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Criminal Proceedings

This archive displays posts tagged as involving criminal law proceedings relevant to whistleblowers. You may also be interested in our pages:

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March 2, 2020

The owners and operators of Middlesex Rheumatology in Connecticut, Dr. Crispin Abarientos and his wife Dr. Antonieta Abarientos, have agreed to pay $4.9 million to settle allegations of violating federal and state False Claims Act.  Between 2013 to 2017, the Abarientos allegedly billed Medicaid for an injectable prescription drug called Remicade, which is used to treat rheumatoid arthritis, but then failed to administer the drugs on Medicaid patients.  Instead, they administered them on patients covered by Medicare or the Connecticut State Employees Health Plan, then billed the two providers for the drugs again even though the cost had already been covered by Medicaid.  USAO CT

February 26, 2020

The two owners and operators of Royal Care Pharmacy in Los Angeles have been ordered to pay restitution of $11.8 million to Medicare and $17,000 to Cigna after being found guilty of healthcare fraud and money laundering.  Aleksandr Suri and Maxim Sverdlov were also sentenced to 12 years in prison.  From 2012 to 2015, the two had fraudulently billed Medicare and Cigna for prescription medications that were not purchased or dispensed to beneficiaries, hiding the conspiracy and laundering the proceeds through fake invoices.  DOJ

February 21, 2020

Husam Tayeh of Illinois and his Nevada corporations, Dinar Corps., Inc. and My Monex, Inc., have agreed to pay the CFTC more than $22.6 million in disgorgement and civil monetary penalties after being found liable for violations of the Commodity Exchange Act arising from defendants’ alleged registration violations, misappropriation of investor funds, and fraudulent solicitation of customers to engage in financed retail forex transactions involving Iraqi Dinar and Vietnamese Dong.  To settle a related criminal action, Tayeh has been sentenced to 1 year in prison, ordered to forfeit more than $8 million, and ordered to pay more than $150,000 in restitution to victims.  CFTC

February 11, 2020

Property developer Monique Brady of Rhode Island has been sentenced to 8 years in prison and ordered to pay $4.8 million in restitution for defrauding 23 investors of $10.3 million in a Ponzi scheme that ran from 2014 to 2018.  Brady told investors, many of them her own family, friends, and business associates, that her property rehabilitation business, MNB LLC, had secured contracts to perform large scale rehabilitation work on foreclosed properties in Connecticut, Massachusetts, New Hampshire, and Rhode Island.  To entice investors, Brady promised a 50% return on profits and showed forged emails that purported to show the contracts were valid.  In reality, however, the jobs she was hired to do were menial and paid less than $1,000, and she was using investor funds to finance an extravagant lifestyle.  When she became the subject of a federal investigation, she told investors to delete all records of their investments with her company, then met with federal officials to request that they investigate her investors for usury, before attempting to abscond to Vietnam.  DOJ; USAO RI

February 6, 2020

A patient recruiter in Kentucky has been sentenced to 5 years in prison and ordered to pay or forfeit over $1.2 million in total for accepting more than $1 million in kickbacks from home health agencies in exchange for providing information about Medicare beneficiaries.  The owner of Trumbo Consulting Agency in Virginia, Dominic Trumbo recruited and paid others to recruit over 4,000 Medicare beneficiaries for home health services by offering incentives to get them to sign up.  Trumbo then sold the information to home health agencies around the country in exchange for kickbacks, then created fake contracts and invoices to conceal the fraud from Medicare.  DOJ

February 3, 2020

Senthil Kumar Ramamurthy of Texas has been sentenced to 10 years in prison for participating in two fraud schemes that amounted to $9.6 million in losses by Medicare and TRICARE.  In the first scheme, which ran for 10 months in 2014, Ramamurthy and his co-conspirators were paid millions of dollars by compounding pharmacies to get TRICARE beneficiaries to sign up for medically unnecessary compounded prescription drugs.  To get beneficiaries to sign up, defendants had falsely represented that the drugs would be free, when in fact co-payments were required.  In the second scheme, which ran from 2015 onward, Ramamurthy and his co-conspirators paid doctors to refer Medicare beneficiaries—without first examining them—for needless genetic cancer screening tests.  Many of Ramamurthy's co-conspirators have plead guilty and face sentencing later this month.  USAO SDFL

January 31, 2020

A former financial adviser, Li Lin Hsu, AKA Yilin Hsu Lee, has been sentenced to 11 years in prison and ordered to pay $5.3 million in restitution to the 20 victims of her $8.1 million Ponzi scheme.  Hsu began her scheme in 2014 while employed at Ameriprise Financial, promising victim investors, including her own relatives, that their funds would go toward low risk municipal bonds when in fact they were going toward homes in affluent neighborhoods, a luxury car, a luxury vacation, and luxury goods for Hsu herself. When Ameriprise discovered the misconduct in 2015, Hsu was fired and then barred by FINRA from working in the investment business, but not before she began her own companies, American Trading Group LLC and American Capital Republic, Inc, where she managed to defraud additional investors.  USAO CDCA

Opioid Executive Sentenced to Over Five Years in Prison for Role in Healthcare Fraud Scheme

Posted  01/31/20
opioid pills scattered around
Insys Therapeutics, an opioid manufacturer whose main product is Subsys, a spray from of fentanyl that is 100 times stronger than morphine and cost tens of thousands a month, is in the news again. The company and its former CEO, John Kapoor, have been facing a mountain of legal issues in the past three years. Last week, in a decision that most of our readers agree with, Kapoor was sentenced to 66 months in prison. 

Catch of the Week: Practice Fusion Pays $145 Million for EHR Kickbacks and Misrepresentations about Software

Posted  01/28/20
Healthcare providers talk about the importance of behavioral “nudges” – gentle pushes to encourage healthy choices and positive behaviors. In our Catch of the Week, healthcare providers were nudged to prescribe highly addictive extended-release opioids in a manner that was not consistent with accepted medical standards. Who nudged them? Their own electronic health records system, which was paid to do so by the...

January 27, 2020

Practice Fusion, Inc., a provider of electronic health records systems, will pay $145 million to resolve criminal and civil charges that it accepted unlawful kickbacks from pharmaceutical companies and misrepresented the capabilities of its EHR software.  As part of the settlement, the defendant entered into a deferred prosecution agreement, paying $26 million in criminal fines and forfeitures, agreeing to compliance policies and monitoring, and admitting that it accepted payment from an unnamed opioid manufacturer in exchange for including "clinical decision support" alerts within its EHR system that were designed to increase prescriptions for the pharma company's drugs.  The civil settlement – $119 million for the federal government and up to an additional $5.2 million for states that choose to opt in – resolves the kickback allegations related to the opioid manufacturer and 13 other such arrangements, as well as allegations that Practice Fusion knowingly misrepresented the capabilities of its EHR system in order to secure federal certification for the software and secure eligibility for federal incentive payments for providers adopting its software.  DOJ; USAO VT
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