Insurance Fraud NEWS

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Insurance Fraud News:
A selection of daily headlines from around the nation

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Paul Fletcher on the National Disability Insurance Fraud's first arrest

October 18, 2018. Melbourne, -- ABC.net : The Federal Government set up the National Disability Insurance Fraud taskforce to target people ripping off the system, and it's made its first arrest. The size of alleged fraud is eye-boggling - 400,000 dollars worth in two months with money used to buy a luxury car, designer clothes and jewellery. A 34 year old man from Parkville in Melbourne's been charged over it. Paul Fletcher the Minister for Families and Social Services discussed this case with AM. ...


Chinese man fakes death, wife kills self thinking death real

October 17, 2018. Hunan Province, -- SupChina : A man in Hunan Province faked his own death in a car accident to collect insurance payments but ended up losing his wife and two children before turning himself in to the police. According to a statement (in Chinese) released by local police on October 12, Hé Yǒng 何勇 (pseudonym), 34, was over 100,000 yuan in debt. In early September, he purchased a life insurance plan worth one million yuan without informing his wife, who was named as the beneficiary. On September 19, He used a borrowed vehicle to fake a road accident and then vanished. A few days later, when ...


Jersey woman still owes repay for $941K kickback scheme

October 17, 2018. Brick, NJ-- Brick Shorebeat : Brick officials say the township has yet to see any restitution payments from Kim Bogan, the ex-employee who pleaded guilty to embezzling $941,354 by submitting phony insurance claims, even though she made an initial payment. Bogan, the daughter of former mayor Joseph C. Scarpelli – who himself served a jail term on corruption charges – was released from prison last week, just 10 months into a five year sentence she received following a plea deal. Bogan was released under an intensive supervision program that allows her to be freed with the conditions that she obtain employment and wear an ankle bracelet ...


Man accused of arson, fraud found competent for trial

October 17, 2018. Hamilton, OH-- The Washington Times : An Ohio man accused of setting his house on fire in 2016 has been ruled competent to stand trial. The Hamilton-Middletown Journal-News reports a Butler County judge on Tuesday found Ross Compton capable of standing trial after a psychological evaluation. The 60-year-old Middletown man whose arrest was based partly on pacemaker data has pleaded not guilty to aggravated arson and insurance fraud charges. Authorities say Compton’s cardiac device showed data inconsistent with actions he reportedly took during the fire, including throwing belongings out a window and carrying them to his car. Compton’s attorney said he isn’t withdrawing a motion for a plea of ...


Travel insurance fraud to be highlighted in TV documentary

October 17, 2018. London, -- Travel Weekly : More than a million viewers are expected to watch BBC1’s Claimed and Shamed probe into travel insurance fraud today. CEGA Special Investigations will feature in series ten of the show at 11am on Thursday. Head of technical claims Simon Cook, a regular contributor to the programme, will educate viewers about the severity of submitting fraudulent travel insurance claims. He also talks about the lengths to which insurers will go to detect dishonest claims – even in the most far-flung parts of the world – using real-life cases to make the point. Cook said: “Unearthing dishonest claims on behalf of our insurer clients helps clients ...


Man who faked his own death loses wife and kids

October 17, 2018. Guizhou, -- The Star Online : The 34-year-old man told the police that he had bought a life insurance policy worth one million yuan (RM600,000) on Sept 7. On Sept 19, he borrowed his employer’s car and drove it into a river to fake his own death before going into hiding in Guizhou. He, however, became homesick and returned home about a month later only to find his wife’s note. The 31-year-old woman, thinking that her husband was dead, left a note and committed suicide ­together with their young daughter and son on Oct 10. In the note, she wrote that she had lost the will to live without her ...


New York med transport firm to repay $900K for fake trips

October 16, 2018. Buffalo, NY-- Buffalo Business First : A transportation company in Buffalo charged with Medicaid fraud will pay back $900,497 to the state in restitution. The announcement came Tuesday in tandem with the sentencing of Wossen Ambaye, president of 716 Transportation, who stole $1.2 million by charging the government for services the company never provided. In addition to paying restitution, Ambaye was sentenced to three years’ conditional discharge and 150 hours of community service by Erie County Supreme Court Judge John Michalski while the company paid an additional fine of $10,000. Last month, driver Haimid Thompson, a.k.a. Mookie, was sentenced in the case for stealing over $7,500 from the ...


