Owner of Doraville Medical Clinic Indicted for Health Care Fraud
Atlanta Hope Medical Group Billed Medicare for Doctor Services Never Performed
U.S. Attorney’s Office January 18, 2012

Northern District of Georgia (404) 581-6000

ATLANTA—DAVID SONG SEN CUI, 43, of Duluth, Georgia, has been indicted by a federal grand jury on charges of health care fraud.

United States Attorney Sally Quillian Yates said of the case, “Medicare dollars provide critical medical services for elderly and disabled persons. This defendant is charged with defrauding Medicare by repeatedly billing for ‘physical therapy’ that in truth was only massages given by unlicensed massage therapists. Medicare and our taxpayers cannot afford such criminal abuse of health care dollars.”

Brian D. Lamkin, Special Agent in Charge, FBI Atlanta Field Office, said, “The FBI, in conjunction with its various law enforcement partners, is committed to the protection of such federally funded programs. Individuals engaged in such fraudulent acts, as is alleged in this indictment, demonstrate a lack of compassion and greed that simply cannot and will not be tolerated. The FBI urges anyone with information regarding healthcare fraud activity to contact its nearest FBI field office.”

According to United States Attorney Yates, the charges, and other information presented in court: From November 2008 through August 2011, CUI operated the Atlanta Hope Medical Group, Inc., a clinic located in Doraville, Georgia. The clinic purported to provide physical therapy services for elderly patients. However, the clinic actually offered massage services, which were performed by unlicensed massage therapists. CUI allegedly billed the massages fraudulently to Medicare as “physical therapy” under a doctor’s name who did not render the services and was not even present at the clinic. As part of the scheme, Atlanta Hope employed a doctor who was present at the clinic only two days a week. The indictment alleges that, during the operation of the clinic, CUI fraudulently billed over $5.5 million in false claims to Medicare.

The indictment charges 11 counts of health care fraud. Each count carries a maximum sentence of 10 years in prison and a fine of up to $250,000. In determining the actual sentence, the court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.

Members of the public are reminded that the indictment contains only allegations. A defendant is presumed innocent of the charges and it will be the government’s burden to prove a defendant’s guilt beyond a reasonable doubt at trial.

This case is being investigated by special agents of the Federal Bureau of Investigation.

Assistant United States Attorney Shanya J. Dingle is prosecuting the case.

For further information, please contact Sally Q. Yates, United States Attorney, or Charysse L. Alexander, Executive Assistant United States Attorney, through Patrick Crosby, Public Affairs Officer, U.S. Attorney’s Office, at (404) 581-6016. The Internet address for the HomePage for the U.S. Attorney’s Office for the Northern District of Georgia is www.justice.gov/usao/gan.

Ending your profile on FaceBook and the further threats of Identity Theft is not as easy as it sounds…read article by Ki Mae Heussner at http://www.whas11.com/home/Quitting-Facebook-What-happens-when-you-deactivate-93412359.html … and discover the nuances and time frames. Don’t lose your identity this Holiday Season while reconnecting on FaceBook with friends and loved ones.

It is tax time again and the IRS wants taxpayers to be protected against identity theft, and has provided 10 safety tips to help people avoid this crime. Here’s what the IRS wants you to know:
1. If you receive a letter or notice from the IRS which leads you to believe someone may have fraudulently used your Social Security Number, respond immediately to the name and address or phone number printed on the IRS notice.
2. If you receive a letter from the IRS that indicates more than one tax return was filed for you, this may be a sign that your SSN was used fraudulently.
3. Another sign that you may be the target of identity theft is an IRS letter indicating you received wages from an employer unknown to you.
4. The IRS has a department which deals specifically with identity theft issues. The IRS Identity Protection Specialized Unit is available if you have been in contact with the IRS about an identity theft issue and have not achieved a resolution.
5. You can contact the IRS Identity Protection Specialized Unit by calling the Identity Theft Hotline at 800-908-4490 Monday through Friday from 8:00 am to 8:00 pm local time (Alaska and Hawaii follow Pacific Standard Time).
6. The IRS Identity Protection Specialized Unit is also available if you believe your identity may be at risk of being stolen due to a lost or stolen purse or wallet or due to questionable activity on your credit card or your credit report.
7. The IRS never initiates communication with taxpayers about their tax account through emails. If you receive an e-mail or find a Web site you think is pretending to be the IRS, forward the e-mail or Web site URL to the IRS at phishing@irs.gov.
8. The IRS has many more resources available to help inform taxpayers about identity theft on the IRS Web site at IRS.gov. On IRS.gov you can access information on how to report scams and bogus IRS Web sites. You can also visit the IRS Identity Theft Resource Page, which you can find by typing Identity Theft Resource Page in the search box on the IRS.gov home page.
9. The Federal Trade Commission is also available to assist taxpayers with identity theft issues. You can reach them at 877-ID-THEFT (877-438-4338).
10. Visit OnGuardOnline.gov for protection tips from the federal government and the technology industry.

