superior Court judge ordered the appointment of Allen Wilen of the Eisner Advisory Group, LLC to run the nursing homes effective June 17, according to the New Jersey Comptroller's Office. The judge's appointment means that the r…
Kickbacks Convinced Doc To Scam Medicare Out Of Nearly $21 Million: NJ Feds Kickbacks Convinced Doc To Scam Medicare Out Of Nearly $21 Million: NJ Feds
Kickbacks Convinced Doc To Scam Medicare Out Of Nearly $21 Million: NJ Feds A doctor pocketed cash kickbacks from lab companies and others for filing more than $20.7 million in bogus Medicare claims for medically unnecessary -- and often expensive -- COVID and cancer genetic tests, among other scams, a federal grand jury in Newark has charged. Alexander Baldonado, 68, of Queens already was awaiting trial dating back to charges brought a few years ago when grand jurors in Newark this week returned a superseding indictment that digs deeper into the allegations. Baldonado approved lab tests billed to Medicare in exchange for cash payoffs "from a laboratory representat…
Bergen Doc Who Said He Treated Medicaid Patients When He Was Not Even In The U.S. Pays Up Bergen Doc Who Said He Treated Medicaid Patients When He Was Not Even In The U.S. Pays Up
Bergen Doc Who Said He Treated Medicaid Patients When He Was Not Even In The U.S. Pays Up A Bergen County doctor and former medical director of the New Jersey Veterans Memorial Home in Paramus busted for "up-coding" and lying about care provided has agreed to pay $700,000, federal authorities said. Arun Sehgal and his Ramsey practice, Preventive & Diagnostic Medical Center P.A., violated the "False Claims Act" by billing patients for more service than they could possibly provide in a single day, or for services that they never provided, U.S. Attorney Philip R. Sellinger said Thursday, Feb. 22. Sehgal and his practice agreed to pay $693,490 plus interest to resolve the three …
Jersey Shore Business Owner From NY Admits $127M Health Care Kickback Scheme: Feds Jersey Shore Business Owner From NY Admits $127M Health Care Kickback Scheme: Feds
Jersey Shore Business Owner From NY Admits $127M Health Care Kickback Scheme: Feds A New Jersey marketing company owner from Rockland County admitted in federal court that he was a major figure in scamming Medicare, TRICARE and other benefit programs out of $127 million. Eric Karlewicz, 44, of Chestnut Ridge, NY, participated in a “circular scheme of kickbacks and bribes” with doctors, durable medical equipment businesses and telemedicine companies to pull off the massive con, U.S. Attorney Vikas Khanna said. Karlewicz – also known as Anthony Mazza -- used his considerable cut from $63.8 million in payoffs to buy himself a fleet of luxury vehicles that included a Ferrari,…
Electrocution Survivor Loses Insurance Benefits, Jersey Shore Friends Rally To Pay His Bills Electrocution Survivor Loses Insurance Benefits, Jersey Shore Friends Rally To Pay His Bills
Electrocution Survivor Loses Insurance Benefits, Jersey Shore Friends Rally To Pay His Bills A Monmouth County man survived being electrocuted but suffered burns over 40 percent of his body. Now, he faces the painful task of paying medical bills after his Medicare coverage was cut. More than $28,000 has been raised in this GoFundMe page to support Paul Roberts, of Fair Haven, who accidentally hit a live wire while cutting a tree branch last August. Per a GoFundMe organized by Paul's friends, Carrie and Ron Drazin: "He was being electrocuted for approximately 20 minutes with his body literally in flames when the police arrived.  When the power was turned off, he fell 25 feet f…
Ex-Con At Morris County Pharmacy Admits Bribing Jersey City Docs For $2.4M In 'Script Business Ex-Con At Morris County Pharmacy Admits Bribing Jersey City Docs For $2.4M In 'Script Business
