POLITICAL TOURIST BILL McCLURE and his mother are currently under investigation for possible "health care fraud, conspiracy to commit health care fraud, Medicaid provider fraud, grand theft, falsifying a death certificate and practicing medicine without a license." See Florida Attorney General's Statewide Prosecutor's General Counsel, Mr. James Schneider June 7, 2018 letter in response to my June 4, 2018 Open Records Request No. 2018-155, stating inter alia that "any information in the custody of the Statewide Prosecutor involving the Medi+MD matter is related to an ongoing criminal investigation which is continuing with a reasonable, good faith anticipation of securing an arrest or prosecution in the forseeable future?
‘Largest health-care fraud’ takedown ever nets 124 in South Florida
U.S. Attorney Jeff Sessions announced today what he called “the largest health-care fraud takedown in history,” with more than 1,000 law enforcement officers charging 601 people — including 76 doctors, 23 pharmacists, 19 nurses — with more than $2 billion in fraud.
The takedown included 124 defendants in South Florida — in locations from Wellington to West Palm Beach to Boca Raton — charged with offenses relating to their participation in various fraud schemes involving over $337 million in false billings for services including home health care and pharmacy fraud.
“These are despicable crimes. We cannot tolerate them. We will not tolerate them,’’ Sessions said. “We are sending a clear message to criminals across county. We will find you. We will bring you to justice. You will pay a very high price for what you have done.’’
The press conferences come a day after federal prosecutors unsealed indictments on Wednesday against two Palm Beach County drug treatment operators. Ken Bailynson, owner of the defunct Good Decisions Sober Living in West Palm Beach, and Eric Snyder, owner of the defunct Real Life Recovery and Halfway There in Delray Beach, both face charges of money laundering and health care fraud.
Six others affiliated with the treatment centers were also indicted, including West Palm Beach psychiatrist Dr. Mark Agresti.
Bailynson has been in custody since his arrest on Wednesday. He is scheduled to appear in federal court on Friday, where a judge will determine whether Bailynson should be released while his case is pending.
Dr. Agresti appeared before a federal magistrate after his arrest on Wednesday. Bond was set at $250,000.
Florida Attorney General Pam Bondi said the nationwide crackdown included the arrests of Stephen Chalker, 42, of Wellington; Christopher Liva, 39, of Boca Raton; and Elaina Liva, 66, of Pompano Beach — all for conspiracy to commit health care fraud.
Chalker is also charged with three counts of health care fraud. According to the indictment, the Livas owned and operated Pop’s Pharmacy, LLC where Chalker worked as a pharmacist. The defendants allegedly submitted false and fraudulent claims to Medicare, TRICARE and Medicaid for compounded drugs and other prescription medications, including expensive pain and scar creams, deemed not medically necessary or never provided. As a result of these false and fraudulent claims, Medicare, TRICARE and Medicaid made payments totaling more than $5 million.
The government is seeking forfeiture of nearly $1.5 million from Chalker and the Livas. The phone number listed for the pharmacy has been disconnected.
Other indictments involving Palm Beach County included two doctors involved Reflections Treatment Center in Margate and Journey to Recovery in Boca Raton. The owner of the two facilities, Kenny Chatman, already is serving a 27-year prison sentence for fraud.
Another defendant connected with Chatman and Reflections Treatment Center is Anthony Jackson of Lantana. The program director was one of Chatman’s top-level employees.
Prosecutors say Jackson was sentenced last week to 3 ½ years in prison and ordered to pay more than $5 million in restitution. After he left Chatman’s establishment, a 26-year-old struggling addictoverdosed and died at Jackson’s Pantherview Sober Home in Boynton Beach.
Dr. Arman Abovyan, 44, and Tina Marie Barbuto, 39, both of Boca Raton, were charged with illegal distribution of controlled substances outside the course of medical practice. The drugs included tranquilizers and amphetamines, prosecutors claim. Barbuto worked as a licensed counselor for the treatment centers.
Lawrence Weisberg, 51, of Boca Raton, was charged with money laundering in connection with proceeds he received from Smart Lab LLC, a clinical lab in Palm Beach Gardens.
Carlos Garcia, 51, of Lake Worth was charged with conspiracy to commit health care fraud and nine counts of health care fraud through American Drugs Pharmacy in Lake Worth and two pharmacies in Miami.
Dr. Kenneth Rivera-Kolb, 66, was charged with a count of conspiracy in connection to his work as medical director of Angel’s Recovery, a treatment facility in Delray Beach.
Prosecutors in May called Angel’s Recovery one of the biggest scams in the county’s illicit sober home industry. The father and daughter –Alan Bostom and Tara Jasperson — who operated the facility were sentenced to 2 ½ and 6 ½ years respectively in federal prison in May and ordered to repay $4 million they pocketed by duping insurance companies.
Rivera-Kolb had his medical license suspended in February 2015, but continued to prescribed drugs at Angel’s Recovery, according to a December 2015 administrative complaint filed with the Florida Department of Health. He wrote 38 suspect prescriptions for tranquilizers and other drugs in a three-month period following his one-year suspension to practice medicine, the complaint stated.
“This is the most fraud, the most defendants, and the most doctors ever charged in a single operation,” Sessions said.
“Some of our most trusted medical professionals look at their patients — vulnerable people suffering from addiction — and they see dollar signs,” he said.
In the Bailynson case, an owner, medical director, and two employees of a sober living facility were charged with conspiracy to commit health care and wire fraud, substantive counts of health care fraud, and substantive counts of money laundering, Sessions said.
The indictment alleges a scheme that illegally recruited patients, paid kickbacks, and defrauded health care benefit programs for widespread fraudulent urine testing. During the course of the fraudulent scheme, the facility submitted more than $106 million in claims for substance abuse treatment services.
The Justice Department also brought charges against medical professionals it said were contributing to the country’s opioid epidemic by participating in the unlawful distribution of prescription painkillers.
In one case, a doctor allegedly distributed 2.2 million unnecessary doses of drugs like oxycodone and fentanyl, allegedly defrauding Medicare of more than $112 million, Sessions said.
“Health care fraud is a betrayal of vulnerable patients, and often it is theft from the taxpayer,” Sessions said. “In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets.”
“It takes a special kind of person to prey on the sick and vulnerable as happened in many of these health care fraud schemes,” said Deputy Chief Eric Hylton.
According to the CDC, approximately 115 Americans die every day of an opioid-related overdose. In 2016, 42,000 people in the United States died from opioid overdoses.
“The perpetrators really are despicable and greedy people,” U.S. Health and Human Services Secretary Alex Azar said.
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