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New York Anesthesiologist Indicted for Alleged Role in Telemedicine Health Care Fraud Conspiracy


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Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Tuesday, July 9, 2019

New York Anesthesiologist Indicted for Alleged Role in Telemedicine Health Care Fraud Conspiracy

A New York anesthesiologist was arraigned today on an indictment charging her for her role in an alleged telemedicine conspiracy to submit fraudulent claims to Medicare, Medicare Part D plans and private insurance plans.  

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Richard P. Donoghue of the Eastern District of New York, Assistant Director in Charge William F. Sweeney Jr. of the FBI’s New York Field Office and Special Agent in Charge Scott J. Lampert of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Office of Investigations made the announcement.

Anna Steiner, also known as “Hanna Wasielewska,” 63, of Valatie, New York, was charged in an indictment filed in the Eastern District of New York with one count of conspiracy to commit health care fraud.  Steiner was previously arrested on a complaint in April 2019.

According to the indictment, starting in approximately January 2015, Steiner participated in a health care fraud scheme in which she and others ordered and prescribed durable medical equipment (DME) and prescription drugs in connection with purported telemedicine services.  As alleged in the indictment, however, Steiner and other providers signed prescriptions and order forms for DME and drugs that were not medically necessary and that were induced by kickbacks, and provided for beneficiaries whom Steiner and others had not examined and evaluated.  Steiner, together with others, allegedly submitted or caused the submission of more than $7 million in claims to Medicare for DME on behalf of more than 3,000 beneficiaries; Medicare paid more than $3 million on those claims.

An indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. 

This case was investigated by the FBI and HHS-OIG.  Trial Attorney Andrew Estes of the Criminal Division’s Fraud Section is prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.




Department of Justice
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Tuesday, June 25, 2019

New Jersey/Pennsylvania Doctor Indicted For Accepting Bribes And Kickbacks From A Pharmaceutical Company In Exchange For Prescribing Powerful Fentanyl Drug

A doctor who practiced in New Jersey and Pennsylvania was charged in an indictment unsealed today for his alleged participation in a scheme to receive bribes and kickbacks from a pharmaceutical company in exchange for prescribing large volumes of a powerful fentanyl narcotic.

Assistant Attorney Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Craig Carpenito of the District of New Jersey, Special Agent in Charge Gregory W. Ehrie of the FBI’s Newark Field Office, Special Agent in Charge Scott J. Lampert of the  U.S. Department of Health and Human Services Office of the Inspector General’s (HHS-OIG) Office of Investigations—New York Region and Special Agent in Charge Susan A. Gibson of the Drug Enforcement Administration’s (DEA) New Jersey Division made the announcement.

Kenneth Sun, M.D., 58, of Easton, Pennsylvania, was charged with one count of conspiracy to defraud the United States and to pay and receive health care kickbacks and four counts of receiving health care kickbacks.  Sun was arrested this morning and appeared this afternoon before U.S. Magistrate Judge Leda Dunn Wettre of the District of New Jersey.  A trial date has not been set.

According to the indictment, Sun owned and maintained a pain management medical practice named Progressive Pain Solutions LLC, which had two locations:  one in Phillipsburg, New Jersey, the other in Wind Gap, Pennsylvania.  The indictment alleges that Sun solicited and received more than $140,000 in bribes and kickbacks from Insys Therapeutics, a pharmaceutical company based in Arizona, in exchange for prescribing more than 28 million micrograms of Subsys, a powerful opioid narcotic designed to rapidly enter a patient’s bloodstream upon being sprayed under the tongue.  Subsys, which is sold by Insys Therapeutics and costs thousands of dollars for a month’s supply, contains fentanyl, a synthetic opioid pain reliever which is approximately 50 to 100 times more potent than morphine.  The U.S. Food and Drug Administration approved Subsys solely for the “management of breakthrough pain in cancer patients who are already receiving and who are tolerant to around the clock therapy for their underlying persistent cancer pain”.  The indictment alleges that Sun prescribed Subsys to patients for whom Subsys was medically unnecessary, not eligible for insurance reimbursement and/or not desired. 

The indictment further alleges that the bribes and kickbacks that Sun received from Insys Therapeutics in exchange for prescribing Subsys were disguised as “honoraria” for educational presentations regarding Subsys that Sun purportedly provided to licensed practitioners.  In reality, the indictment alleges, these presentations were a sham:  they lacked the appropriate audience of licensed practitioners, there was no presentation about Subsys whatsoever, the same individuals attended over and over again and Sun did not attend some of the presentations at all.  Sun caused Medicare to pay more than $847,000 for Subsys prescriptions that were medically unnecessary, procured through the payment of kickbacks and bribes, and not eligible for Medicare reimbursement, the indictment alleges. 

An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.        

This case was investigated by the FBI, HHS-OIG and the DEA.  Trial Attorney Rebecca Yuan of the Criminal Division’s Fraud Section is prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.




Department of Justice
Office of Public Affairs

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Thursday, March 21, 2019

MedStar Health to Pay U.S. $35 Million to Resolve Allegations that it Paid Kickbacks to a Cardiology Group in Exchange for Referrals

MedStar Health Inc. (MedStar) in Columbia, Maryland., MedStar Union Memorial Hospital, and MedStar Franklin Square Medical Center, both in Baltimore, have agreed to pay the United States $35 million to settle allegations under the False Claims Act that it paid kickbacks to MidAtlantic Cardiovascular Associates (MACVA), a cardiology group based in Pikesville, Maryland, in exchange for referrals, through a series of professional services contracts at Union Memorial and Franklin Square Hospitals in Baltimore.