Ex-Con At Morris County Pharmacy Admits Bribing Jersey City Docs For $2.4M In 'Script Business A former Morris County pharmacist once convicted of selling oxycodone without prescriptions admitted masterminding a kickback scheme that steered $2.4 million worth of business to his new employer, federal authorities said. Srinivasa Raju, 51, of Haskell, began the new scam at another Morris County pharmacy after serving three years probation -- and losing his pharmacist's license -- following his 2016 state conviction. SEE: Jurors Convict Clifton Pharmacist In Oxycodone Scheme While in that job, Raju "worked with other pharmacy personnel to pay kickbacks and bribes to medical employees in…
GUILTY: Fort Lee Doc With Clifton Practice Convicted Of Multi-Million-Dollar Medicare Fraud GUILTY: Fort Lee Doc With Clifton Practice Convicted Of Multi-Million-Dollar Medicare Fraud
Guilty: Fort Lee Doc With Clifton Practice Convicted Of Multi-Million-Dollar Medicare Fraud A rheumatologist from Fort Lee was convicted of billing Medicare and other health insurance programs for nearly a decade for services that patients never got and expensive medication that her Clifton practice never bought, federal authorities said. Alice Chu, 64, went to trial in U.S. District Court in Newark after federal authorities accused her of submitting more than $8.8 million in bogus claims for "items and services that were medically unnecessary, ineligible for reimbursement, and/or not provided as represented," court papers show. Jurors found her guilty on Tuesday, March 8 of consp…
NJ Doc Took Bribes From Pharma Company For Toxic Fentanyl Prescriptions: Feds NJ Doc Took Bribes From Pharma Company For Toxic Fentanyl Prescriptions: Feds
NJ Doc Took Bribes From Pharma Company For Toxic Fentanyl Prescriptions: Feds A doctor from Central Jersey is accused of taking bribes and kickbacks in exchange for prescribing potentially fatal doses of fentanyl, authorities said. Mukaram Gazi, 51, of Marlboro in Monmouth County was charged with conspiracy to pay and receive kickbacks, receiving kickbacks, health care fraud and conspiring to unlawfully distribute dangerous narcotics, according to Acting U.S. Attorney Rachael A. Honig. According to Thursday's indictment: Gazi owned a urology practice with offices in Freehold, Hamilton, Howell and Toms River.  Gazi received more than $130,000 in bribes and…
Feds In NJ Charge Rockland Doc, Wife With $1.3M Genetic Testing Scheme Feds In NJ Charge Rockland Doc, Wife With $1.3M Genetic Testing Scheme
Feds In NJ Charge Rockland Doc, Wife With $1.3M Genetic Testing Scheme COVID-19 hardly fazed a Rockland doctor who, with his wife, continued to collect bribes and kickbacks in exchange for ordering millions of dollars in genetic tests from his offices in Pennsylvania, a federal grand jury in Newark charged. Yitzchok “Barry” Kurtzer, 61,and Robin Kurtzer, 60, both of Monsey, collected monthly cash kickbacks and bribes ranging in exchange for “collecting DNA samples from Medicare patients and sending them for genetic tests to clinical laboratories in New Jersey and Pennsylvania,” Acting U.S. Attorney for New Jersey Rachael Honig said. The payoffs ranged up $5,00…
Hudson Doctor's Employee Admits Role In $24.8M Kickback Scheme Hudson Doctor's Employee Admits Role In $24.8M Kickback Scheme
Hudson Doctor's Employee Admits Role In $24.8M Kickback Scheme UPDATE: Dominoes continued to fall in the federal takedown of a $24.8 million kickback scheme when a Jersey City woman who worked for a local doctor took a plea deal. Yudelka “Vicky” Ayala, 42, admitted conspiring with six co-defendants associated with the now-defunct Prime Aid Pharmacy in Union City to boost prescription sales through kickbacks and bribes to health care professionals in New Jersey and New York. Prime Aid, which also had a location in the Bronx, processed expensive medications used to treat various conditions, including Hepatitis C, Crohn’s disease, and rheumatoid arthritis…
COVID-19: Feds Charge NYC-Area Pharmacy Owners In $30 Million Health Care Fraud COVID-19: Feds Charge NYC-Area Pharmacy Owners In $30 Million Health Care Fraud