Jersey woman faces up to 10 years for compound kickbacks

October 16, 2018. Ocean County, NJ-- NJ.com : An Ocean County woman faces up to 10 years in prison after she admitted she was part of a massive scheme to defraud state health benefits programs and led to her receiving $388,600 in kickbacks for unnecessary prescriptions. The guilty plea is part of a wide-ranging federal probe into the prescription fraud scam involving an out-of-state compounding pharmacy that supplied $50 million in medications "including pain, scar, antifungal, and libido creams, as well as vitamin combinations." Kristie Masucci, 36, of the Cedar Run section of Stafford, conspired with others to recruit state and local government and education employees, including teachers, firefighters, municipal ...


Worker claims disabled, allegedly caught fishing in Pennsylvania

October 16, 2018. Bucks, PA-- Bucks County Courier Times : Prosecutors say Bucks County corrections officer Carl Stokes received workers’ compensation benefits while working as a fishing guide. On a Tuesday morning in June, three men embarked on a small motorboat for a five-hour fishing trip along the Susquehanna River. The two who paid $240 for the excursion, court documents revealed, were actually police officers working undercover; their guide was a Bucks County corrections officer out of work on disability and receiving workers’ compensation benefits. Now Carl Wayne Stokes, 51, of Bridgeton, faces felony charges of workers’ compensation fraud, insurance fraud and related offenses, court records show. He was arraigned before District Judge Gary ...


California teacher allegedly bribes colleagues to get meds

October 16, 2018. Lodi, CA-- Cresskill-Closter : A Lodi High School social studies teacher ran a scam that billed a state employees' health insurance program more than $550,000 for unnecessarily prescribed metabolic vitamins and special creams for himself and three colleagues, a federal grand jury indictment charges. Jason Nardachone, 45, of Nutley, "bribed the three other teachers with monthly payments of $500 in exchange for their agreement to obtain compounded medications they did not need," U.S. Attorney Craig Carpenito said. The medications cost the N.J. School Employees’ Health Benefits Program (SEHBP) from $3,300 to $22,800 each, Carpenito said. Carpenito credited special agents of the FBI with an ongoing investigation ...


Plea possible for New Yorker who allegedly left crash scene

October 16, 2018. Wheatfield, NY-- Niagara Gazette : A plea deal could be in the works for a Wheatfield man accused of violating the terms of his probation by committing insurance fraud after serving six months in jail for his role in a fatal hit-and-run accident. Niagara County prosecutors and an attorney for Anthony DiFilippo told State Supreme Court Justice Richard C. Kloch Sr. that they had "had some discussions on a plea in this case." Those discussions led DiFilippo's defense to waive a scheduled hearing onTuesday on the admissibility of statements he made to Niagara County Sheriff's Office investigators. "I believe we've taken significant steps toward the resolution of this ...


Rutledge announces two Medicaid fraud arrests

October 16, 2018. Little Rock, AR-- KAIT 8 : Arkansas Attorney General Leslie Rutledge announced Tuesday the arrest of a Benton County woman and a Randolph County woman on unrelated Medicaid Fraud charges. Angela Miller, 36, of Bentonville, is accused of stealing hydrocodone and oxycodone pills while working at a northwest Arkansas facility in December 2017 and January 2018. Following an investigation by the Attorney General’s Office, Miller was arrested. She is charged with one count of obtaining a controlled substance by fraud, a Class D felony. Cindy Bass, 32, of Pocahontas, is accused of fraudulently billing for unauthorized services and for altering documents in order to bill for services prior ...


Scammer admits to $505M in claims for meds in Florida, Texas

October 15, 2018. Nashville, TN-- Citizen Tribune : A man who owned a telemedicine company called HealthRight did not contest government claims the company was responsible for $505 million in fraudulent insurance claims that involved 531 patients in East Tennessee and tens of thousands of other victims across 22 other states, according to federal court documents unsealed Thursday afternoon. Scott Gregory Roix pleaded guilty to conspiracy to commit both heath-care fraud and wire fraud on Sept. 26. Rather than wait on an indictment, Roix admitted guilt through a 32-page, scrupulously documented roadmap of the health-care fraud that commenced in June 2015 and concluded on April Fools’ Day 2017. Croix ...


