Department of Justice
Office of Public Affairs Press Release

WASHINGTON – Ninety-four people have been charged for their alleged participation in schemes to collectively submit more than $251 million in false claims to the Medicare program in the continuing operation of the Medicare Fraud Strike Force in Miami; Baton Rouge, La.; Brooklyn, N.Y.; Detroit and Houston, announced Attorney General Eric Holder, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, FBI Director Robert Mueller and Daniel R. Levinson, Inspector General of HHS. The operation announced today is the largest federal health care fraud takedown since Medicare Fraud Strike Force operations began in 2007.

The joint DOJ-HHS Medicare Fraud Strike Force is a multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. More than 360 law enforcement agents from the FBI, HHS-Office of Inspector General (HHS-OIG), multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in today’s operation.

“Our continued Strike Force operations reflect the unprecedented commitment that inspired the creation of the Health Care Fraud Prevention and Enforcement Action Team in May 2009,” said Attorney General Holder. “With today’s arrests, we’re putting would-be criminals on notice: Health care fraud is no longer a safe bet. The federal government is working aggressively – and collaboratively – to pursue health care criminals around the country and to bring these offenders to justice.”

“Today’s arrests send a strong message that attempts to defraud Medicare will not be tolerated,” said Secretary Sebelius. “With the help of new tools in the Affordable Care Act, including stiffer penalties and better information sharing, we will continue to work with our federal, state and local partners to stamp out Medicare fraud and protect beneficiaries and the American taxpayer.”

Charges were unsealed today against 94 individuals who are accused of various Medicare fraud-related offenses, including conspiracy to defraud the Medicare program, criminal false claims, violations of the anti-kickback statutes and money laundering. The charges are based on a variety of fraud schemes, including physical therapy and occupational therapy schemes, home health care schemes, HIV infusion fraud schemes and durable medical equipment (DME) schemes. Thirty-six defendants charged in these schemes have been arrested in Miami, New York, Baton Rouge and Detroit and additional arrests are expected throughout the day.

According to the court documents, the defendants charged today participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes, never provided. In many cases, indictments and complaints allege that beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the treatments that, in reality, were unnecessary or never provided. Collectively, the doctors, health care company owners, executives and others charged in the indictments and complaints are accused of conspiring to submit more than $251 million in false claims to the Medicare program.

In Miami, 24 defendants were charged for allegedly participating in various fraud schemes that led to approximately $103 million in false billings. According to court documents, the fraud schemes involved fraudulent billing for HIV infusion services, home health care and physical therapy services, DME and pharmaceutical medications. The defendants include owners and operators of companies, doctors, nurses, and patient recruiters, as well as a medical biller who is alleged to have billed approximately $49 million for fraudulent services.

Thirty-one defendants were charged in Baton Rouge for various schemes allegedly involving fraudulent claims for DME totaling approximately $32 million. The defendants include the owners and operators of nine different purported medical services companies and four doctors, 14 patient recruiters and other individuals who allegedly worked at the medical services companies.

Twenty-two defendants were charged in Brooklyn for their alleged participation in schemes to submit fraudulent claims totaling approximately $78 million. These fraud schemes involved false billing for physical and occupational therapy and DME. The defendants include the owners and operators, patient recruiters and employees at three different purported medical clinics and a medical equipment company, as well as three doctors. According to court documents, six of the defendants charged are serial Medicare beneficiaries, who purported to seek medical treatment from numerous providers, causing the submission of multiple claims to Medicare for purported medical treatments.

In Detroit, 11 defendants were charged for their alleged roles in schemes to submit fraudulent claims to Medicare for home health services, nerve conduction tests and injection and infusion therapy sessions. The schemes involved a total alleged fraud of approximately $35 million and five different purported medical services companies.

Four defendants were also charged in Houston for their alleged roles in a $3 million scheme to submit fraudulent claims for DME.

In addition to making arrests around the country, law enforcement agents are executing search warrants in connection with ongoing health care fraud investigations.

“Today’s charges allege attempts by individuals to defraud the Medicare program of $251 million,” said FBI Director Robert S. Mueller, III. “Countless Americans rely on Medicare for their well-being, and the FBI, working in conjunction with our federal agency partners, is resolute in its commitment to stop those who would illegally manipulate the system.”

“Today’s arrests illustrate how health care fraud schemes can replicate virally and migrate rapidly across communities,” said Daniel R. Levinson, Inspector General of HHS. “To combat this fraud, the government’s response must also be swift, agile, and organized – a HEAT initiative goal which is well illustrated by today’s Strike Force actions.”