Covid-19: Feds Charge Nyc-area Pharmacy Owners In $30 Million Health Care Fraud The owners of more than a dozen New York City-area pharmacies exploited the COVID-19 pandemic to scam Medicaid out of $30 million, then used the money to buy themselves real estate and luxury items, federal authorities charged. Peter Khaim, 40, and Arkadiy Khaimov, 37, both of Forest Hills, got others to pose as pharmacy owners or supervisors to take advantage of emergency override codes added to the Medicare system during the national state of emergency, an indictment returned by a grand jury in Brooklyn alleges. They used these to submit fraudulent claims for the expensive cancer medicati…
UPDATE: NJ Hospitals Await First Batch Of COVID-19 Vaccines UPDATE: NJ Hospitals Await First Batch Of COVID-19 Vaccines
Update: NJ Hospitals Await First Batch Of Covid-19 Vaccines NOTE: A spokeswoman for Hackensack University Medical Center said Friday that the hospital hadn't yet received the initial doses of COVID-19 vaccines. "We do NOT have any vaccine at this point nor does anyone else in NJ," said the spokeswoman, Mary Jo Layton. This corrects a previous story published here following what staffers said was a notification that initial shipments of the vaccines had arrived and will continue to do so. ****** HUMC was expected to be among the first hospitals in New Jersey to receive the COVID-19 vaccine. Officials couldn’t provide an exact number, although …
Feds Charge Jersey Shore Pain Management Doc With Massive $24.6M Billing Fraud Feds Charge Jersey Shore Pain Management Doc With Massive $24.6M Billing Fraud
Feds Charge Jersey Shore Pain Management Doc With Massive $24.6M Billing Fraud A Jersey Shore pain management doctor accused of running a $24.6 million fraud scheme billed insurance plans for more than 24 hours worth of services in a single day no fewer than 900 times, federal authorities said Monday. Morris Antebi, 68, of Long Branch, also billed Medicare, Medicaid, and private insurance companies frequently on dates when travel records show he was overseas -- including trips to China, Israel, Turkey, the Dominican Republic and across Europe – and at other times when he was otherwise out of state, U.S. Attorney Craig Carpenito said. Antebi, who specializes in pain ma…
NJ Feds: COVID Couldn't Slow Doc, Wife In Multi-Million Dollar Bribery Scam NJ Feds: COVID Couldn't Slow Doc, Wife In Multi-Million Dollar Bribery Scam
NJ Feds: COVID Couldn't Slow Doc, Wife In Multi-Million Dollar Bribery Scam The coronavirus pandemic hardly fazed a Rockland doctor who with his wife continued to collect bribes and kickbacks in exchange for ordering millions of dollars in genetic tests, federal authorities said Thursday. Yitzachok “Barry” Kurtzer, 60, of Monsey operated an office in Scranton, PA, as did another physician, Lee Besen, 64, of Waverly, PA, U.S. Attorney for New Jersey Craig Carpenito said. Both collected monthly cash kickbacks and bribes ranging from $500 to $5,000 in exchange for “collecting DNA samples from Medicare patients and sending them for genetic tests to clinical laboratorie…
Supreme Court Chief Justice Joins Liberal Minority In Upholding Abortion Rights Supreme Court Chief Justice Joins Liberal Minority In Upholding Abortion Rights
Supreme Court Chief Justice Joins Liberal Minority In Upholding Abortion Rights For the first time since President Trump’s new appointees took their seats, the U.S. Supreme Court issued a pro-abortion decision on Monday. Chief Justice John Roberts, placing precedent over all else, joined the court's four minority liberals in striking down a Louisiana law that would have required doctors at abortion clinics to have hospital admitting privileges. The Louisiana Unsafe Abortion Protection Act, which never went into effect, required abortion doctors in the state to have admitting the privileges at hospitals within 30 miles of the clinics where they worked. The law was simi…
Husband-Wife Owners Of Bayonne Telemedicine Company Indicted In $56M Medicare Fraud Husband-Wife Owners Of Bayonne Telemedicine Company Indicted In $56M Medicare Fraud
