SEC CHARGES RETIREMENT PLANNING FIRM WITH MAKING FALSE CLAIMS REGARDING SAFETY OF LIFE SETTLEMENTS

FROM:  U.S. SECURITIES AND EXCHANGE COMMISSION
05/11/2015 02:25 PM EDT

The Securities and Exchange Commission today charged a self-described retirement planning firm and its principals with falsely telling customers that interests in life settlements they offered and sold were “guaranteed,” “safe as CDs,” and “federally insured.”

The SEC also alleges that they used a bogus “net worth calculator” that improperly qualified some prospective investors for purchases by including income that investors hadn’t received, such as future pension and Social Security benefits.

The SEC charges were filed in the U.S. District Court for the Northern District of Texas against Novers Financial and its principals Christopher A. Novinger and Brady J. Speers, who live in Mansfield, Texas, and host a financial radio show.  The SEC’s complaint alleges that from 2012 to 2014, they sold approximately $4.3 million in life settlement interests to 26 investors.

“We allege that Novinger and Speers described speculative investments as safe and secure and were willing to manipulate investors’ financial information to make a sale,” said David Peavler, Associate Director of the SEC’s Fort Worth Regional Office.  “No matter what a salesperson tells you, interests in life settlements are never guaranteed, risk-free, or federally insured.”

Interests in life settlements are investments based on potential payouts on insurance policies held by others.  Typically they can only be sold to investors who meet certain income or net worth levels.  The SEC alleges that, to get around those limits, Novinger and Speers provided prospective investors with a net worth calculator on that factored in future income to artificially inflate client assets.  For example, according to the SEC complaint, one couple’s non-homestead assets falsely “ballooned” from $263,000 to nearly $1.5 million when the calculator improperly included 20 years’ worth of Social Security and retirement payments the couple anticipates receiving in the future.

In addition to the charges against Novers Financial and the two principals, the SEC charged ICAN Investment Group LLC and Speers Financial Group LLC for acting as unregistered broker-dealers.  The SEC seeks injunctive relief, return of allegedly ill-gotten gains with interest, and financial penalties.

The SEC investigation was conducted by Ronda Blair and Barbara Gunn of the SEC’s Fort Worth Regional Office.  B. David Fraser will handle the litigation.

FTC OBTAINS COURT ORDER HALTING MARKETING OF WEIGHT LOSS PRODUCTS BY SALES SLASH

FROM:  U.S. FEDERAL TRADE COMMISSION
FTC Halts Deceptive Marketing of Bogus Weight-Loss Products

Sale Slash Charged With Using “Fake News” Websites, False Weight-Loss Claims, Phony Celebrity Endorsements, and Spam Email to Sell Their Unproven Dietary Supplements

The Federal Trade Commission has obtained a court order temporarily halting a Glendale, California, operation  that allegedly used millions of illegal spam emails, along with false weight-loss claims and fake, unauthorized endorsements from celebrities like Oprah Winfrey, to market its unproven diet pills.

The court order halts the defendants’ illegal conduct, freezes their assets, and appoints a temporary receiver over the corporate defendants. The Commission ultimately is seeking to recover money from the defendants that would be used to provide refunds to consumers who bought the defendants’ diet pills.

The FTC’s complaint charges that the defendants behind Sale Slash violated the FTC Act and the CAN-SPAM Act.  According to the complaint, the defendants used affiliate marketers to send illegal spam emails and post banner ads online that led consumers to fake news sites designed to appear as if an independent consumer reporter, rather than a paid advertiser, had reviewed and endorsed the products. The complaint alleges that these fake news sites made false weight-loss claims and used phony celebrity endorsements to promote the defendants’ diet pills.

“Sale Slash is a fraud trifecta,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection. “The company made outlandish weight-loss claims for its diet pills using fake news sites, phony celebrity endorsements, and millions of unwanted spam emails.”

Since 2012, the defendants allegedly have marketed and sold a variety of products nationwide, including supposed weight-loss supplements such as Premium Green Coffee, Pure Garcinia Cambogia, Premium White Kidney Bean Extract, Pure Forskolin Extract, and Pure Caralluma Fimbriata Extract.

According to the complaint, the defendants’ affiliates used stolen email user accounts to blast the users’ contacts with spam containing brief messages like: “Breaking news…,” and “Hi! Oprah says it’s excellent,” followed by hyperlinks. Because the messages were sent to the “contacts” of hacked accounts, they appeared to be coming from a friend or family member instead of defendants’ affiliates. The spam often contained no information about how consumers could opt out of getting future emails. Sale Slash’s affiliate marketers also placed banner ads making claims like, “1 Tip for a tiny belly,” “Cut down on a bit of your belly every day following this 1 old weird tip,” and “Garcinia Cambogia Exposed – Miracle Diet or Scam?”

Sale Slash paid its affiliate marketers a commission whenever consumers clicked through from a fake news website to one of the defendants’ sites and bought their supplements, according to the complaint.

The defendants named in the case include: Sale Slash, LLC; Purists Choice, LLC; Artur Babayan, individually and as an owner and manager of the two companies; and Vahe Haroutounian, individually and doing business as Prisma Profits.

CALIFORNIA DOCTOR INDICTED FOR ROLE IN $6.5 MILLION MEDICARE FRAUD

FROM:  U.S. JUSTICE DEPARTMENT
Thursday, April 16, 2015

Valencia, California, Doctor Indicted in $6.5 Million Medicare Fraud Scheme
An indictment was unsealed today charging a doctor from Valencia, California, with operating a $6.5 million scheme to defraud the Medicare program by billing Medicare for medical services that were not actually provided.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Acting U.S. Attorney Stephanie Yonekura of the Central District of California, Assistant Director in Charge David Bowdich of the FBI’s Los Angeles Division and Special Agent in Charge Glenn R. Ferry of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Los Angeles Region made the announcement.

Gary J. Ordog, 60, of Valencia, California, was indicted by a federal grand jury in the Central District of California on March 27, 2015, for nine counts of health care fraud.  The indictment alleges that Ordog billed Medicare for services that were not actually provided to the Medicare beneficiaries.

According to allegations in the indictment, Ordog was a physician who purportedly assisted beneficiaries with various toxicological symptoms, including those related to mold and chemical exposures.  Ordog would allegedly see a beneficiary at least once in connection with the potential evaluation and management of his or her conditions.  Subsequently, often several years after the last time he saw a particular beneficiary, Ordog would allegedly submit false claims to Medicare for purported additional visits with the same beneficiary, when the visits never actually occurred.  In certain instances, Ordog allegedly billed Medicare for services provided to beneficiaries who were deceased as of the claimed date of service.

The charges contained in an indictment are merely accusations, and a defendant is presumed innocent unless and until proven guilty.

This case is being investigated by HHS-OIG and the FBI, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California.This case is being prosecuted by Trial Attorney Ritesh Srivastava of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

In Detroit, Hiring Former Inmates Is Beneficial for Businesses
For too many Americans who have been caught up in the criminal justice system, finding a path to career and economic stability can be challenging. Studies have shown that lack of job opportunities is a factor in high rates of recidivism. In Detroit on April 15, Secretary Perez met with employers who are playing leading roles in breaking down barriers for formerly incarcerated individuals to help stop the cycle of crime and incarceration. Joined by Mayor Mike Duggan and U.S. Attorneys Barb McQuade and Patrick Miles, Perez toured the Sakthi Automotive Group, an India-based parts supplier for General Motors. Sakthi has committed to hiring at least two former inmates from Detroit each month as the company ramps up operations in the United States. Following his tour, Perez led a roundtable discussion with other local employers — Detroit Manufacturing Systems and Total Construction and Renovation — that found hiring former inmates has been beneficial to their businesses. Perez's visit came on the heels of several recent grant announcements that will fund job training and employment services for formerly incarcerated individuals seeking marketable skills and good jobs.

FTC WARNS BIODEGRADABLE DOG WASTE BAG CLAIMS MAY BE DECEPTIVE

FROM:  U.S. FEDERAL TRADE COMMISSION 
FTC Staff Warns Marketers and Sellers of Dog Waste Bags That Their Biodegradable and Compostable Claims May Be Deceptive

Staff of the Federal Trade Commission has sent letters warning 20 manufacturers and marketers of dog waste bags that their “biodegradable,” “compostable,” and other environmental claims may be deceptive.

