More Arrests Made Of Perpetrators In Unique Health Care Fraud Cases

The term “health care fraud” is a broad one. As the
 Allegiant Experts Blog has showcased over the past few years, there are many
 different ways to illegally bilk our nation’s health insurance programs out of
 millions of dollars. Many medical professionals have submitted phony bills to
 be compensated for treatments they’ve never performed. Others write fake
 prescriptions in order to attain drugs to sell on the street.

In this week’s blog, we’ll take a look at a couple
 of cases with different spins.

In the case of 60 year-old Rhonda Bernal, committing social security and food stamp fraud was more her speed. As reported by the District of Massachusetts branch of the United States Department of Justice last week, the Fitchburg native was arrested and charged with fraudulently receiving Social Security disability benefits, MassHealth, and Supplemental Nutrition Assistance Program (SNAP) benefits.   

“According to the indictment,” details the DoJ
 report, “over a period of approximately eight years, Bernal stole $71,462 in
 Social Security benefits, $6,444 in MassHealth benefits, and $13,505 in SNAP
 benefits (previously known as Food Stamps). In February 2015, she allegedly
 falsely informed the Massachusetts Department of Transitional Assistance that
 she was the only person in her household when, in fact, she was living with her
 husband.”

Bernal didn’t stop there. The indictment also
 alleges that she falsely told Social Security in April 2016 that she and a
 relative, who was not her husband, were the only members of her household. She
 currently faces up to 10 years in prison as that is the maximum sentence for individuals
 who have stolen public funds. Bernal may also receive a fine of $250,000 or
 twice the gross gain or loss, whichever is greater.

According to the Eastern District of Missouri branch of the United States Department of Justice, the St. Louis-based doctor and his wife were indicted on July 25th on 21 counts of purchasing non-FDA approved medical devices known as Orthovisc. They are pre-filled syringes used to relieve osteoarthritis pain in the knee.

Sneaking in the devices from Canada and England, Dr.
 Naushad did not disclose to his patients that they were receiving non-FDA
 approved treatments. “The couple was also charged with health care fraud
 related to billing for the same devices, when they knew Medicare and Medicaid
 would not reimburse for the non-FDA approved devices,” the DoJ report informs.

As the owners and operators of as much as six
 Missouri-based pain management clinics known as Advanced Pain Center (or APC), Dr.
 Naushad and his wife, Wajiha had already reached an $820,000 civil agreement
 with the United States in 2010. The settlement was to resolve accusations that
 the couple submitted false reimbursement claims to Medicare, Medicaid, and
 TRICARE.

“The claims falsely indicated that a physical
 therapist provided one-on-one services to patients, when they knew the services
 were provided on a machine that was experimental and not covered by federal
 health care programs,” says the DoJ, “If convicted, Dr. Naushad and his wife
 will be excluded from participating in any way with the federal health care
 programs for a minimum of five years.”

Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.

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