Husband-Wife Owners Of Bayonne Telemedicine Company Indicted In $56M Medicare Fraud A husband and wife who own two telemedicine companies with a location in Bayonne were indicted by a federal grand jury Wednesday for defrauding Medicare in a $56 million bribe and kickback scheme involving orthotic braces, authorities said. Reinaldo Wilson, 51, and Jean Wilson, 49, of Richmond Hill, Ga., are accused of using their companies to solicit kickbacks and bribes from patient recruiters, pharmacies and brace supplies – then hiring providers to order medically unnecessary braces for Medicare recipients, the U.S. Department of Justice said. Both were arrested Wednesday morning and la…
Paramus Man Who Owned WNY Pharmacy Pleads Guilty To Fraud, Bribery Paramus Man Who Owned WNY Pharmacy Pleads Guilty To Fraud, Bribery
Paramus Man Who Owned WNY Pharmacy Pleads Guilty To Fraud, Bribery A Paramus man who owned a now-closed pharmacy in West New York admitted bribing a psychiatrist and defrauding public and private insurers in a scheme involving high-priced medications, the U.S. Attorney said Monday.  Eduard Shtindler, 36, carried out the bribery scheme for five years beginning in 2012. Schtindler, the owner of the shuttered Empire Pharmacy, sent employees to deliver the payments -- sometimes in the form of $100 bills stuffed into pill bottles -- to the Hudson County psychiatrist in exchange for steering patients to Empire.  Schintdler was heard on a recording refe…
Doc Who Had Office In Phillipsburg Admits Taking Bribes To Prescribe Fentanyl Doc Who Had Office In Phillipsburg Admits Taking Bribes To Prescribe Fentanyl
Doc Who Had Office In Phillipsburg Admits Taking Bribes To Prescribe Fentanyl A doctor who had a practice in Warren County has admitted accepting bribes and kickbacks from a pharmaceutical company in exchange for prescribing a painkiller containing a powerful opioid, the Department of Justice said Friday.  Kenneth Sun, 58, an Easton, Pa., resident who also practiced in Pennsylvania, received $140,000 in illicit payouts between 2012 and 2016 from the Arizona-based  company, Insys. The medically unnecessary prescriptions resulted in $847,000 in Medicare reimbursements.  Sun, who owned Progressive Pain Solutions in Phillipsburg, prescribed Subsys, a …
Feds: Northeast Opioid 'Pill Mill' Takedown Nets Paramus Pharmacy Owner, Clifton Surgeon Feds: Northeast Opioid 'Pill Mill' Takedown Nets Paramus Pharmacy Owner, Clifton Surgeon
Feds: Northeast Opioid 'Pill Mill' Takedown Nets Paramus Pharmacy Owner, Clifton Surgeon The arrests of a Paramus pharmacy owner and a Clifton orthopedic surgeon earlier this month by federal agents were part of a massive crackdown involving the distribution of over 3.25 million opioid doses in “pill mill” clinics and doctors’ offices throughout the Northeast, the Justice Department said Thursday. A total of 54 defendants – 15 of them doctors -- have been charged for their roles in submitting nearly $800 million in bogus health insurance claims, the Justice Department said. Others include marketing executives, pharmacists, and the owners and operators of a genetic testing labor…
Former Union City Pharmacy At Center Of $65M Scam, Authorities Say Former Union City Pharmacy At Center Of $65M Scam, Authorities Say
Former Union City Pharmacy At Center Of $65M Scam, Authorities Say A pharmacy in Union City and another one in the Bronx netted nearly $100 million combined through fraud, kickbacks and other illicit means, the U.S. Attorney for New Jersey said Monday.  Prime Aid Pharmacy established relationships with pharmacy benefit managers (PBMs) to receive reimbursements for medications, including specialized medicines. The PBMs acted as a go-between with Medicare and Medicaid and Prime Aid, authorities said.  Starting a decade ago, principals connected with Prime began paying bribes and kickbacks to physicians and physicians' employees to bolster business …
WIRED: Feds Charge Pharmacy Owner From Paramus In $5M Fraud, Bribery Schemes WIRED: Feds Charge Pharmacy Owner From Paramus In $5M Fraud, Bribery Schemes
