Department of Justice Press Release

For Immediate Release
February 1, 2011 United States Attorney’s Office
Southern District of Texas
Contact: (713) 567-9000

Dr. Arun Sharma Sentenced to Prison and Ordered to Forfeit More Than $43 Million in Cash/Property Gained Through Fraud

HOUSTON—Dr. Arun Sharma, 56, of Kemah, Texas, has been sentenced to 15 years for engaging in a conspiracy with his wife, Dr. Kiran Sharma, to commit health care fraud and committing health care fraud over a 10-year-period in the Southern District of Texas, United States Attorney José Angel Moreno announced today.

United States District Judge David Hittner handed down the prison sentence today and further ordered Sharma to forfeit more than $43 million, including their $700,000 home in Kemah, Texas, numerous parcels of real property, more than $700,000 in cash found during a search of their Kemah home, more than $800,000 in cash found in two safe deposit boxes and a number of investment accounts funded with the proceeds of their fraudulent scheme. At the conclusion of the sentencing, Sharma was remanded back into the custody of the U.S. Marshals Service.

Arun Sharma (Dr. A) pleaded guilty to one count of conspiracy and one count of health care fraud before United States District Judge David Hittner on April 26, 2010. During his plea, Dr. A admitted that from Jan. 1, 1998, through June 10, 2009, he and Kiran Sharma (Dr. K) fraudulently billed Medicare, Medicaid and various private health care providers for medical procedures that were not performed.

During the time period of the conspiracy, the defendants owned and operated multiple medical clinics operating under the name Allergy, Asthma, Arthritis Pain Center, with two principle locations in Baytown and Webster, Texas. While some of patients at the clinics were referred by other medical doctors, approximately 50 percent of the patients came to the clinics through word of mouth. Dr. A Sharma was known as an easy touch for prescribing the “pain cocktail” of hydrocodone, Xanax and Soma. As time went on, Dr. A began prescribing stronger narcotics such as Oxycontin, morphine, methadone, and fentanyl patches.

In addition to the prescription of narcotics, a large part of the practice conducted at the clinics was to provide patients with injections of lidocaine combined with steroids which at times provided temporary relief of various joint and muscle pain. Although the injections given to the patients were superficial, they were billed falsely to the insurance companies as facet joint injections, paravertebral injections, sacroiliac nerve injections, sciatic nerve injections, and various nerve block injections.

The pain management practice at the clinics grew quickly during the time period of the conspiracy. Dr. A and Dr. K went from seeing an average of 50-60 patients per day in 1998 to more than 100 per day beginning in 2003 with a high of 279 on Jan. 6, 2005. From 1998 through 2002, Dr. K saw pain patients at the clinics in addition to her own allergy patients. Dr. K, who maintained a modest allergy practice, would sign patient procedure forms and superbills, falsely indicating that she had administered facet joint injections or other paravertebral injections when in reality she did not. She also prescribed the pain cocktail when she saw pain management patients.

Nearly every patient was prescribed one or more controlled substances and put on a regimen of shots every two weeks. The patients were required to sign the medical progress and procedure notes in their patient chart to prove they were at the clinic and received the shots. Dr. A tried to convince all patients to have shots at every visit, but many of the patients did not want the shots every two weeks. For those patients who ultimately refused the shots, Dr. A regularly required the patients to sign the progress and procedure notes even though they received only a prescription for controlled substances and did not receive any injections. By the beginning of 2000, Dr. A was having certain patients sign blank procedure/progress notes and then using those forms to generate a superbill in order to bill the insurance companies for injection procedures on days when the patient was not in the clinic.

Dr. K hired several foreign medical graduates (FMGs) over the course of the conspiracy to assist in the movement of patients through the clinics. Several of the FMGs helped add fictitious patient examination information to the blank progress/procedure notes after Dr. A had added non-existent medical procedures to the blank forms so that insurance companies could be billed as if the person had been in the clinic when in reality they had not. Dr. K witnessed the FMGs creating the fictitious patient progress/procedure notes and knew that their ultimate purpose was to bill the insurance companies for procedures that never occurred.

Demonstrative of the implausibility of the volume of patients who allegedly received injections is the fact that the defendants’ own records purport to show that more than 100 patients purportedly received injections on 708 different days during the conspiracy. Further, the defendants’ billings showed that as many as 279 patients allegedly received injections on Jan. 6, 2005.

Dr. Kiran Sharma, who also has been convicted of conspiracy and health care fraud after pleading guilty in April 2010, is scheduled to be sentenced on Feb. 23, 2011. She remains in custody at the Federal Detention Center in Houston pending sentencing.