The letters, which the staff sent after examining the companies’ environmental, or “green,” claims on their websites and in other media, provide examples of potentially deceptive statements regarding the bags’ biodegradability or compostability. The letters also provide information on how to comply with truth-in-advertising principles when making environmental claims.

“Consumers looking to buy environmentally friendly products should not have to guess whether the claims made are accurate,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection. “It is therefore critical for the FTC to ensure that these claims are not misleading, to protect both consumers and honest competitors.”

The staff notified 20 marketers that they may be deceiving consumers with the use of their unqualified “biodegradable” claim.  Based on the FTC’s  Guides for the Use of Environmental Marketing Claims (the Green Guides), such a claim without any qualification generally means to consumers that the product will completely break down into its natural components within one year after customary disposal.  Most waste bags, however, end up in landfills where no plastic biodegrades in anywhere close to one year, if it biodegrades at all.

According to the Green Guides, consumers generally think that unqualified “compostable claims” mean that a product will safely break down at the same rate as natural products, like leaves and grass clippings, in their home compost pile. If marketers disclose that a product will only compost in commercial or municipal facilities, consumers think that those facilities are generally available in their area. However, dog waste is generally not safe to compost at home, and very few facilities accept this waste. Therefore, compostable claims for these products are generally untrue.

The FTC advised the companies that they should review their marketing materials and contact agency staff to tell them how they intend to revise or remove the claims, or explain why they won’t.

The staff notes that marketers who did not receive a letter should not assume that their claims are fine. Staff is not disclosing the recipients of the letters at this time.

The Federal Trade Commission works for consumers to prevent fraudulent, deceptive, and unfair business practices and to provide information to help spot, stop, and avoid them.

GREEN COFFEE BEAN WEIGHT-LOSS MARKETER AGREES TO SETTLEMENT WITH FTC

FROM:  U.S. FEDERAL TRADE COMMISSION 
Marketer Who Promoted a Green Coffee Bean Weight-Loss Supplement Agrees to Settle FTC Charges
Used Appearances on Dr. Oz, Other Shows to Launch Ad Campaign
OZ EFFECT
Lindsey Duncan and the companies he controlled have agreed to settle Federal Trade Commission charges that they deceptively touted the supposed weight-loss benefits of green coffee bean extract through a campaign that included appearances on The Dr. Oz Show, The View, and other television programs.

Under the FTC settlement, the defendants are barred from making deceptive claims about the health benefits or efficacy of any dietary supplement or drug product, and will pay $9 million for consumer redress.

“Lindsey Duncan and his companies made millions by falsely claiming that green coffee bean supplements cause significant and rapid weight loss,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection. “This case shows that the Federal Trade Commission will continue to fight deceptive marketers’ attempts to prey on consumers trying to improve their health.”

The FTC charged that Duncan and his companies, Pure Health LLC and Genesis Today, Inc., deceptively claimed that the supplement could cause consumers to lose 17 poundsand 16 percent of their body fat in just 12 weeks without diet or exercise, and that the claim was backed up by a clinical study. In September 2014, the FTC settled charges against the company that sponsored the severely flawed study that Duncan discussed on Dr. Oz.

According to the FTC’s complaint, shortly after Duncan agreed to appear on Dr. Oz but before the show aired, he began selling the extract and tailored a marketing campaign around his appearance on the show to capitalize on the “Oz effect” – a phenomenon in which discussion of a product on the program causes an increase in consumer demand.

For example, while discussing green coffee bean extract during the taping of Dr. Oz, Duncan urged viewers to search for the product online using phrases his companies would use in search advertising to drive consumers to their websites selling the extract. He reached out to retailers, describing his upcoming appearance on The Dr. Oz Show and saying he planned to discuss the clinical trials that purportedly proved the supplement’s effectiveness. He and his companies also began an intensive effort to make the extract available in Walmart stores and on Amazon.com when the program aired.

The defendants continued to use Duncan’s Dr. Oz appearance in their marketing campaign after the show aired, the complaint states, posting links to the episode on websites and using retail point-of-sale displays showing messages such as “New Health Discovery!  As Seen on TV, ‘The Dieter’s Secret Weapon.’” After appearing on Dr. Oz, Duncan and his companies sold tens of millions of dollars’ worth of the extract, according to the FTC.

The FTC also alleged that Duncan and several of the companies’ paid spokespeople portrayed themselves on television shows as independent sources of information about green coffee bean extract and other natural remedies, while failing to disclose their financial ties to the companies.

The proposed stipulated court order requires the defendants to substantiate any future weight-loss claims with at least two well-controlled human clinical tests. Any claims the defendants make about the health benefits and efficacy of any dietary supplement or drug cannot be misleading and must be substantiated by competent and reliable scientific evidence. Further, the order prohibits false claims that the benefits of any such product are scientifically proven.

The order also bars the defendants from misrepresenting the status of any endorser, and requires them to disclose all material connections between them and anyone who endorses their products. Finally, it imposes a $9 million redress judgment, with an initial payment of $5 million due within two weeks of when the court enters the order.

Information for Consumers

Consumers should carefully evaluate advertising claims for weight-loss products. For more information, see the FTC’s guidance for consumers of products and services advertised for Weight Loss & Fitness.

The Commission vote authorizing the staff to file the complaint was 5-0. The vote authorizing the filing of the proposed stipulated court order was 3-2, with Commissioners Ohlhausen and Wright voting no. The majority, Chairwoman Ramirez, Commissioner Brill, and Commissioner McSweeny, issued a separate statement. Commissioners Ohlhausen and Wright also issued a separate statement. The complaint and order were filed in the U.S. District Court for the Western District of Texas on January 26, 2015.

The FTC is a member of the National Prevention Council, which provides coordination and leadership at the federal level regarding prevention, wellness, and health promotion practices. This case advances the National Prevention Strategy’s goal of increasing the number of Americans who are healthy at every stage of life.

NOTE: The Commission files a complaint when it has “reason to believe” that the law has been or is being violated and it appears to the Commission that a proceeding is in the public interest. Stipulated orders have the force of law when approved and signed by the District Court judge.

U.S. FILES LAWSUIT CLAIMING COMPANY BILLED GOVERNMENT FOR INELIGIBLE PATIENTS

FROM:  U.S. JUSTICE DEPARTMENT
Tuesday, November 25, 2014
United States Files False Claims Act Lawsuit Against Las Vegas Hospice and Related Entities for Billing Medicare and Medicaid for Ineligible Patients

The United States has filed suit against Creekside Hospice II LLC, Skilled Healthcare Group Inc. (SKG), its holding company, and Skilled Healthcare LLC (SKH), an administrative services subsidiary of SKG that operates Creekside (collectively the Creekside entities), alleging that these entities knowingly submitted ineligible claims for hospice services and inflated claims for patient visits to government health care programs, the Justice Department announced today.

“The Medicare hospice benefit is intended to provide pain management and other palliative care to patients nearing the end of life, to help make them as comfortable as possible,” said Acting Assistant Attorney General Joyce R. Branda for the Civil Division.  “Too often, however, companies abuse this critical service by using aggressive marketing tactics to pressure patients who do not need, and may be ill-served, by these services in order to get higher reimbursements from the government.  The department will take swift action to protect taxpayer dollars and make sure that Medicare benefits are available to those who truly need them.”

The Medicare and Medicaid hospice benefits are available for patients who elect palliative treatment (medical care focused on providing patients with relief from pain and stress) for a terminal illness and have a life expectancy of six months or less if their disease runs its normal course.  When Medicare or Medicaid patients receive hospice services, they no longer receive services designed to cure their illnesses.

The government’s complaint alleges that the Creekside entities knowingly submitted or caused the submission of false claims for hospice care for patients who were not terminally ill.  According to the complaint, the companies allegedly directed staff to enroll patients in the hospice program regardless of the patients’ eligibility for hospice benefits, sometimes by instructing staff to change records after the hospice submitted claims for payment to indicate that all requirements had been met.  Management from Creekside, SKG and SKH also allegedly instructed employees to alter medical records to make it appear that doctors at the hospice had conducted personal visits with the patients, when in fact they had not occurred, in order to ensure reimbursement from Medicare and Medicaid.  The complaint alleges that Creekside management aggressively discouraged staff from permitting patients or their families to revoke their elections to accept hospice benefits.  The complaint also alleges that staff at Creekside were discouraged from documenting known improvements in a patient’s health in the medical record, called “Chart Killers” by the hospice, to ensure that Medicare or Medicaid would pay the hospice’s claim.