Wired: Feds Charge Pharmacy Owner From Paramus In $5M Fraud, Bribery Schemes A former Hudson County pharmacy owner from Paramus bribed a local doctor with $100 bills stuffed into pill bottles to steer patients to his business, said federal authorities who took him into custody on Friday -- thanks, in part, to conversations secretly recorded by the FBI. Eduard “Eddy” Shtindler, 36, also produced bogus documents that generated even more income, raking in nearly $5 million in illegal proceeds through both schemes combined, U.S. Attorney Craig Carpenito said in announcing his arrest by the FBI. Federal agents raided Shtindler’s since-closed Empire Pharmacy on Bergenline…
Mahwah Generic Drug Maker Among 20 Companies, 16 Individuals Accused In Price-Fixing Scheme Mahwah Generic Drug Maker Among 20 Companies, 16 Individuals Accused In Price-Fixing Scheme
Mahwah Generic Drug Maker Among 20 Companies, 16 Individuals Accused In Price-Fixing Scheme A Mahwah-based generic drug manufacturer was among 20 companies accused of participating in what authorities called “one of the most egregious and damaging price-fixing conspiracies in the history of the United States.”  A complaint filed by the 44 states in U.S. District Court in Connecticut also accuses 16 individuals of participating in the scheme. More than half of the drug companies and five of the individual defendants – all of whom are drug company executives responsible for sales, marketing, pricing and operations -- are from New Jersey. They include Glenmark Pharmaceuticals I…
Doc From Morristown Falsely Prescribed Adult Diapers In Huge Billing Fraud Doc From Morristown Falsely Prescribed Adult Diapers In Huge Billing Fraud
Doc From Morristown Falsely Prescribed Adult Diapers In Huge Billing Fraud Two medical professionals, including a doctor who lives in New Jersey, were found guilty of helping scam tens of millions of dollars from Medicare and Medicaid in New York, authorities said. Paul Mathieu, 53, of Morristown and Brooklyn resident Hatem Behiry, 51, used three medical clinics to send false claims to the federal programs over the course of a decade beginning in 2017, U.S. Attorney Geoffrey Berman of the Southern District of New York said. Authorities estimate the scam cost the federal government $30 million.  Initially, Mathieu posed as the owner of the three clinics actua…
'Operation Brace Yourself': Feds Smash $1B Medical Fraud Scheme Targeting Elderly, Disabled 'Operation Brace Yourself': Feds Smash $1B Medical Fraud Scheme Targeting Elderly, Disabled
'Operation Brace Yourself': Feds Smash $1B Medical Fraud Scheme Targeting Elderly, Disabled Federal authorities charged 24 people in connection with a $1.2 billion health-care kickback scheme that used a network of foreign call centers to sell hundreds of thousands of seniors and disabled patients orthopedic braces that they didn't need -- on the government's dime. Those charged in "Operation Brace Yourself" – seven of them in New Jersey – included the CEOs, COOs and others associated with five telemedicine companies, the owners of dozens of durable medical equipment (DME) companies and three licensed medical professionals, U.S. Attorney Craig Carpenito said. Some of them controll…
Franklin Lakes Doctor Gets 18 Months In Fed Pen For Test Company Bribes Franklin Lakes Doctor Gets 18 Months In Fed Pen For Test Company Bribes
Franklin Lakes Doctor Gets 18 Months In Fed Pen For Test Company Bribes FRANKLIN LAKES, N.J. -- A physician from Franklin Lakes was sentenced to a plea-bargained 18 months in federal prison Wednesday for his role in a massive test-referral bribery scheme. Basel Batarseh, 57, will have to serve the entire term: There is no parole in the federal prison system. Batarseh, who had an internal medicine practice in West New York, previously admitted that he took more than $104,000 in payoffs from employees and associates of Biodiagnostic Laboratory Services LLC (BLS) of Parsippany between November 2007 and August 2010. In exchange, Batarseh said, he generated more t…