The criminal charges are the result of a joint investigation conducted by agents of the FBI, the United States Department of Health and Human Services-Office of Inspector General, the Medicaid Fraud Control Unit of the Texas Attorney General’s Office, the Office of Personnel Management-Office of Inspector General, the Railroad Retirement Board-Office of Inspector General, the Drug Enforcement Administration and the National Insurance Crime Bureau. The case is being prosecuted by Assistant United States Attorneys Al Balboni and Jason Varnado.

Press Releases | Houston Home

This is such a great idea by Health and Human services, I am sure it will gain more public awareness of the massive amount of money lost from the system. The most wanted list includes photo’s, profiles and physical descriptions. The website also has an online tip form and phone number to report fraudsters.The 10 below have allegedly cost taxpayers over $124 million with their fraudulent schemes.
Daniel Levinson, the HHS’ inspector general said “With our Most Wanted Fugitives List, OIG is asking the public’s help in tracking down fugitives. (It) has a stake in the fight against fraud, waste and abuse.” In all, they are seeking more than 170 fugitives on charges related to health care fraud and abuse.

Web site is: http://oig.hhs.gov/fugitives/

Department of Justice Press Release

For Immediate Release
January 20, 2011 U.S. Department of Justice
Office of Public Affairs
(202) 514-2007/TDD (202) 514-1888

Two Owners of Houston Health Care Company Plead Guilty to Alleged $5.2 Million Medicare Fraud Scheme

WASHINGTON—Two owners of a Houston health care company pled guilty today in connection with an alleged $5.2 million Medicare fraud scheme, announced the Departments of Justice and Health and Human Services (HHS).

Clifford Ubani, 52, and Princewill Njoku, 51, each pled guilty before U.S. District Court Judge Nancy Atlas in Houston to one count of conspiracy to commit health care fraud, one count of conspiracy to pay kickbacks and 16 counts of payment of kickbacks to Medicare beneficiary recruiters.

According to court documents, Ubani and Njoku were owners and operators of Family Healthcare Group (Family Group), a home health care company. Family Group purported to provide skilled nursing to Medicare beneficiaries. According to court documents, Ubani and Njoku hired co-conspirators to recruit Medicare beneficiaries for the purpose of filing claims with Medicare for skilled nursing that was medically unnecessary and/or not provided. Ubani and Njoku admitted that they paid kickbacks to the recruiters for their referrals.

Ubani and Njoku previously pled guilty to conspiracy to commit health care fraud related to their ownership of another Houston health care company, Family Healthcare Services (Family Services). Family Services submitted approximately $1.1 million in fraudulent claims to Medicare for the costs of durable medical equipment.

At sentencing, scheduled for July 19, 2011, Ubani and Njoku each face a maximum sentence of 10 years in prison for each health care fraud conspiracy count, five years in prison for each kickback conspiracy count and five years in prison for each kickback count.

Today’s guilty pleas were announced by Assistant Attorney General of the Criminal Division Lanny A. Breuer; U.S. Attorney José Angel Moreno of the Southern District of Texas; Special Agent-in-Charge Richard C. Powers of the FBI’s Houston Field Office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of HHS Office of Inspector General (HHS-OIG), Office of Investigations; and Texas Attorney General Greg Abbott.

This case is being prosecuted by Trial Attorneys Charles D. Reed and Laura Cordova, and Assistant Chief Sam S. Sheldon of the Criminal Division’s Fraud Section. The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section.

Since their inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than 850 individuals who collectively have falsely billed the Medicare program for more than $2.1 billion. In addition, HHS’s 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.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov

Press Releases | Houston Home

School is starting. Who is asking you for your child’s social security number? How are they protecting that information? Does you school have computerized records? Are they encrypted? Do they do background checks on all new hires? These questions need to be foremost in your mid as you send your little one or even your college bound sons and daughters off to college!

Anyone can be a victim of identity theft. Unfortunately, since young people are less likely to monitor their credit and may make themselves especially vulnerable to identity thieves, students at all levels are a common victim of identity theft.

Whether your child is six years old and is just starting school, or is eighteen and going off to college, he can be a target and victim of identity theft for many reasons. By taking a few simple steps to safeguard his identity, you can help prevent your child from becoming the next victim of identity theft.

A Victim of Identity Theft in Elementary School
There are many actions you can take to reduce the risk of your child becoming a victim of identity theft. The first thing you need to do is setup a system for keeping tabs on your child’s credit. We recommend creating a Credit Calendar to make it easy and free to monitor his credit and be alerted of any suspicious activity all year round.

Here’s how a Credit Calendar works to help prevent your child from being a victim of identity theft: There are three credit bureaus, Equifax, Experian, and Transunion, and each bureau allows you to order your child’s credit report for free once every year. Use your child’s Credit Calendar to record when you can order your child’s credit report from each agency. You’ll request a report from one of the three credit bureaus every four months, on a rotating schedule, to ensure there is no lapse in his credit monitoring each year.