Further, the complaint alleges that the Creekside entities knowingly submitted or caused the submission of inflated claims to Medicare for services performed by the medical director.  The government alleges that the companies repeatedly used billing codes that resulted in higher payment by Medicare than were justified by the services actually performed.  As a result of the conduct alleged in the complaint, the government contends that the Creekside entities misspent tens of millions of taxpayer dollars from the Medicare and Medicaid programs. 

“In order to protect the financial integrity of the Medicare and Medicaid programs, upon which so many of our senior American citizens rely, both the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) have made combating healthcare fraud an enforcement priority,” said U.S. Attorney Daniel G. Bogden for the District of Nevada.  “This type of fraud will not be tolerated and DOJ and HHS will act swiftly when it does occur to pursue False Claims Act suits against violators.”

The United States filed its complaint in two consolidated lawsuits brought under the whistleblower provisions of the False Claims Act and the Nevada False Claims Act by Joanne Cretney-Tsosie, a clinical manager for Creekside, and Veneta Lepera, a former clinical manager for Creekside.  Under these statutes, a private citizen can sue for fraud on behalf of the United States and the state of Nevada, respectively, and share in any recovery.  The federal and state governments are entitled to intervene in such a lawsuit, as they have done in this case.

The United States’ suit is part of the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $23.1 billion through False Claims Act cases, with more than $14.8 billion of that amount recovered in cases involving fraud against federal health care programs.

This matter was investigated by the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office for the District of Nevada, the Nevada Attorney General’s Office and the HHS Office of Inspector General.  The claims asserted against Creekside Hospice, SKG and SKH are allegations only and there has been no determination of liability.

HOUSTON HOSPITAL PRESIDENT CONVICTED FRO ROLE IN $158 MILLION MEDICARE FRAUD

FROM:  U.S. JUSTICE DEPARTMENT 

Monday, October 20, 2014

President of Houston Hospital and Three Others Convicted in $158 Million Medicare Fraud Scheme

A federal jury in Houston today convicted the president of Riverside General Hospital (Riverside), his son, and two others for their participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment.  Ten defendants have now been convicted in connection with the Riverside fraud scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth Magidson of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office, Special Agent in Charge Lucy R. Cruz of the Internal Revenue Service – Criminal Investigation’s (IRS-CI) Houston Field Office and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.  U.S. District Judge Lee H. Rosenthal of the Southern District of Texas presided over the trial.

“The former president of Riverside hospital, his son, and their co-conspirators systematically defrauded Medicare, treating mentally ill and disabled Americans like chits to be traded and cashed out to pad their own pockets,” said Assistant Attorney General Caldwell.  “For over six years, the Gibsons and their co-conspirators stuck taxpayers with millions in hospital bills, purportedly for intensive psychiatric treatment. But the ‘treatment’ was a sham – some patients just watched television all day, others had dementia and couldn’t understand the therapy they supposedly received, and other patients never even went to the hospital at all.  Today’s verdict sends another powerful message that the department will hold accountable anyone who seeks personal profits at the expense of America’s most vulnerable citizens.”

Earnest Gibson III, 70, the former president of Riverside, Earnest Gibson IV, 37, the operator of one of Riverside’s satellite locations, and Regina Askew, 49, a group home owner, were each convicted of conspiracy to commit health care fraud and conspiracy to pay kickbacks, as well as related counts of paying and receiving illegal kickbacks.  Robert Crane, 58, a patient recruiter, was convicted of conspiracy to pay and receive kickbacks.  Gibson III and Gibson IV were also convicted of conspiracy to commit money laundering.  Gibson III was acquitted of two substantive counts of paying and receiving illegal kickbacks.

According to evidence presented at trial, Gibson III, Gibson IV, and Askew operated a scheme to defraud Medicare beginning in 2005 and continuing until June 2012.  The defendants caused the submission of false and fraudulent claims for partial hospitalization program (PHP) services to Medicare through the hospital.  A PHP is a form of intensive outpatient treatment for severe mental illness.

Specifically, evidence at trial demonstrated that the Medicare beneficiaries for whom Riverside and its satellite locations billed Medicare for PHP services did not qualify for or need PHP services.  Moreover, the Medicare beneficiaries rarely saw a psychiatrist and did not receive intensive psychiatric treatment.  In fact, some of the Medicare beneficiaries were suffering from Alzheimer’s and could not actively participate in any treatment even if they actually qualified to receive PHP services.  Nevertheless, Gibson III, Gibson IV and Askew submitted claims for reimbursement to Medicare claiming that PHP services were provided to the Medicare beneficiaries.

Evidence presented at trial also showed that Earnest Gibson III paid kickbacks to patient recruiters and to owners and operators of group care homes, including Askew, in exchange for those individuals delivering ineligible Medicare beneficiaries to the hospital’s PHPs.  Gibson IV also paid patient recruiters, including Crane and others, in exchange for those individuals delivering ineligible Medicare beneficiaries to the specific PHP operated by Gibson IV.

Approximately $158 million in claims to Medicare were submitted for PHP services purportedly provided by the hospital to the recruited beneficiaries, when in fact, the PHP services were medically unnecessary or never provided.  The proceeds from the health care fraud were used to promote the fraud scheme by paying kickbacks to patient recruiters and group home owners in exchange for their sending Medicare beneficiaries to the hospital’s PHPs.

Gibson III, Gibson IV, Askew and Crane are scheduled to be sentenced on Feb. 17, 2015.

Others involved in the fraudulent scheme have already pleaded guilty and are awaiting sentencing.  Mohammad Khan, an assistant administrator at the hospital, who managed many of the hospital’s PHPs, pleaded guilty to conspiracy to commit health care fraud, conspiracy to defraud the United States and to pay illegal kickbacks, and five counts of paying illegal kickbacks.  William Bullock, an operator of a Riverside satellite location, as well as Leslie Clark, Robert Ferguson, Waddie McDuffie, and Sharonda Holmes, who were all involved in paying or receiving kickbacks, have also pleaded guilty to their roles in the scheme.

The case was investigated by the FBI, IRS-CI, and Texas MFCU, with assistance from the U.S. Department of Health and Human Services, Office of Inspector General’s (HHS-OIG) Dallas Regional Office, the Railroad Retirement Board, Office of Inspector General’s Chicago Field Office and the Office of Personnel Management’s Office of Inspector General, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.  The case is being prosecuted by Assistant Chiefs Laura M.K. Cordova and Jennifer L. Saulino and Trial Attorney Ashlee C. McFarlane of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

BOEING RESOLVES FALSE CLAIMS ALLEGATIONS BY PAYING $23 MILLION

FROM:  U.S. JUSTICE DEPARTMENT

Friday, October 10, 2014

Boeing Pays $23 Million to Resolve False Claims Act Allegations

The Boeing Company paid $23 million to resolve allegations that it submitted false claims for labor charges on maintenance contracts with the U.S. Air Force for the C-17 Globemaster aircraft, the Justice Department announced today.  Boeing, an aerospace and defense industry giant, is headquartered in Chicago.

“Today’s settlement demonstrates that the Justice Department vigilantly ensures that companies meet their contractual obligations and charge the government appropriately,” said Acting Assistant Attorney General Joyce R. Branda for the Justice Department’s Civil Division.  “Government contractors who seek illegal profit at the expense of taxpayers will face serious consequences.”

The government alleged that Boeing improperly charged labor costs under contracts with the Air Force for the maintenance and repair of C-17 Globemaster aircraft at Boeing’s Aerospace Support Center in San Antonio, Texas.  The C-17 Globemaster aircraft, which is both manufactured and maintained by Boeing, is one of the military’s major systems for transporting troops and cargo throughout the world.  The government alleged that the company knowingly and improperly billed a variety of labor costs in violation of applicable contract requirements, including for time its mechanics spent at meetings not directly related to the contracts.