The Strike Force operations in Miami, Baton Rouge, Brooklyn, Detroit and Houston 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. The HEAT task force, co-chaired by Acting Deputy Attorney General Gary G. Grindler and Deputy Secretary Bill Corr, is made up of top-level law enforcement agents, prosecutors and staff from both departments and their operating divisions. In the May 2009 announcement, Attorney General Holder and Secretary Sebelius announced the expansion of the Strike Force into Detroit and Houston to build upon existing partnerships between the agencies in a heightened effort to reduce fraud and recover taxpayer dollars. In December 2009, Strike Force operations were expanded to Brooklyn, Baton Rouge and Tampa.

Since its inception in March 2007 with Phase One in South Florida and continuing through its most recent expansion into Tampa, Fla., the Strike Force has obtained indictments of more than 810 individuals and organizations that collectively have billed the Medicare program for more than $1.85 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.

The cases announced today are being prosecuted and investigated by Strike Force teams comprised of attorneys from the Fraud Section in the Justice Department’s Criminal Division and from the U.S. Attorneys’ Offices for the Southern District of Florida, the Eastern District of New York, the Middle District of Louisiana, the Eastern District of Michigan and the Southern District of Texas; and agents from the FBI and HHS-OIG.

The Railroad Retirement Board Office of Inspector General and the Office of Personnel Management-Office of Inspector General also participated in today’s operation.

An indictment is merely an allegation, and defendants are presumed innocent until and unless proven guilty.

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

U.S. Department of Justice June 22, 2011

Office of Public Affairs (202) 514-2007/TDD (202) 514-1888

WASHINGTON—Today the Department of Justice and the FBI, along with international law enforcement partners, announced the indictment of two individuals from Latvia and the seizure of more than 40 computers, servers and bank accounts as part of Operation Trident Tribunal, an ongoing, coordinated enforcement action targeting international cyber crime. The operation targeted international cyber crime rings that caused more than $74 million in total losses to more than one million computer users through the sale of fraudulent computer security software known as “scareware.”

Scareware is malicious software that poses as legitimate computer security software and purports to detect a variety of threats on the affected computer that do not actually exist. Users are then informed they must purchase what they are told is anti-virus software in order to repair their computers. The users are then barraged with aggressive and disruptive notifications until they supply their credit card number and pay for the worthless “anti-virus” product. The product is, in fact, fake.

Warrants obtained from the U.S. District Court for the Western District of Washington and elsewhere throughout the United States led to the seizure of 22 computers and servers in the United States that were involved in facilitating and operating a scareware scheme. In addition, 25 computers and servers located abroad were taken down as part of the operation, including equipment in the Netherlands, Latvia, Germany, France, Lithuania, Sweden and the United Kingdom.

The first of the international criminal groups disrupted by Operation Trident Tribunal infected hundreds of thousands of computers with scareware and sold more than $72 million of the fake antivirus product over a period of three years. The scareware scheme used a variety of ruses to trick consumers into infecting their computers with the malicious scareware products, including web pages featuring fake computer scans. Once the scareware was downloaded, victims were notified that their computers were infected with a range of malicious software, such as viruses and Trojans and badgered into purchasing the fake antivirus software to resolve the non-existent problem at a cost of up to $129. An estimated 960,000 users were victimized by this scareware scheme, leading to $72 million in actual losses. Latvian authorities also executed seizure warrants for at least five bank accounts that were alleged to have been used to funnel profits to the scam’s leadership.

A second international crime ring disrupted by Operation Trident Tribunal relied on online advertising to spread its scareware products, a tactic known as “malvertising.” An indictment unsealed today in U.S. District Court in Minneapolis charges the two operators of this scareware scheme with two counts of wire fraud, one count of conspiracy to commit wire fraud and computer fraud. The defendants, Peteris Sahurovs, 22, and Marina Maslobojeva, 23, were arrested yesterday in Rezekne, Latvia on the charges out of the District of Minnesota. According to the indictment, the defendants created a phony advertising agency and claimed that they represented a hotel chain that wanted to purchase online advertising space on the Minneapolis Star Tribune’s news website, startribune.com. The defendants provided an electronic version of the advertisement for the hotel chain to the Star Tribune, and technical staff at startribune.com tested the advertising and found it to operate normally.

