As the Allegiant Experts Blog has made pretty clear over the past several months, there are far too many instances of health insurance fraud taking place in the United States. And while we’re not necessarily saying that last month set a record for fraud cases, September was a month when we were inundated with news stories about occurrences of Medicaid fraud. Needless to say, scam artists in the medical world continue to run rampant from coast to coast in this great nation of ours.
From Nevada: Dave Maxwell of Lincoln County Record reports that Dr. Adam Katschke of Meadow Valley Pharmacy pled guilty to one count of insurance fraud and one count of submitting false Medicaid claims last month. Katschke agreed to pay $1.5 million in restitution and $100,000 in investigative costs related to his Class D felonies. In a written statement, the disgraced pharmacy owner admitted to presenting false statements to Medicaid.
Katschke writes that he “knowingly, willfully and unlawfully” made insurance claims for payments and other benefits that omitted facts and contained false information. Maxwell notes that Katschke is expected to be sentenced in January to up to four years in prison by the Nevada State Department of Corrections. He is also likely to pay a fine of $5,000 for each count.
From Wisconsin: Frank Schultz of GazetteXtra reports that Janesville pharmacist, Mark Johnson has taken a different route for his 46-count federal indictment in the U.S. court for Wisconsin’s Western District. He’s pleading not guilty to his charges of Medicare and Medicaid fraud stemming from his tenure running Kealey Pharmacy. The 55 year-old, Johnson is being accused of defrauding the government of $1 million.
Apparently, he was submitting false prescription orders for reimbursement using two doctors’ Drug Enforcement Agency numbers. Johnson, however, isn’t going down without a fight. His lawyer is seeking “discovery”, which represents a request to see the prosecution’s evidence. Schultz reveals that with the amount of work necessary for each legal team to do, a trial date won’t likely be set until April or May 2017.
From New York: Will Cleveland of Democrat & Chronicle reports that three Monroe County women conspired in a scheme to defraud Medicaid of over $6,000. The trio, made up of Sarah Merlau, her daughter, Rachael Merlau and their family friend, Toya Torraance submitted false time sheets for care that was never provided to a Medicaid recipient.
“Sarah and Rachael Merlau were each charged with first-degree falsifying business records,” explains Cleveland, “Rachael Merlau was also charged with third-degree grand larceny and first-degree offering a false instrument for filing. Torrance was charged with fourth-degree grand larceny and first-degree false instrument for filing. They were all arraigned in Rochester City Court.”
The number of health insurance fraud cases in the United States is alarming, isn’t it? This is why, at Allegiant Experts, our team of clinical experts is committed to assisting attorneys with their litigations against those who commit health insurance fraud. For more information about our experience, expertise and how we may be able help your case, please don’t hesitate to contact us at 407-217-5831.