“Defense contractors are required to obey strict accounting standards when submitting billing for work performed on government contracts,” said U.S. Attorney Robert Pitman for the Western District of Texas.  “The pursuit and favorable settlement of this civil litigation was the result of effective teamwork between the Justice Department and the investigative agencies.”

The settlement resolves allegations originally brought in a lawsuit by present and former Boeing employees Clinton Craddock, Fred Van Shoubrouek, Anthony Rico and Fernando de la Garza in federal court in San Antonio under the False Claims Act.  The act permits private parties to sue for false claims on behalf of the United States and to share in any recovery.  The individuals who filed the suit will receive $3,910,000 as their share of the settlement.

The settlement was the result of a coordinated effort by the Civil Division, the U.S. Attorney’s Office for the Western District of Texas, the Defense Criminal Investigative Service, the Air Force Office of Special Investigations, the Defense Contract Audit Agency and the Defense Contract Management Agency.

The case is United States ex rel. Craddock v. Boeing, Case No. SA-07-CA-0880FB (W.D. Tex.).  The claims resolved by the settlement are allegations only; there has been no determination of liability.

BNP PARIBAS TO PAY $80 MILLION JUDGEMENT FOR FALSE CLAIMS TO USDA

FROM:  U.S. JUSTICE DEPARTMENT 

Thursday, July 24, 2014

$80 Million Judgment Entered Against BNP Paribas for False Claims to the U.S. Department of Agriculture

The Department of Justice announced today that an $80 million False Claims Act judgment was entered against BNP Paribas for submitting false claims for payment guarantees issued by the U.S. Department of Agriculture (USDA).  BNP Paribas is a global financial institution headquartered in Paris.    

 “We will not tolerate the misuse of taxpayer funded programs designed to help American businesses,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.  “Companies that abuse these programs will be held accountable.”

The United States filed a lawsuit against BNP Paribas in connection with its receipt of payment guarantees under USDA’s Supplier Credit Guarantee (SCG) Program.  The program provided payment guarantees to U.S.-based exporters for their sales of grain and other agricultural commodities to importers in foreign countries.  The program encouraged American exporters to sell American agricultural commodities to foreign importers and covered part of the losses if the foreign importers failed to pay.  The SCG Program regulations provided that U.S. exporters were ineligible to participate in the SCG Program if the exporter and foreign importer were under common ownership or control.
         
The judgment entered by the court resolves the government’s allegations that, from 1998 to 2005, BNP Paribas participated in a sustained scheme to defraud the SCG Program.  In furtherance of the scheme, American exporters and Mexican importers who were under common control improperly obtained SCG Program export credit guarantees for transactions between the affiliated exporters and importers.  In some cases, the underlying transactions were shams and did not involve any real shipment of grain.  BNP Paribas accepted assignment of the credit guarantees from the American exporters, even though it knew that the affiliated exporters and importers were ineligible for SCG Program financing, and a BNP Paribas vice-president, Jerry Cruz, received bribes from the exporters.  Beginning in April 2005, when the Mexican importers began defaulting on their payment obligations, BNP Paribas submitted claims to the USDA for the resulting losses.

On Jan. 20, 2012, Cruz pleaded guilty to conspiracy to commit bank fraud, mail fraud and wire fraud, and conspiracy to commit money laundering.  

“I would like to thank the Department of Justice and the USDA General Counsel’s office for their collaboration in recovering $80 million under this judgment,” said Administrator of USDA’s Foreign Agricultural Service Phil Karsting.  “This illustrates the importance USDA and this administration places on protecting the integrity of our programs.”

The resolution of this matter was the result of a coordinated effort among the Commercial Litigation Branch of the Justice Department’s Civil Division, the USDA, the USDA Office of Inspector General, the U.S. Postal Inspection Service and the Internal Revenue Service Criminal Investigation.

ALLEGED DEBT-COLLECTOR BULLY TO PAY $100,000 AND SURRENDER ASSETS

FROM:  U.S. FEDERAL TRADE COMMISSION 

FTC Continues Crack Down on Deceptive Debt Collection; Houston-based Defendants Agree to Stop Deceptive Fees and Practices

Owner to Pay $100,000, Surrender Assets, Including Luxury Motor Home

A Houston debt collection company, RTB Enterprises, Inc., which does business as Allied Data Corporation, and Raymond T. Blair, its president and sole shareholder, have agreed to a federal court order prohibiting them from the allegedly deceptive tactics they have been using to bully English and Spanish-speaking consumers into paying debts and unnecessary fees.

 According to a complaint filed by the Federal Trade Commission, the defendants violated the FTC Act and the Fair Debt Collection Practices Act by using false and deceptive methods to collect more than $1.3 million in so-called “convenience fees” and “transaction fees” from consumers who authorized payments by telephone. The defendants allegedly trained their collectors to deceive consumers into believing that payments were not accepted by U.S. mail and that the fees were unavoidable. In some instances, the fees were added to consumers’ accounts without their knowledge or consent, the FTC charged.

The FTC also alleged that the defendants’ collectors deceived both English and Spanish- speaking consumers by falsely claiming to speak for attorneys, falsely threatening to sue consumers who did not pay, and using deceptive schemes to coerce consumers into paying or providing their personal information.

“It’s illegal for debt collectors to lie, make false threats, use a false identity, or trick people into paying a debt or an unauthorized fee,” said Jessica Rich, Director of the FTC’s Bureau of Consumer Protection. “The FTC will continue to protect consumers from deceptive or abusive debt collection practices, regardless of whether the deception or abuse occurs in English, Spanish, or any other language.”          

The federal court order imposes a penalty of $4 million, which will be partially suspended based on inability to pay once Blair surrenders assets totaling $100,000. The proposed order also requires Blair to relinquish a luxury motor home. The order prohibits Blair and his company from repeating any of the unfair or deceptive practices alleged in the complaint, and it requires them to truthfully disclose information about any fees they charge, and the steps consumers can take to avoid paying.

For consumer information about dealing with debt collectors, see Debt Collection.

The Commission vote authorizing the staff to file the complaint and approving the proposed federal court order was 5-0. The FTC filed the complaint and proposed order in the U.S. District Court for the Southern District of Texas, Houston Division on June 17, 2014.

NOTE: The Commission files a complaint when it has “reason to believe” that the law has been or is being violated and it appears to the Commission that a proceeding is in the public interest. The proposed order has the force of law when approved and signed by the District Court judge.

The Federal Trade Commission works for consumers to prevent fraudulent, deceptive, and unfair business practices and to provide information to help spot, stop, and avoid them.

UNLICENSED DOCTOR, OTHERS CONVICTED IN $14.9 MILLION MEDICARE FRAUD

FROM:  U.S. JUSTICE DEPARTMENT 

Wednesday, April 30, 2014

Detroit-Area Physical Therapist, Physical Therapy Assistant and Unlicensed Doctor Convicted in $14.9 Million Medicare Fraud Scheme

A federal jury in Detroit today convicted a physical therapist, physical therapy assistant and unlicensed doctor for their participation in a nearly $15 million Medicare fraud scheme.

Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the Detroit Office of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Office of Investigations made the announcement.

Shahzad Mirza, 43, a physical therapist; Jigar Patel, 30, a physical therapy assistant; and Srinivas Reddy, 38, a foreign medical school graduate without a license to practice medicine were each found guilty of one count of conspiracy to commit health care fraud in connection with a scheme perpetrated from approximately July 2008 through September 2011 at Detroit area companies Physicians Choice Home Health Care LLC (Physicians Choice), Quantum Home Care Inc. (Quantum), First Care Home Health Care LLC (First Care), Moonlite Home Care Inc. (Moonlite) and Phoenix Visiting Physicians.  In addition, Mirza and Patel were each found guilty of two counts of health care fraud in connection with the submission of false claims to Medicare for home health services, and Reddy was found guilty of three counts of health care fraud in connection with the submission of false claims to Medicare for home health services and physician home visits.  Patel was found guilty of one count of money laundering in connection with his laundering of the proceeds of the fraud through his company MI Healthcare Staffing.

The defendants were charged in a superseding indictment returned Feb. 6, 2012.  Three other individuals charged in the indictment remain fugitives.