Begin protecting your child from being a victim of identity theft by creating his Credit Calendar today. Here’s the contact information for the three credit bureaus:
• Equifax: 800.685.1111 and www.equifax.com
• Experian: 888.397.3742 and www.experian.com
• Transunion: 800.680.7289 and www.transunion.com

A Clear Sign Your Child Is the Victim of Identity Theft
Your mail carrier may be the one to deliver the news that your child has become a victim of identity theft. If your child begins to receive credit card offers in the mail, it’s very likely that he is a victim of identity theft. A typical scenario is that someone steals a child’s Social Security Number, creates a new identity, and uses that new identity to obtain credit. Of course, this can destroy your child’s credit, not to mention his good name, before he’s even old enough to actually use his own credit!

So, what’s the identity of that “someone” who stole your child’s personal information and made him an unwitting victim of identity theft? Studies show that the most common child identity thief is a close relative, including a parent. Indeed, vigilance is vital to protecting your child from being a victim of identity theft.

A Victim of Identity Theft in College
By the time he’s ready for college, your child may be smarter but, unfortunately, being smart doesn’t necessarily correlate to avoiding becoming the victim of identity theft. There are many actions your college age child can take to prevent identity theft:
• If he hasn’t done so already, it’s time to create that Credit Calendar to regularly keep track of his credit with the three credit bureaus
• Shred every credit card application that arrives in the mail
• Be careful when obtaining school-branded credit cards, which often contain such incentives as free gift cards, tee-shirts, and pizza when he applies

In addition to the damage inflicted by identity thieves on your child’s credit, many employers also review credit reports of job candidates. As competition for the best jobs increases, you don’t want your child’s future to be jeopardized simply because you didn’t take the proper precautions to avoid becoming a victim of identity theft from the time he began his education to the time he began his career. Whether you have a young child just starting first grade or a teenager ready to start college, now is the time to take action to prevent him from being another victim of identity theft.

Need help and more information to learn how you can protect your child from becoming a victim of identity theft? Contact The Identity Advocate today at 310.831.4400 or email info@theidentityadvocate.com. Visit www.theidentityadvocate.com.

LifeLock will refund consumers in 34 states $10.87 as part of an FTC settlement for misleading advertising practices. Not being able to provide “guaranteed” protection from medical identity theft or employment information theft and no protection against misuse of current their existing account information, the FTC settlement was reached in March of this year. Read the Consumer Affairs.com article at: http://www.consumeraffairs.com/news04/2010/11/nearly-one-million-consumers-getting-refunds-from-lifelock.html

Data Breeches are costing millions each year. The HITECH Act has not changed data protection as first thought. Dr. Larry Ponemon from the Ponemon Institute (which conducts independent research on privacy, data protection and information security policy) has submitted a great blog on the statistics which is available at : http://www.ponemon.org/blog/post/poor-privacy-practice-is-ailing-healthcare-industry

Think again if you believe Medical Identity Theft can’t happen to you. Watch this news clip from ABC news and Good Morning America:

Keeping your own personal health records is critical when it comes preventing Medical Identity Theft. This record can be paper or electronic. Also there are a number of online solutions. The American Health Information Management Association can help you in creating your own records. Their web site is www.myphr.com. Portable storage devices, CD’s or flash drives even a smart phone can be used to create your electronic record. The disadvantage is it may be lost or damaged and physician offices may not be able to read your records.
The following components should be included: Personal identification; emergency contacts (including phone numbers); health care providers (including specialists, dentists, pharmacists and their phone numbers); health insurance information; living will, advanced directives or power of attorney; organ donor authorization; current medications and dosages; allergies; immunizations; significant surgeries or illnesses; results from recent exams; and family history.
There are a number of resources and advocacy groups that help patients navigate the health care systems, an example being Guardian Nurses Healthcare Advocates.
If you have your own information always available to you, if someone tries to steal your medical identity you have your own records that are up to date and safe in your hands, thus preventing the HIPAA nightmare of trying to change what never really belonged to you. Be proactive in your health and all records involved with your care.

See Fox News clip on You Tube: http://www.youtube.com/watch?v=Pz__DUISB6E&feature=player_embedded

Despite the law stating medical breaches involving more than 500 people must be listed on the Health and Human Services (HHS) breach list, the Identity Theft Resource Center recorded medical breaches which never made the list. Do you know why? The HHS list allows the loophole of “risk of harm” without requiring federal law enforcement verification. One state has reported more than 200 breaches. Most are not included in the Identity Theft Resource Center Breach Report because they did not include sufficient pertinent details regarding the event. Some states now harbor a protected breach list which is not made public at all, or is only accessible by exercising the Freedom of Information Act. Doesn’t this make you wonder why is it all so protected? Read the entire article from the Office of Inadequate Security
http://www.databreaches.net/?p=12436