Department of Justice Press Release

For Immediate Release
March 29, 2011 U.S. Department of Justice
Office of Public Affairs
(202) 514-2007/TDD (202) 514-1888

Los Angeles Woman Pleads Guilty to Participating in a Medicare Fraud Scheme Using Fraudulent Medical Clinics and Stolen Doctor Identities to Defraud Medicare of More Than $6.2 Million

WASHINGTON—A Los Angeles woman has pleaded guilty to using fraudulent medical clinics and the stolen identities of physicians to defraud Medicare of more than $6.2 million, the Departments of Justice and Health and Human Services (HHS) announced.

Carolyn Ann Vasquez, 46, pleaded guilty yesterday before U.S. District Judge Terry J. Hatter Jr. in the Central District of California. Vasquez admitted that from 2007 to 2008, she conspired with others to use a series of fraudulent Los Angeles-area medical clinics to defraud Medicare. Vasquez admitted that her co-conspirators used the identities and Medicare provider numbers of physicians who both worked and did not work at the clinics to submit false claims to Medicare for reimbursement for services the physicians did not perform and for power wheelchairs, medical equipment and diagnostic tests that the physicians did not order or prescribe. According to court documents, physician assistants recruited to work at the clinics by Vasquez and working at her direction performed these services and prescribed and ordered the wheelchairs, medical equipment, and diagnostic tests.

According to court documents, Vasquez told the physicians she recruited that they would be the medical directors of the clinics, but that if they did not want to work full time, the clinics would hire physician assistants. Vasquez assisted the physicians in obtaining Medicare provider numbers and entering into management agreements that gave Vasquez’s co-conspirators authority to operate and manage the clinics in exchange for 75 percent of the reimbursement payments the physicians received from Medicare.

According to court documents, Vasquez’s involvement in the recruitment of the physicians gave her access to their personal and Medicare information, which Vasquez stole to further the fraud scheme at the medical clinics. Vasquez admitted that in approximately 2007, a physician contacted her about a job at one of the fraudulent medical clinics, but the physician decided not to accept the job. Nevertheless, Vasquez’s co-conspirators printed prescription pads with the physician’s name and Medicare provider number on them. Vasquez admitted that she instructed a physician assistant working at one of the fraudulent medical clinics to use the prescription pads to write fraudulent prescriptions and medical documentation for diagnostic tests, power wheelchairs and other medical equipment in the physician’s name even through Vasquez knew that the physician did not work at the clinic. Vasquez admitted that as a result of her conduct, Medicare was defrauded of approximately $6,268,899.

At sentencing, scheduled for July 11, 2011, Vasquez faces a maximum penalty of 10 years in prison and a $250,000 fine.

According to information contained in court documents in this case, Vasquez pleaded guilty in 1993 to participating in a health care fraud scheme. According to court documents, Vasquez and others used telemarketing or “boiler room” schemes to defraud government-funded health care benefit programs of approximately $41 million.

The guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney André Birotte Jr. for the Central District of California; Tony Sidley, Assistant Chief of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse; Glenn R. Ferry, Special Agent-in-Charge for the Los Angeles Region of the HHS Office of Inspector General (HHS-OIG); and Steven Martinez, Assistant Director in Charge of the FBI’s Los Angeles Field Office.

The case is being prosecuted by Trial Attorney Jonathan T. Baum of the Criminal Division’s Fraud Section. Former Special Trial Attorney Joseph Hudzik participated in the prosecution. The case is being investigated by the FBI.

The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Since their inception in March 2007, strike force operations in nine districts have charged 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 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.

To learn more about HEAT, go to: www.stopmedicarefraud.gov.

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Beware as more people see desperate times and the cost of healthcare rises. Watch this quick video and take head of their advice:  

Check out this channel 3 broadcast on electronic pickpocketing. Not only your credit card information but even your passport:  

The thieves are always ready to take your money or your identity. Thinking gift card? Trying the auction websites? The FBI this year has posted the top ways to prevent the various types of scams from happening to you or your family or your business: http://www.fbi.gov/news/pressrel/press-releases/escams_112410
For more information on e-scams, including take over of financial accounts of small to medium size businesses visit the FBI’s E-Scams and Warnings web page: www.fbi.gov/scams-safety/e-scams

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

Thieves are always looking for an easy way to steal your identity. Credit card monitoring companies are great if someone steals your information and tries to open an account. But what if you already have an account in place. You are receiving your new card in the mail. The thief steals the new card and activates it. Your account exists. She or he can go out and begin charging that day.
Now consider a locking mailbox. Safe, secure, and no one can reach in, to take your mail. Read this special report and rethink about reasons why you should have a locking mail box. http://www.mailcase.com/american-express. Don’t get caught up in the scam for loosing your credit cards.

More worries about the security of patient information and private medical data with the onset of Electronic Healthcare Records. Read the article available at:

http://www.healthcareitnews.com/news/survey-personal-health-information-less-secure-2010