According to evidence presented at trial, Physicians Choice, Quantum, First Care and Moonlite operated a fraudulent scheme to bill Medicare for home health care services that were never provided.  The home health care companies paid kickbacks to recruiters who in turn paid Medicare beneficiaries cash and promised them access to narcotic prescriptions.  The conspirators created the company Phoenix Visiting Physicians, which employed unlicensed individuals, including Reddy, to visit patients and provide them with narcotic prescriptions as well as obtain the information necessary to fill out paperwork to refer them for medically unnecessary home health care services.

Evidence presented at trial showed that beneficiaries pre-signed medical paperwork that was provided to Patel and other physical therapist assistants to fill in with false information purporting to show that the care was provided, when it was not.  Patel, registered physical therapist Mirza and others would sign this paperwork as though they had provided services.  In the course of the conspiracy, Patel incorporated his own staffing company, MI Healthcare Staffing, through which he laundered proceeds of the fraud from home health care companies and a shell company owned and operated by his co-conspirators.

Physicians Choice and the related companies were paid nearly $15 million in the course of the conspiracy.

Sentencing for all three defendants has not yet been scheduled.

The investigation was led by the FBI and HHS-OIG, and was brought by the Medicare Fraud Strike Force, a joint effort of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.  The case was prosecuted by Assistant Chief Catherine K. Dick and Trial Attorneys Matthew C. Thuesen and Rohan A. Virginkar of the Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

THREE PEOPLE ACCUSED OF DEFRAUDING U.S. GOVERNMENT OF $32 MILLION

FROM:  FEDERAL COMMUNICATIONS COMMISSION 
Thursday, April 10, 2014
Three Men Charged with Allegedly Defrauding the FCC of Approximately $32 Million

Three individuals have been indicted for their alleged roles in an approximately $32 million fraud against a Federal Communications Commission (FCC) program designed to provide discounted telephone services to low-income customers.

The charges were announced today by Acting Assistant Attorney General David A. O’Neil of the Justice Department’s Criminal Division, Assistant Director in Charge Valerie Parlave of the FBI’s Washington Field Office, Inspector General David L. Hunt of the FCC Office of Inspector General (FCC-OIG) and Chief Richard Weber of the Internal Revenue Service – Criminal Investigation (IRS-CI).

Thomas E. Biddix, 44, of Melbourne, Fla., Kevin Brian Cox, 38, of Arlington, Tenn., and Leonard I. Solt, 49, of Land O’Lakes, Fla., were charged by a criminal indictment returned on April 9, 2014, and unsealed today in federal court in Tampa, Fla.   The indictment charges the three defendants with one count of conspiracy to commit wire fraud and 15 substantive counts of wire fraud, false claims and money laundering.   The court also authorized a seizure warrant seeking the defendants’ ill-gotten gains, including the contents of multiple bank accounts, a yacht and several luxury automobiles.

As alleged in the indictment, the defendants engaged in a scheme to submit false claims with the federal Lifeline Program administered by the Universal Service Administrative Company, a not-for-profit corporation designated and authorized by the FCC.   The program aims to provide affordable, nationwide telephone service to all Americans through discounted phone service for qualifying low-income customers.

The indictment alleges that the defendants owned and operated Associated Telecommunications Management Services LLC (ATMS), a holding company that owned and operated multiple subsidiary telephone companies that participated in the Lifeline Program.   Biddix, chairman of the board at ATMS, and Cox and Solt allegedly caused the submission of falsely inflated claims to the Lifeline Program between September 2009 and March 2011 that resulted in ATMS fraudulently receiving more than $32 million.

The investigation has been conducted by the FBI, FCC-OIG, and IRS-CI.   The United States Marshals Service provided assistance coordinating the seizures of assets.

The case is being prosecuted by Trial Attorneys Andrew H. Warren and Kyle Maurer of the Criminal Division’s Fraud Section, with assistance from Darrin McCullough of the Criminal Division’s Asset Forfeiture and Money Laundering Section, and the United States Attorney’s Offices for the District of Columbia, the Western District of Tennessee and the Middle District of Florida.

The charges contained in the indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

MILITARY CONTRACTED MAP CO. PAYS $2.1 MILLION TO RESOLVE FALSE CLAIM ACT ALLEGATIONS

FROM:  U.S. JUSTICE DEPARTMENT 
Friday, February 7, 2014

Sanborn Map Co. Pays $2.1 Million to Resolve Allegations of False Claims for Map Work Related to United States Military Convoy Routes in Iraq and Marine Corps Bases in United States

Sanborn Map Company Inc. has agreed to pay $2.1 million to the U.S. government to resolve allegations that it submitted false claims in connection with U. S. Army Corps of Engineers contracts, the Justice Department announced today.  Sanborn, headquartered in Colorado Springs, Colo., provides photogrammetric mapping and geographic information system services.  

“We are committed to defending the integrity of our public contracting process,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.  “ The Department of Justice will not hesitate to pursue companies that knowingly fail to comply with their contractual obligations, particularly obligations involving the protection of our national security interests.”

From 2005 to 2011, Sanborn contracted with the U.S. Army Corp of Engineers to produce maps for U.S. convoy routes in Iraq, Marine Corps bases in the U. S. and other military and civilian projects.  Allegedly, in an effort to save money, Sanborn used unapproved foreign subcontractors on three projects, which violated contractual obligations and caused delays on these projects.  Sanborn also allegedly used unapproved domestic subcontractors when Sanborn was required to complete all map work in-house and charged unrelated work to the government contracts.

"We applaud the hard work and dedication of our agents and partners at the Department of Justice and other fellow law enforcement agencies," said Director Frank Robey of the U. S. Army Criminal Investigation Command's Major Procurement Fraud Unit.  "Our specially trained agents will doggedly pursue all who would undermine the needs and resources of the military.”

The allegations arose from a lawsuit filed by a former Sanborn employee, James Peterson, in a federal court in St. Louis, Mo., under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private individuals known as “relators” to sue on behalf of the government and to share in the proceeds of any settlement or judgment.  Peterson’s share of today’s settlement has not been determined.  

The settlement was the result of a coordinated effort  among the Commercial Litigation Branch, Civil Division, Department of Justice; the U. S. Attorney’s Office for the Eastern District of Missouri and the  U. S. Army Corps of Engineers.  The U.S. Army Criminal Investigation Command – Major Procurement Fraud Unit; the Department of Defense Office of Inspector General, Defense Criminal Investigative Service; and Defense Contract Audit Agency assisted in the investigation.
           
The case is United States ex rel. James Peterson v. Sanborn Map Company Inc., 4:11CV000902 AGF (E.D. Mo.).  The claims settled by this agreement are allegations only, and there has been no determination of liability.

JP MORGAN WILL PAY $614 FOR FALSE CLAIMS ACT VIOLATIONS

FROM:  JUSTICE DEPARTMENT 
Tuesday, February 4, 2014
JPMorgan Chase to Pay $614 Million for Submitting False Claims for FHA-insured and VA-guaranteed Mortgage Loans

The Department of Justice today announced that JPMorgan Chase (JPMC) will pay $614 million for violating the False Claims Act by knowingly originating and underwriting non-compliant mortgage loans submitted for insurance coverage and guarantees by the Department of Housing and Urban Development’s (HUD) Federal Housing Administration (FHA) and the Department of Veterans Affairs (VA).  JPMC is a bank and financial services company headquartered in New York.
 
“The resolution announced today is a product of the Justice Department’s continuing efforts to hold accountable those whose conduct contributed to the financial crisis,” said Associate Attorney General Tony West.  “This settlement recovers wrongfully claimed funds for vital government programs that give millions of Americans the opportunity to own a home and sends a clear message that we will take appropriately aggressive action against financial institutions that knowingly engage in improper mortgage lending practices.”

“The Department of Justice will continue to hold accountable financial institutions whose irresponsible mortgage lending undermines the housing market and costs the taxpayers many millions of dollars,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.  “I thank U.S. Attorney Bharara and his team for their stellar efforts in this case and look forward to our coordinated efforts in these cases.”

As part of the settlement, which was handled by the U.S. Attorney’s Office for the Southern District of New York, JPMC admitted that, for more than a decade, it approved thousands of FHA loans and hundreds of VA loans that were not eligible for FHA or VA insurance because they did not meet applicable agency underwriting requirements.  JPMC further admitted that it failed to inform the FHA and the VA when its own internal reviews discovered more than 500 defective loans that never should have been submitted for FHA and VA insurance.

