May 29: Week That Was in Healthcare Fraud and Malpractice
By - Here is a general roundup of the past week’s developments in healthcare fraud and malpractice, as reported by the Department of Justice and the Office of Inspector General. The crimes reported below result in multiple millions of dollars in healthcare fraud and the possibility of extensive prison time.
Psychologist claims she provided services to the deceased
Licensed psychologist Sharon A. Rinaldi pled guilty this week for involvement in a healthcare Medicare fraud scheme. Rinaldi was charged with defrauding Medicare by submitting thousands of false claims to Medicare beneficiaries in Chicago-based skilled nursing homes. Rinaldi received nearly $450,000 in funds via false claim submission to Medicare.
Rinaldi alleged she provided medical services to Medicare beneficiaries who were deceased before recorded points of service. She also alleged she provided services on days when she was found to actually be in an entirely different state, such as Nevada or California. According to documentation, Rinaldi claimed she provided services that exceeded 24 hours within a single day.
Rinaldi concurred to forfeit $100,000 seized from her home and a personal bank account.
$3.3M billed to Medicare for costly, unneeded medical equipment
Hakop Gambaryan, the former owner of a California-based medical supply company was sentenced this week to seven years in jail for involvement in a $3.3 million Medicare fraud scheme. Gambaryan, convicted of 4 counts of healthcare fraud, will pay over $1.7 million in restitution.
According to evidence presented within a trial, Gambaryan billed Medicare for $3.3 million for durable medical equipment that was considered medically unnecessary. Such equipment included costly power wheelchairs. Additionally, Gambaryan paid cash kickbacks to medical clinics for medically unnecessary fraudulent prescriptions. Gambaryan used these prescriptions to bill Medicare for the power wheelchairs and other unneeded equipment.
Gambaryan made strong efforts to make sure beneficiaries received their power wheelchairs. According to evidence within the trial, Gambaryan personally delivered power wheelchairs to beneficiaries unable to walk independently, carried a power wheelchair up a flight of stairs for a woman residing in a second floor apartment sans elevator, and left a power wheelchair in a beneficiary’s garage after it was determined it was too large to fit inside his or her home.
According to evidence, Gambaryan made hundreds of photocopies of beneficiaries’ signatures to fraudulently maintain their ongoing consent to continuous equipment rentals. At least 2 of the beneficiaries’ signatures involved patients who had passed away prior to their alleged signing of the documentation. Gambaryan additionally fabricated other documentation means, including fake home assessments.
12-count indictment in $2.4M Medicare and Medicaid scheme
Walter Beich, owner and licensed pharmacist at Lockport Pharmacy, Inc (Corwin Pharmacy) in Illinois, was charged this week in a 12-count indictment for falsely billing millions of dollars worth of prescription claims.
Beich was charged via the indictment with identity theft for using both patient and physician names throughout his scheme. Beich additionally filed fraudulent claims for prescription drugs. These were not dispensed to customers. Some FDA-approved prescription drugs were switched for cheaper supplements. Fake prescriptions were also created. The indictment additionally alleges Beich replaced Viagra prescriptions with foreign-sourced drugs.