Snyder's move sparks calls for auto insurance fraud prevention with ‘teeth’

October 15, 2018. Lansing, MI-- Crain's Detroit Business : The lack of any additional personnel for Gov. Rick Snyder's new anti-fraud initiative in the state insurance department has sparked renewed calls from lawmakers to create and fund a new agency charged with rooting out fraud and waste in Michigan's no-fault auto insurance system. The anti-fraud unit Snyder created in the Department of Insurance and Financial Services last month came with no additional money or employees to investigate fraud in the insurance and financial services markets, said Randall Gregg, senior deputy director and general counsel of DIFS. Instead, DIFS is moving around existing personnel to launch fraud investigations with assistance from the ...


Suspected $1B telemed con in Tennessee bilks tens of thousands

October 15, 2018. Greenville, TN-- The Tullahoma News : Seven companies and four men are facing charges, accused of roles in a $1 billion telemedicine fraud scheme that deceived tens of thousands of patients and more than 100 doctors, federal prosecutors announced Monday. The eastern Tennessee U.S. attorney's office said six Florida companies, a Houston firm and four Florida men are named in a 32-count indictment charging them with conspiracy to commit health care fraud, introducing misbranded drugs into interstate commerce and mail fraud. According to prosecutors, the companies and the men associated with them created an "elaborate" scheme in which telemedicine firm HealthRight LLC fraudulently solicited insurance information and prescriptions ...


Med group allegedly makes 4,500 false allergy claims in Georgia

October 15, 2018. Atlanta, GA-- Atlanta Patch : The CEO and COO of Atlanta-based Primera Medical Group have been arraigned on federal charges that they submitted more than 4,500 fraudulent claims for allergy treatments. CEO Shailesh Kothari and COO Timothy McMenamin have been charged for their alleged roles in the scheme, in which prosecutors say they sought more than more than $8.5 million in insurance payments after submitting the claims. "Healthcare fraud not only betrays the trust a patient places in their providers, but costs everyone when their insurance premiums rise because of it," said Chris Hacker, Special Agent in Charge of FBI Atlanta. "The FBI is committed to ...


Michigan provider makes patients get injections in $150M con

October 15, 2018. West Bloomfield, MI-- United States Department of Justice : A health care CEO pleaded guilty today to a superseding indictment as part of an investigation into a $300 million health care fraud scheme that involved the distribution of over 6.6 million dosage units of controlled substances and the administration of medically unnecessary injections that resulted in patient harm. Attorney General Jeff Sessions, Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Matthew Schneider of the Eastern District of Michigan, Special Agent in Charge Timothy R. Slater of the FBI’s Detroit Field Office, Special Agent in Charge Lamont Pugh III of the U.S. Department of ...


Airbags being stolen from late-model Hondas, Acuras

October 15, 2018. Washington, DC-- Auto Blog : The latest hot target for car thieves might just be the airbag mounted inside your steering wheel. And late-model Honda and Acura vehicles are a particularly hot target right now, for reasons not well understood. USA Today reports that criminals across the country are stealing airbags out of relatively new Honda models for apparent resale online or to black market repair shops. It's a trend that has caught the attention of law enforcement agencies in cities like Miami, New York City and Washington D.C. The National Insurance Crime Bureau (NICB) estimates that around 50,000 airbags are stolen each year. In Miami-Dade County, ...


Driver claims theft, allegedly stopped for DUI in Pennsylvania

October 15, 2018. Middletown, PA-- FOX 43 : The Cumberland County District Attorney’s Office has charged a Middletown man with insurance fraud and theft by deception in connection to an incident in June, the office announced Monday. Bryan Nissley is accused of reporting to his insurance company that his vehicle was stolen and damaged. He denied being involved in an accident in the vehicle, a Dodge pickup truck. A police investigation revealed Nissley had been involved in a crash on June 14 on the 400 block of Maple Avenue in Lebanon. Police say Nissley was driving his vehicle, a 2001 Dodge Ram 1500, while under the influence of alcohol at ...