“For years, JPMorgan Chase has enjoyed the privilege of participating in federally subsidized programs aimed at helping millions of Americans realize the dream of homeownership,” said U.S. Attorney for the Southern District of New York Preet Bharara.  “Yet, for more than a decade, it abused that privilege.  JPMorgan Chase put profits ahead of responsibility by recklessly churning out thousands of defective mortgage loans, failing to inform the government of known problems with those loans and leaving the government to cover the losses when the loans defaulted.  With today’s settlement, however, JPMorgan Chase has accepted responsibility for its misconduct and has committed to reform its business practices.  This settlement adds to the list of successful mortgage fraud cases this office has pursued.”

Beginning as early as 2002, JPMC falsely certified that loans it originated and underwrote were qualified for FHA and VA insurance and guarantees.  As a consequence of JPMC’s misrepresentations, both the FHA and the VA incurred substantial losses when unqualified loans failed and caused the FHA and VA to cover the associated losses.

“This settlement with JP Morgan Chase will enable HUD to recover funds lost due to Chase’s past unacceptable mortgage underwriting practices,” said HUD’s Acting General Counsel Damon Smith.  “In addition, Chase must now institute new and tighter controls to prevent abuses of FHA’s automated underwriting system.  HUD will continue working with the Department of Justice to ensure that lenders are held accountable and are required to institute practices that will benefit both borrowers and the FHA insurance fund.”

“The agreement reached with JPMC was possible due to the dedication of the U.S. Attorney’s Office for the Southern District of New York and the hard work of the talented staff at the Office of Inspector General,” said Inspector General of the Department of Housing and Urban Development David A. Montoya.  “It also demonstrates the combined commitment of the Justice Department and the Office of Inspector General to continuing efforts to enforce FHA mortgage insurance requirements.”

The FHA’s Single Family Mortgage Insurance Program enables low- and moderate- income borrowers to purchase homes by insuring qualified loans made by participating lenders, such as JPMC, against losses if the loans later default.  A participating lender may only submit to the FHA creditworthy loans meeting certain requirements and must maintain a quality control program that can prevent and correct any deficiencies in the lender’s underwriting practices.  The VA’s Loan Guaranty Program provides similar assistance to veterans, service members and qualifying surviving spouses.

“I commend the efforts of the United States Attorney’s Office for the Southern District of New York to hold lenders accountable for conduct that defrauds the government and deserving veterans who rely on VA’s Loan Guaranty Program to purchase their homes,” said Acting Inspector General for the Office of Inspector General, Department of Veterans Affairs Richard J. Griffin.

The settlement resolves allegations in a complaint filed by a private whistleblower.

Today’s settlement is part of efforts underway by President Obama’s Financial Fraud Enforcement Task Force (FFETF), which was created in November 2009 to wage an aggressive, coordinated and proactive effort to investigate and prosecute financial crimes.  With more than 20 federal agencies, 94 U.S. Attorney’s Offices and state and local partners, it is the broadest coalition of law enforcement, investigatory and regulatory agencies ever assembled to combat fraud.  Since its formation, the task force has made great strides in facilitating increased investigation and prosecution of financial crimes; enhancing coordination and cooperation among federal, state and local authorities; addressing discrimination in the lending and financial markets; and conducting outreach to the public, victims, financial institutions and other organizations.  Over the past three fiscal years, the Justice Department has filed more than 10,000 financial fraud cases against nearly 15,000 defendants, including more than 2,700 mortgage fraud defendants.  For more information on the task force, visit www.stopfraud.gov .

This settlement was the result of a coordinated effort among the U.S. Attorney’s Office for the Southern District of New York , the department’s Civil Division, the Department of Housing and Urban Development’s Inspector General and the Department of Veterans Affairs’ Inspector General.

COMPANIES SUED IN IRAQ KICKBACK AND FALSE CLAIMS CASE

FROM:  JUSTICE DEPARTMENT 

Thursday, January 23, 2014

United States Government Sues Kellogg, Brown & Root Services Inc. and Two Foreign Companies for Kickbacks and False Claims Relating to Iraq Support Services Contract

The government has filed a complaint against Kellogg, Brown & Root Services Inc. (KBR) and Kuwaiti companies La Nouvelle General Trading & Contracting Co. (La Nouvelle) and First Kuwaiti Trading Co. (First Kuwaiti) for submitting false claims in connection with KBR’s contract with the Army to provide logistical support in Iraq, the Department of Justice announced.  KBR is an engineering, construction and services firm headquartered in Houston, Texas.  Kuwait-based La Nouvelle and First Kuwaiti provided transportation, maintenance and other services in support of KBR’s contract with the Army.

“We depend on companies like KBR and its subcontractors to provide valuable services to our military,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery.  “We will en sure that contractors do not engage in corrupt practices at the expense of our troops abroad, while profiting at the expense of taxpayers at home.”

Allegedly, KBR made claims to the government, knowing them to be false, under a contract with the Army to provide wartime logistical support, known as the Logistics Civil Augmentation Program (LOGCAP) III.  The award of LOGCAP III paved the way for the company to become a critical source for logistical support services in Iraq, which included transportation, maintenance, food, shelter and facilities management.  KBR performed many of these services through subcontracts awarded to foreign companies local to the region, such as La Nouvelle and First Kuwaiti.

In its complaint, filed in federal court in Rock Island, Ill., the government alleged that, in 2003 and 2004, KBR employees took kickbacks from La Nouvelle and First Kuwaiti in connection with the award and oversight of subcontracts awarded to these companies.  KBR then claimed reimbursement from the government for costs it incurred under the subcontracts that allegedly were inflated, excessive or for goods and services that were grossly deficient or not provided.  For example, KBR allegedly awarded La Nouvelle a subcontract to supply fuel tankers for more than three times the tankers’ value.  La Nouvelle later rewarded the KBR employee who awarded the subcontract with a $1 million bank draft.  As another example, KBR allegedly continued to make monthly lease payments to First Kuwaiti for trucks KBR had already returned to the subcontractor.  KBR billed the government for the costs of both of these subcontracts.  The lawsuit also alleges that KBR used refrigerated trailers to transport ice for consumption by the troops that had previously been used as temporary morgues without first sanitizing them.

“Our office investigated the actions of KBR and related companies, as well as certain KBR employees,” said U.S. Attorney for the Central District of Illinois Jim Lewis.  “We were able to obtain criminal convictions against several subcontract managers whose actions were illegal and caused damage to our military, and we are now committed to pursue these civil claims against the companies themselves.”
         
The U.S. Attorney’s Office in Rock Island has convicted 10 companies and individuals in connection with wartime contracts in Iraq.  The convictions include three KBR subcontract managers who admitted taking kickbacks or making false statements in connection with the allegations made in the government’s complaint.  Anthony J. Martin pleaded guilty in 2007 to taking kickbacks in return for awarding First Kuwaiti subcontracts for trucks and trailers and also admitted including the amount of the kickbacks in the price of the subcontracts.  In 2005, Jeff Alex Mazon pleaded guilty to making a false written statement in connection with a subcontract for fuel tankers awarded to La Nouvelle in 2003.  And in 2006, Stephen Lowell Seamans admitted taking kickbacks from La Nouvelle, during a guilty plea to a kickback arrangement with another subcontractor, Saudi Arabia-based Tamimi Global Co. Ltd. (Tamimi).  The government previously entered into criminal and civil agreements with Tamimi in which Tamimi paid the U.S. government $13 million, including $7.4 million for civil claims and $5.6 million in criminal fines, to resolve its liability for the kickbacks.

The government is suing KBR, La Nouvelle and First Kuwaiti under the False Claims Act, as well as the Anti-Kickback Act.

“Contractors and subcontractors are expected to comply with their statutory obligations and act in good faith when dealing with the United States government,” said Special Agent in Charge of the Defense Criminal Investigative Service’s Southwest Field Office Janice M. Flores.  “The lawsuit demonstrates the commitment of DCIS and its partner agencies to prevent false billing and corrupt practices involving the military contracting process.”        