According to court documents, after the advertisement began running on the website, the defendants changed the computer code in the ad so that the computers of visitors to the startribune.com were infected with a malicious software program that launched scareware on their systems. The scareware caused users’ computers to “freeze up” and then generate a series of pop-up warnings in an attempt to trick users into purchasing purported “antivirus” software, which was in fact fake. Users’ computers “unfroze” if the users paid the defendants for the fake antivirus software, but the malicious software remained hidden on their computers. Users who failed to purchase the fake antivirus software found that all information, data and files stored on the computer became inaccessible. The scam allegedly led to at least $2 million in losses. If convicted, the defendants face penalties of up to 20 years in prison and fines of up to $250,000 on the wire fraud and conspiracy charges, and up to 10 years in prison and fines of up to $250,000 on the computer fraud charge. The defendants also face restitution and forfeiture of their illegal profits. An indictment is merely a charge and defendants are presumed innocent until proven guilty.

“Today’s operation targets cybercrime rings that stole millions of dollars from unsuspecting computer users,” said Assistant Attorney General Lanny A. Breuer of the Criminal Division. “These criminal enterprises infected the computers of innocent victims with malicious scareware, and then duped them into purchasing fake anti-virus software. Cyber crime is profitable, and can prey upon American consumers and companies from nearly any corner of the globe. We will continue to be aggressive and innovative in our approach to combating this international threat. At the same time, computer users must be vigilant in educating themselves about cyber security and taking the appropriate steps to prevent dangerous and costly intrusions.”

“This case shows that strong national and global partners can ensure there is no sanctuary for cyber-crooks,” said U.S. Attorney Jenny A. Durkan of the Western District of Washington. “We will continue to work with the public and the computer industry, to fortify our cyber defenses. A combination of safe on-line habits and smart technology will help reduce the threat posed by these organized criminal groups.”

“The global reach of the Internet makes every computer user in the world a potential victim of cyber crime,” said U.S. Attorney B. Todd Jones of the District of Minnesota. “Addressing cybercrime requires international cooperation; and in this case, the FBI, collaborating with our international law enforcement and prosecution partners, have worked tirelessly to disrupt two significant cybercriminal networks. Their efforts demonstrate that no matter the country, Internet criminals will be pursued, caught and prosecuted.”

Assistant Director Gordon M. Snow of the FBI’s Cyber Division said, “Scareware is just another tactic that cyber criminals are using to take money from citizens and businesses around the world. This operation targeted a sophisticated business enterprise that had the capacity to steal millions. Cyber threats are a global problem, and no single country working alone can be effective against these crimes. The FBI thanks the participating foreign law enforcement agencies for their ongoing partnership and commitment in disrupting this threat.”

Operation Trident Tribunal was conducted by the FBI’s Cyber Division, Seattle Field Office and Minneapolis Field Office; the Computer Crime and Intellectual Property Section and the Asset Forfeiture and Money Laundering Section of the Justice Department’s Criminal Division; the U.S. Attorney’s Office for the District of Minnesota; and the U.S. Attorney’s Office for the Western District of Washington. Operation Trident Tribunal was the result of significant international cooperation and substantial assistance from the Criminal Division’s Office of International Affairs. Multiple foreign law enforcement partners provided invaluable assistance in this operation, including the Cyprus National Police in cooperation with its Unit for Combating Money Laundering (MOKAS); German Federal Criminal Police (BKA); Latvian State Police; Security Service of Ukraine; Lithuanian Criminal Police Bureau; French Police Judiciare; the Netherlands’ National High-Tech Crime Unit; the Cyber Unit of the Swedish National Police; London Metropolitan Police; Romania’s Directorate for Combating Organized Crime; and the Royal Canadian Mounted Police.

To avoid falling victim to a scareware scheme, computer users should avoid purchasing computer security products that use unsolicited “free computer scans” to sell their products. It is also important for users to protect their computers by maintaining an updated operating system and using legitimate, up-to-date antivirus software, which can detect and remove fraudulent scareware products.

Additional tips on how to spot a scareware scam include:

Scareware advertising is difficult to dismiss. Scareware purveyors employ aggressive techniques and badger users with pop-up messages into purchasing their products. These fake alerts are often difficult to close and quickly reappear.
Fake anti-virus products are designed to appear legitimate, and can use names such as Virus Shield, Antivirus or VirusRemover. Only install software from trusted sources that you seek out. Internet service providers often make name-brand anti-virus products available to their customers for free.
Become familiar with the brand, look and functionality of the legitimate anti-virus software that is installed on your computer. This will assist you in identifying scareware.

Computer users who think they have been victimized by scareware should file a complaint with the FBI’s Internet Crime Complaint Center, www.ic3.gov.

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.

Press Releases | Los Angeles Home

Department of Justice Press Release

For Immediate Release
January 18, 2011 United States Attorney’s Office
Northern District of Ohio
Contact: (216) 622-3600

Inmate Who Ran a Quarter-Million-Dollar Identity Theft Ring from Inside Federal Prison Receives an Additional 14.5 Years in Prison

The man who led an identity-theft ring that ran up a quarter-million dollars worth of charges from inside a federal prison was sentenced to more than 14 years in prison, Steven M. Dettelbach, United States Attorney for the Northern District of Ohio, announced today.

