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April Sees an Influx of New Medicare Fraud Charges

April Sees an Influx of New Medicare Fraud Charges

April 15, 2016

Healthcare fraud continues to take on Medicare as well as the entire US healthcare system. Several cases involve providers who are taking advantage of both the healthcare system and the patients.

Since 2007, the Medicare Fraud Strike Force, charged numerous defendants who collectively billed the Medicare more than $7 billion. There may be no end in sight for this costly problem. In the news recently, fraudulent activity related to healthcare still ran rampant.

RELATED: Hospice Fraud Costing Medicare Millions

Physical therapy practice owners implicated in $45 million fraud scheme

On Monday, US Immigration and Customs Enforcementcharged Chicago couple Richard Tinimbang, 38 and Maribel Tinimbang, 40, with running Patients First Physical Therapy Inc., which cheated Medicare out of $45 million dollars. In addition, the Chicago couple also conspired to employ a Filipino woman to work against her will as a nanny and housekeeper.

Their physical therapy scheme involved three Lincolnwood, Illinois-based home health care companies that were owned by Richard Tinimbang’s mother, Josephine Tinimbang. Allegedly, these companies paid kickbacks and bribes to gain Medicare beneficiaries. They also falsified medical records to make patients’ health conditions to appear worse than they actually were.

The companies also allegedly ignored doctors who would not certify patients as being in need of home health care. The couple was charged with multiple counts of conspiracy for their wide array of alleged crimes. The indictment was part of a larger healthcare fraud investigation where 13 others were charged. From 2008 to 2014, the Tinimbangs and others conspired to commit fraud and launder money to hide their tracks. Three of the defendants pled guilty while the rest are awaiting trial.

Pain management physician gets nine years for $3 million fraud

On April 12, The Associated Press reported that sixty-year-old Potomac physician, Paramjit Ajrawat, was sentenced for nine years for running a pain management clinic known as Washington Pain Management Center that bilked the healthcare system out of $3 million.

Ajrawat ran the clinic with his wife, Dr. Sukhveen Kaur Ajrawat, who recently died. In September, the couple was convicted of obstruction of justice, aggravated identity theft and healthcare and wire fraud,The Associated Press reported.

Drug screening fraudsters must repay $2.5 million for Medicare, Medicaid wrongdoing

The Pioneer News reported on April 12 that PremierTox 2.0, Inc., a company that provides drug urine screening services to individuals in Kentucky and Tennessee, has to pay the US government $2.5 million to resolve allegations that the company violated the False Claims Act. PremierTox allegedly submitted false claims when billing TennCare, Medicare and Kentucky Medicaid for drug urine screening services.

False patient visits cost gastroenterologist $400,000 in settlement

On April 7, the Napa Valley Register reported that Napa gastroenterologist, Ali Vaziri, agreed to pay the government $400,000 to settle allegations that he had filed false claims for Medicarereimbursement. Between 2007 and 2011, the doctor allegedly billed Medicare for more services than he actually provided and for patient office visits that were much longer than typical visits.

Vaziri allegedly also billed Medicare for office visits separately when they were supposed to be billed together. In the past Vazirir was also indicted on other chargers. In 2015, he was required to serve seven years of probation prohibiting him from supervising physician assistants because of tax fraud he committed. In 2014, he agreed to plead guilty to four counts of filing false income tax returns connected to his medical practices between 2005 and 2008.

RELATED: Doctors and Nurses Arrested in Huge Medicare Fraud Sting

Home healthcare owner sentenced to 57 months for $34 million fraud scheme

The Department of Justice reported on April 5 that the owner of a Detroit home healthcare agency, Mohammad Rafiq, 49, was sentenced to 57 months in prison for his part in a $34 million healthcare fraud scheme spanning from 2009 to 2013.

According to admissions made as part of his plea agreement, Rafiq paid recruiters and physicians to refer Medicare beneficiaries to his clinic, Perfect Home Health Care, where he had them falsely signed medical documents certifying that home healthcare was required.

Rafiq also admitted to directing patient recruiters and employees of the home health care agency to pay cash kickbacks to Medicare beneficiaries in exchange for signing multiple blank physical therapy records.

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Article courtesy of RevCycle Intelligence and Photo courtesy of