Some of the allegations contained in the government’s complaint were originally alleged in a lawsuit filed in a federal court in Houston by a whistleblower, Bud Conyers, under the qui tam provisions of the False Claims Act.  The case was later transferred to the U.S. District Court for the Central District of Illinois in Rock Island, Ill., where LOGCAP III is administered by the Department of Defense at the Rock Island Arsenal.  The False Claims Act authorizes private parties to sue, on behalf of the government, companies and persons whom they believe have falsely claimed federal funds and to share in any recovery.  The Act also allows the government to intervene and take over the action, as it has done in this case.  The government notified the court earlier this year that it was intervening in Conyers’ case and intended to file its own complaint with additional allegations.

The lawsuit is being handled by the Civil Division of the Department of Justice with investigative support by the Defense Contract Audit Agency, the Defense Criminal Investigative Service and the Army Criminal Investigation Command.  The U.S. Attorney’s Office for the Southern District of Texas also participated in the investigation.

The case is captioned United States ex rel. Conyers v. Kellogg Brown & Root Inc. et al., No. 4:12-cv-04095-SLD-JAG (C.D. Ill.).  The claims asserted in this case are allegations only; there has been no determination of liability except to the extent of admissions made in the criminal proceedings.

HEALTH CARE COMPANY EXECS TO PAY OVER $1 MILLION TO RESOLVE FALSE CLAIMS ALLEGATIONS

FROM:  JUSTICE DEPARTMENT 
Friday, January 10, 2014
Former HealthEssentials Solutions Inc. Executives to Pay More Than $1 Million to Resolve Allegations of Submitting False Claims to Federal Health Care Program

Michael R. Barr, former chief executive officer of Louisville, Kentucky-based HealthEssentials Solutions Inc., has agreed to pay $1 million to resolve allegations that he knowingly caused HealthEssentials to submit false claims to Medicare between 1999 and 2004, the Justice Department announced today.  Norman J. Pfaadt, HealthEssentials’ former chief financial officer, also agreed to pay $20,000 to resolve similar allegations.  H ea lt h E s s e nt i a ls provided primary medical care to patients in nursing facilities, assisted living facilities and other settings from 1998 until it filed for bankruptcy and ceased operations in 2005.  Barr founded HealthEssentials and served as its president, chief executive and board chairman.  Pfaadt served as HealthEssentials’ senior vice president and chief financial officer.

“Healthcare executives should lead by example and create cultures of compliance within their companies, not pressure their employees to cheat the taxpayers,” said Assistant Attorney General for the Civil Division Stuart F. Delery.  “We will continue to hold health care executives personally accountable for their dealings with Medicare.”

“Pursuing health care fraud is a priority of this office and the Department of Justice,” said U.S. Attorney for the Western District of Kentucky David J. Hale.  “We will continue to work with the Department of Health and Human Services and the public to ensure that fraudulent claims are investigated and those responsible are required to pay.”
         
In March 2008, HealthEssentials pleaded guilty to submitting false statements to Medicare relating to services it provided to patients in assisted living facilities and entered into a civil settlement with the government.  In May 2011, HealthEssentials’ former director of billing, Karen Stone, pleaded guilty for her role in the company’s billing scheme.

The settlement announced today resolves Barr’s and Pfaadt’s alleged liability under the False Claims Act for their roles in HealthEssentials’ false billings.  The government alleged that, between 1999 and 2004, HealthEssentials billed for services that were inflated or not medically necessary and that Barr and Pfaadt pressured HealthEssentials employees to inflate the company’s billings, despite having been advised by attorneys and others that doing so would be improper.  The government further alleged that Barr pressured HealthEssentials employees to conduct special medical assessments on patients, without regard to whether the patients required the assessments, solely to increase the amount that HealthEssentials could bill for the visits.  As part of the settlement, Barr has agreed to a three-year period of exclusion from participating in federally funded health care programs.

“Executives cheating taxpayers and patients – as alleged in this case – should beware of exclusion from Medicare, Medicaid and all other federal health programs, as well as criminal and civil liability,” said Inspector General of the U.S. Department of Health and Human Services Daniel R. Levinson.  “Vulnerable beneficiaries deserve protection from potentially harmful, medically unnecessary services.”

The allegations that were resolved by the settlement arose in part from a lawsuit filed by former HealthEssentials employees Michael and Leigh RoBards under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens to bring suit on behalf of the government and to share in any recovery.  Mr. and Mrs. RoBards will receive a total of $153,000.

This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $17 billion through False Claims Act cases, with more than $12.2 billion of that amount recovered in cases involving fraud against federal health care programs.

The case was handled by the Commercial Litigation Branch, Civil Division, U.S. Department of Justice and the U.S. Attorney’s Office for the Western District of Kentucky, with assistance from the Department of Health and Human Services Office of Inspector General and the Federal Bureau of Investigation.

The claims settled by this agreement are allegations only; there has been no determination of liability.  The case is captioned United States ex rel. Stydinger, et al. v. Michael R. Barr and Norman J. Pfaadt, Civil No. 3:03-cv-00380-TBR (W.D. Ky.).

NURSE SENTENCED FOR ROLE IN $11 MILLION FRAUD

FROM:  U.S. JUSTICE DEPARTMENT 
Friday, December 20, 2013
Unlicensed Miami Clinic Nurse Convicted at Trial and Sentenced for Role in $11 Million HIV Infusion Fraud Scheme

An unlicensed nurse who fled after being charged in 2008 and was captured this year was sentenced today to serve 108 months in prison for her role in a fraud scheme that resulted in more than $11 million in fraudulent claims to Medicare.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office made the announcement.

Carmen Gonzalez, 39, of Cape Coral, Fla., worked at St. Jude Rehabilitation Center, a fraudulent HIV infusion clinic in Miami, that was controlled by her cousins, Jose, Carlos and Luis Benitez, aka the Benitez Brothers.  Gonzalez was also sentenced for failing to appear at a June 2008 bond hearing.   The sentencing follows her conviction at trial to one count of conspiracy to defraud the United States to cause the submission of false claims and to pay health care kickbacks and one count of conspiracy to commit health care fraud.   Gonzalez had previously pleaded guilty to a separate charge of failure to appear.

Gonzalez was sentenced by Chief United States District Judge Federico A. Moreno in Miami, who also sentenced her to serve three years of supervised release.

Evidence at trial revealed that Gonzalez was an unlicensed nurse who paid thousands of dollars over a five month period to HIV beneficiaries so that St. Jude could submit millions of dollars in false and fraudulent claims to Medicare.  Gonzalez knew that St. Jude billed millions of dollars to Medicare for expensive HIV infusion therapy that was neither medically necessary nor provided.   Gonzalez fabricated patient medical records to facilitate and conceal the fraud, and these fabricated records were utilized to support the false and fraudulent claims submitted to Medicare on behalf of St. Jude.

On Oct. 17, 2013, Gonzalez pleaded guilty to knowingly and willfully failing to appear at a June 2008 hearing as directed by Judge Moreno.   Court documents reveal that Gonzalez was released on bond pending trial, but she knowingly and willfully failed to appear as directed by the court to a June 2008 hearing.

In January 2013, Gonzalez’s father, Enrique Gonzalez, was sentenced to 70 months in prison by U.S. District Judge Cecilia M. Altonaga in the Southern District of Florida for his role in separate health care fraud conspiracy.

The Benitez Brothers remain fugitives.   Anyone with information regarding their whereabouts is urged to contact HHS-OIG at 202-619-0088.

The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Southern District of Florida.   This case was prosecuted by Trial Attorneys Allan Medina and Nathan Dimock of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion.   In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

DOCTOR INDICTED FOR ALLEGED ROLE IN $158 MILLION MEDICARE FRAUD

FROM:  U.S. JUSTICE DEPARTMENT 
Tuesday, December 17, 2013
Houston Doctor Indicted for Her Alleged Role in $158 Million Medicare Fraud Scheme

A Houston doctor has been arrested on charges related to her alleged participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Kenneth Magidson of the Southern District of Texas, Special Agent in Charge Stephen L. Morris of the FBI’s Houston Field Office, Special Agent in Charge Mike Fields of the Dallas Regional Office of the Department of Health and Human Services Office of the Inspector General (HHS-OIG) and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU) made the announcement.