“The defendant thought he found a way to occupy his time in prison,” Dettelbach said. “With this prosecution and this sentence, he’ll have lots more time to learn to follow the rules.”

Dimorio McDowell, age 34, of Atlanta, Georgia, previously pled guilty to aggravated identity theft and conspiracy to commit wire fraud and bank fraud. McDowell was an inmate at Fort Dix Federal Correctional Institution at the time of the scheme, which took place between August 2009 and April 2010. U.S. District Judge Donald Nugent ordered McDowell’s 174-month sentence on this case begin in 2014, when he completes the current sentence that resulted in his incarceration at Fort Dix.

McDowell was the ringleader who obtained personal information on people who had credit card accounts at various retailers, including Best Buy, Home Depot, J.C. Penney, Lowe’s, Macy’s, Nordstrom’s, Saks Fifth Avenue, Sears and Staples, according to court documents.

McDowell contacted the retailers and impersonated the true account holders, store employees, or corporate fraud investigators. He used information about the account holders, such as name, address, or Social Security number during those calls to obtain additional information about them and adding co-conspirators names as authorized users of the accounts, thus taking over the accounts, according to court documents.

After taking over the accounts, adding additional users to the accounts and opening new accounts, McDowell communicated with his co-conspirators, all of whom lived in the Cleveland area.

McDowell continued to run his scheme from prison even after he was charged and after he pled guilty. He also posed as a deputy U.S. Marshal over the telephone and attempted to have prisoners moved, according to information presented during the sentencing hearing.

Overall, the ring purchased more than $254,000 worth of merchandise as part of their scheme, according to court documents.

Also charged in the case are: Andre Reese, 37; Jeffery McClain, 39; Kevin McBride, 34; Michael Sailes, 51; Edwin Peavy, 52; Daniel Ashford, 37; James L. Wiggins, 47, and Jay Williams, 27, all of Cleveland, Ohio. All have entered guilty plea to charges against them.

This prosecution is the result of cooperation from a number of law enforcement agencies who identified the defendants, gathered the evidence and prepared the case for prosecution. The investigative team included the Federal Bureau of Investigation’s Cleveland Division and Trenton Resident Agency, the U.S. Bureau of Prisons, the Postal Inspection Service, Bath Township Police Department, Stow Police Department, Mentor Police Department and other state and local law enforcement agencies. The case was prosecuted by Assistant U.S. Attorney Matthew B. Kall.

“This case is a stark reminder about the need to protect yourself from identity theft and fraud,” Dettelbach said. “I want to thank the FBI, the Bureau of Prisons and all our partners who made prosecuting this case possible.”

Press Releases | Cleveland Home

Alabama, Florida, Indiana, Michigan, Minnesota, New York and South Carolina–will pay a combined $9.4 million to settle a whistleblower suit by two former employees of the company responsible for the therapy–Kyphon, Inc., and now part of Medtronic Spine LLC. The Department of Justice announced the hospitals were accused of keeping patients overnight after having kyphoplasty, typically an outpatient back procedure, merely so that they could bill Medicare at a higher rate.
Read entire article from Fierce Healthcare at: http://www.fiercehealthcare.com/story/nine-hospitals-pay-9-4-million-medicare-fraud-settlements/2010-05-18?utm_medium=nl&utm_source=internal

Earlier this year, HHS and the Department of Justice created a new Health Care Fraud Preventing and Enforcement Action Team (HEAT). The program expands existing DOJ-HHS Medicare Fraud Strike Force teams that focus on data analysis to track fraud. Also new is a requirement that DME suppliers except pharmacies be certified by CMS in order to reduce fraud.

The OIG has also launched an online consumer program, http://www.StopMedicareFraud.gov/, to combat medical identity theft. The website and printed materials offer tips on how to recognize medical identity theft and what to do if it happens. Common scams include offering free services, groceries, transportation, or other items in exchange for Medicare numbers, as well as telephone surveyors or marketers who ask for Medicare numbers as an identifier.

Depart of Justice is making Health Care Fraud a top priority with settlements and judgments added up to $1.6 billion, $867 million of which came from settlements with the pharmaceutical and medical device industries.
Read more at Fierce Healthcare Daily News: http://www.fiercehealthcare.com/story/false-claims-prosecutions-focused-healthcare/2009-12-14?utm_medium=nl&utm_source=internal