The settlement was announced by Assistant Attorney General Jody Hunt of the Justice Department’s Civil Division, United States Attorney for the District of Maryland Robert K. Hur;  and Special Agent in Charge Maureen Dixon of the Department of Health and Human Services, Office of Inspector General - Office of Investigations.

“Kickbacks made in connection with the provision of medical services undermine the integrity of our health care system,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division. “We will take action against medical service providers who through unlawful conduct put their own financial interests ahead of the best interests of patients.”


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“Kickbacks give doctors an incentive to pursue unnecessary treatments that are costly and sometimes even dangerous to patients,” said U.S. Attorney Robert K. Hur. “We will not tolerate medical care providers who put their patients at risk and waste taxpayers’ dollars in order to line their own pockets.”

“Patients rightly expect their doctors will make recommendations based on sound medical practice – not payoffs that too often result in needless and sometimes even harmful procedures,” said Maureen R. Dixon, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services.  “We will continue to protect patients and taxpayer-funded government health programs from these unnecessary services, as the government contended in this case.”

The allegations resolved in the settlement include the payment of kickbacks to MACVA under the guise of professional services agreements, in return for MACVA’s referrals to Union Memorial of lucrative cardiovascular procedures, including cardiac surgery and interventional cardiology procedures, from Jan. 1, 2006, through July 31, 2011. 


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Under the settlement MedStar also agrees to settle allegations that it received Medicare payments from Jan. 1, 2006, through Dec. 28, 2012, for medically unnecessary stents performed by John Wang, M.D., a one-time employee of MACVA who was later employed by MedStar.

The settlement resolves a lawsuit brought by whistleblowers, Stephen D. Lincoln, M.D.; Peter Horneffer, M.D.; and Garth McDonald, M.D., cardiac surgeons who practiced together as members of Cardiac Surgery Associates in Baltimore. The lawsuit, which was filed in the District of Maryland in June 2010, alleges that Union Memorial and Franklin Square, and others, violated the Anti-Kickback Act and the False Claims Act by paying various forms of illegal remuneration to MACVA to induce referrals of patients insured by Medicare for cardiac procedures which caused false claims to be submitted to Medicare.



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The settlement also resolves another lawsuit brought by whistleblowers who were former patients of John Wang, M.D. who claimed that Dr. Wang, MedStar, and Union Memorial engaged in a pattern and practice of performing medically unnecessary percutaneous transluminal coronary angioplasty with stent placement procedures and submitted false claims to Medicare for those cardiac stent procedures.  The lawsuit was filed in the District of Maryland in December 2012.

The whistleblowers, or relators, brought their actions under the qui tam or whistleblower provisions of the False Claims Act, which permit private citizens with knowledge of false claims against the government to bring a lawsuit on behalf of the United States and to share in any recovery. Under the civil settlement announced today, the relators will receive a portion of the federal share of the recovery.

The settlement announced today was the result of an investigation by the U.S. Attorney’s Office for the District of Maryland and the Commercial Litigation Branch of the Justice Department’s Civil Division with assistance from the U.S. Department of Health and Human Services, Office of Inspector General.  The case was handled by Maryland Assistant U.S. Attorneys Matthew P. Phelps and Roann Nichols.









Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Thursday, March 21, 2019

California Resident Sentenced to Prison for Stealing Over $1.6 Million of Taxpayer Money

Jacqueline Ramos, aka Jackie Acosta, of Salinas, California, was sentenced to 60 months in prison on conspiracy and bank fraud charges, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division and United States Attorney David L. Anderson.

According to court filings, Ramos conspired with her co-defendants to file false income tax returns seeking refunds from the Internal Revenue Service (IRS).  These returns reported fake wages and fraudulently claimed dependents, education expenses, and tax credits. Ramos and her co-conspirators directed the fraudulently obtained refunds into bank accounts they controlled. United States District Court Judge Lucy H. Koh determined that the returns sought more than $1.6 million in refunds from the IRS.


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On July 13, 2017, a federal grand jury indicted Ramos, 49, and four of her co-conspirators, charging them with conspiring to submit false claims against the United States.  Ramos and her husband, Antonio Ahumada Rivas, were also each charged with two counts of bank fraud.  On Oct. 17, 2018, Ramos entered a guilty plea to the conspiracy count and two counts of bank fraud. On Nov. 14, 2018, co-defendant, Norma Morfin Mandujano was sentenced to 30 months in prison for conspiracy. Co-defendants Antonio Ahumada Rivas and Ana Bajo have sentencing dates of March 27th and April 10th respectively.

In addition to the 60-month sentence, Judge Koh ordered Ramos to pay $1,641,610 restitution to the United States. Judge Koh also ordered forfeiture in the amount of $736,592 and ordered Ramos to serve three years of supervised release. The defendant will begin serving the sentence on May 29, 2019.


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Principal Deputy Assistant Attorney General Zuckerman and United States Attorney Anderson commended IRS-Criminal Investigation special agents, who investigated the case, and Assistant United States Attorney Michael Pitman and Trial Attorney Christopher Magnani, who are prosecuting the case. 

Additional information about the Tax Division and its enforcement efforts may be found on the division’s website.












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