Sharon Iglehart, 56, of Houston, was charged in an indictment, filed in the Southern District of Texas and unsealed today, with one count of conspiracy to commit health care fraud and four counts of health care fraud.   If convicted, Iglehart faces a maximum penalty of 10 years in prison on each count.   Iglehart was arrested on Dec. 16, 2013, and made her initial appearance in federal court in Houston today.

According to the indictment, Iglehart allegedly participated in a scheme to defraud Medicare beginning in 2005 and continuing until May 2012.  The defendant allegedly caused the submission of false and fraudulent claims for partial hospitalization program (PHP) services to Medicare through a Houston hospital.  A PHP is a form of intensive outpatient treatment for severe mental illness.

The indictment alleges that the defendant and her co-conspirators submitted or caused to be submitted approximately $158 million in claims to Medicare for PHP services purportedly provided by the hospital, when in fact the PHP services were medically unnecessary or never provided.

In February 2012, Mohammad Khan, an assistant administrator at the hospital who managed many of the hospital’s PHPs, was indicted for his role in the scheme.   Khan pleaded guilty to one count of conspiracy to commit health care fraud, one count of conspiracy to pay illegal kickbacks, and five counts of paying illegal kickbacks.   Khan has not yet been sentenced.

In October 2012, Earnest Gibson III, the administrator of the hospital, along with Earnest Gibson IV, William Bullock III, Robert Ferguson, Regina Askew, Leslie Clark and Robert Crane, were indicted for their roles in the scheme.   Leslie Clark pleaded guilty to one count of conspiracy to pay and receive illegal kickbacks.   Clark has not yet been sentenced.

An indictment is merely an allegation, and the defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

The case was investigated by the FBI, HHS-OIG, MFCU, Internal Revenue Service’s Houston Field Office, the Chicago Field Office of the Railroad Retirement Board’s Office of Inspector General, and the Office of Personnel Management’s Office of Inspector General and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.   The case is being prosecuted by Assistant Chief Laura M.K. Cordova of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion.   In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

COURT ORDERS TELEMARKETER AND OWNED COMPANIES TO PAY OVER $5 MILLION DUPED CONSUMERS

FROM:  U.S. FEDERAL TRADE COMMISSION 

At the Federal Trade Commission’s request, a federal court has ordered a Canadian telemarketer and four companies he owns to pay more than $5.1 million to American and Canadian consumers who were duped into paying hundreds of dollars based on false claims that the defendants had buyers lined up for their cars, and that refunds would be provided if the cars weren’t sold.  The court also permanently banned the defendants from telemarketing and payment processing.

According to the FTC’s complaint against Matthew J. Loewen  and his companies, the defendants called consumers who listed vehicles for sale on websites such as craigslist.org or ebay.com.  The defendants falsely claimed that, in exchange for a fee, typically $399, they would put the consumer in touch with a buyer, often telling consumers they had undervalued the vehicle and that the price the buyer was willing to pay would cover the defendants’ fee.  The defendants also offered $99 “refund insurance,” falsely promising consumers who purchased it a risk-free refund of their initial fee if the vehicle was not sold in 90 days.
           
On October 29, 2013, the U.S. District Court for the Western District of Washington found the FTC’s allegations to be true and ruled that the defendants’ telemarketing operation violated the FTC Act and the FTC’s Telemarketing Sales Rule.  According to the Court, the defendants’ promises to match consumers with car buyers was “simply false,” and the impression they conveyed of easily obtainable refunds was “decidedly deceptive.”

The Court also noted that, in order to evade detection, the defendants operated under a series of ever-changing corporate names (including Auto Marketing Group, Secure Auto Sales, and Vehicle Stars).  It also cited the defendants’ high rate of credit card chargebacks – in which consumers dispute charges and get them reversed -- as further proof of the fraudulent nature of the defendants’ operation.

In addition to the Order requiring Loewen and his co-defendants to pay $5.1 million, the Court permanently banned Loewen and his companies from telemarketing and payment processing.  The court order announced today also permanently prohibits the defendants from misrepresenting any material fact in selling used cars, including that they have identified potential buyers for a consumer’s vehicle and that, for a fee, they will put them in touch with the buyers.  The defendants are also barred from misrepresenting that those who buy their services are highly likely to sell their vehicle, and that some or all of the initial fee will be refunded if the consumer buys a refund insurance policy and the vehicle is not sold within some period of time.

The order also bars the defendants from misrepresenting material facts about any goods or services, selling or otherwise benefitting from consumers’ personal information, failing to properly dispose of customer information, and violating the Telemarketing Sales Rule.

The FTC acknowledges the assistance of Business Practices and Consumer Protection Authority, British Columbia, Canada.

To learn more about telemarketing scams, read Telemarketing Scams.

The Commission vote authorizing the staff to file the complaint was 5-0.  The complaint against Defendants Matthew J. Loewen and his companies 0803065 B.C. Ltd., 0881046 B.C. Ltd., ReadyPay Services, Inc., and Xavier Processing Services, LLC, was filed in the U.S. District Court for the Western District of Washington in Seattle.  The court entered summary judgment against the defendants on October 29, 2013.

FINAL SIX 'RACHEL ROBOCALL' DEFENDANTS BANNED FROM TELEMARKETING

FROM:  FEDERAL TRADE COMMISSION 
Final Six Defendants in 'Rachel Robocall' Scheme Settle FTC Charges

They Will Be Permanently Banned from All Telemarketing and Debt Relief Services

The final six of 10 defendants named in an alleged “Rachel from Cardholder Services” scam have agreed to settle Federal Trade Commission charges that they misled consumers with bogus claims that they would lower their credit card interest rates.

The FTC settlement bans Emory L. “Jack” Holley IV, Lisa Miller, and the remaining corporate defendants from telemarketing and marketing debt relief services or assisting others in such conduct, prohibits them from misrepresenting any products or services, and imposes a partially suspended $11.9 million judgment.

The FTC filed its complaint in this matter in October 2012, alleging that the defendants violated Section 5 of the FTC Act and the agency’s Telemarketing Sales Rule (TSR) by charging illegal up-front fees during telemarketing calls in which they made false promises to reduce the interest rate on consumers’ credit cards and save them thousands of dollars.

In the complaint, the FTC also charged the defendants with making other misrepresentations, such as claiming that consumers who bought their services would be able to pay off their debts much faster as a result of the lowered credit card interest rates and making false claims about their refund policies.

The other four Key One defendants agreed to settle the FTC charges against them in June of this year. They allegedly defendants participated in the scheme by opening merchant and bank accounts in their names for processing consumer payments obtained in connection with the deceptive sales of credit card interest rate-reduction and by providing substantial assistance, such as web pages, mail drops, customer service, and shipping of CDs with general debt and other financial information to consumers.

Under the settlement announced today, Emory L. “Jack” Holley, Lisa Miller, and the companies they control, will be permanently banned from all telemarketing, with extremely limited exceptions to allow them to engage in legitimate business activities. The settlement also bans the defendants from advertising, marketing, promoting, offering for sale, or selling any debt relief-related products or services. Several of the defendants are repeat offenders, and this ban will permanently stop them from preying on consumers in financial distress.

The final order also prohibits the six defendants from making any misrepresentations related to any financial product or service, and requires them to substantiate any claims they make to consumers in the future about the potential benefits or effectiveness of any product or service. Finally, the order imposes a partially suspended judgment of $11.9 million jointly against the corporate and individual defendants. The defendants' assets, currently being held in receivership, will be paid to the Commission.

The Commission vote approving the proposed consent decree announced today was 4-0. It was filed in the U.S. District Court for the District of Arizona on October 16, 2013, and entered by the court the next day. The final order settles the FTC’s allegations against: 1) ELH Consulting, LLC, also doing business as Proactive Planning Solutions; 2) Purchase Power Solutions, LLC; 3) Allied Corporate Connection, LLC; 4) Complete Financial Strategies, LLC; 5) Emory L. Holley IV, a/k/a Jack Holley, individually and as the sole member of ELH Consulting, LLC; and 6) Lisa Miller, individually and as the sole member of Allied Corporate Connection, LLC, Complete Financial Strategies, LLC, and Purchase Power Solutions, LLC.