Pennsylvania drivers allegedly claim prior damage

October 15, 2018. Erie, PA-- Go Erie : A man also charged in the case had his hearing moved to December on Monday. One of two Erie residents charged by the Pennsylvania Office of Attorney General in an insurance fraud probe from earlier this year has waived her criminal case to court as the second person awaits a December court date. Anissa M. Weber, 22, waived her preliminary hearing before Erie 1st Ward District Judge Sue Mack Monday morning on third-degree felony counts of false or fraudulent insurance claim, theft by deception and insurance fraud in an incident from March 17. State investigators charge in a criminal complaint filed on ...


Car insurance scams after Hurricane Michael – How to avoid them

October 15, 2018. Tallahassee, FL-- Insurancenewsnet.com : Hurricane Michael's brutal assault on Florida brought damage to an unprecedented scale. Entire communities were obliterated and even an Air Force base suffered catastrophic damage. Authorities in Florida are still assessing the toll of Hurricane Michael, both in terms of human casualties and structural damage. But one thing is for certain: the costs will be huge, topping more than $4 BN. The grimmest estimates say it will top $30 billion. In the days before the storm hit, Florida Insurance Commissioner David Altmaier estimated that roughly 500,000 policyholders would be impacted. This represents a nightmare for both insurance companies that have to ...


Fake Norwalk addresses used in $27M Obamacare fraud scam: Feds

October 15, 2018. Hartford, CT-- Norwalk Patch : A father and son from California entered guilty pleas in Hartford federal court Friday in a multi-state Obamacare fraud case, prosecutors said. Four localities in Connecticut were involved, including Norwalk according to case records. Jeffrey White, 60, and Nicholas White, 33, pleaded guilty to conspiring to defraud Affordable Care Act programs in at least 12 states of more than $27 million, prosecutors said. U.S. Attorney John H. Durham of the District of Connecticut, Special Agent in Charge Phillip Coyne of the Boston Regional Office of the Office of the Inspector General of the Department of Health and Human Services, Special Agent in ...


Four men and seven companies indicted for billion-dollar telemedicine fraud conspiracy

October 15, 2018. Clearwater, FL-- United States Department of Justice : On October 12, 2018, the District Court for the Eastern District of Tennessee unsealed a 32-count indictment charging four individuals and seven companies in a $1 billion health care fraud scheme. The court also unsealed an additional two plea agreements and an information charging another individual and his company for their role in the scheme. Andrew Assad, 33, of Palm Harbor, Florida, Peter Bolos, 41, of Lutz, Florida, and Michael Palso, 44, of Odessa, Florida, were indicted along with their compounding pharmacies, Synergy Pharmacy Services, located in Palm Harbor, and Precision Pharmacy Management, located in Clearwater. Co-conspirator Larry Everett Smith, 48, ...


Mobile devices in healthcare increase, as do security challenges

October 15, 2018. Washington, DC-- HealthIT Security : Healthcare organizations are deploying mobile devices in greater numbers to improve employee productivity and patient experience. In fact, 90 percent of healthcare IT decision-makers surveyed recently by Vanson Bourne said their institution is implementing or intends to implement a mobility program. Nearly half of the 600 respondents said they plan to increase mobile device usage within the next two years. Respondents are using or plan to use mobile devices at nursing stations, administrative offices, and patient rooms, as well as for clinical care teams and administrative staff. Wearables, too, are gaining popularity in healthcare. According to the Deloitte 2018 Health Care Consumer Survey, ...


Anthem to pay record $16M for hack of 79M patients

October 15, 2018. Washington, DC-- ABC News : The nation's second-largest health insurer has agreed to pay the government a record $16 million to settle potential privacy violations in the biggest known health care hack in U.S. history, officials said Monday. The personal information of nearly 79 million people — including names, birthdates, Social Security numbers and medical IDs — was exposed in the cyberattack, discovered by the company in 2015. The settlement between Anthem Inc. and the Department of Health and Human Services represents the largest amount collected by the agency in a health care data breach, officials said. "When you have large breaches it erodes people's confidence in the ...