March 28, 2014, Detroit, MI -- Police from several agencies paid surprise visits to suspected members of an auto theft rein today in raids that stretched from Detroit to the suburbs. Investigators recovered several stolen vehicles during the raids.
Several arrests and search warrants were executed in Wayne and Oakland counties on Friday as part of a theft and fraud investigation.
Hamtramck police said the investigation stemmed from a stolen vehicle and turned into possible insurance fraud involving the Somerset Collisions Shop on John R Road in Detroit.
Neighbors have seen this scene play out before at this auto shop.
"Not too surprised," Anthony Miles said. "But I just came
March 07, 2014, Tumwater, WA -- A Bothell landscaper who claimed he was suffering from an on-the-job injury has admitted to stealing state workers’ compensation benefits.
Jose De Jesus Bernal-Ruiz pleaded guilty to second-degree theft this week in King County Superior Court, according to the Washington Attorney General’s Office. The 39-year-old Bothell resident also agreed to repay the Department of Labor & Industries more than $71,000 in vocational and cash benefits he should not have received.
Judge Monica Benton sentenced Bernal-Ruiz to 30 days of jail, but allowed the time to be served through community service.
Bernal-Ruiz filed a workers’ comp claim in October 2007 after suffering a back
March 07, 2014, San Antonio, TX -- A federal agent based in San Antonio has been arrested following his indictment on charges of wire fraud and lying to authorities.
Federal prosecutors say 37-year-old Reynaldo Gonzalez made an initial court appearance in San Antonio on Thursday. He's a deputy U.S. marshal facing a 13-count indictment.
Authorities say Gonzalez in 2008 and 2009 defrauded an insurance company by submitting claims for medical treatment for various injuries. He allegedly used a physician's signature and tax identification number without the doctor's knowledge. The insurer then sent several benefit checks to Gonzalez.
Prosecutors contend Gonzalez lied to investigators by saying the claims of injury were
March 07, 2014, Fayetteville, NC -- A couple from Tabor City has been charged in a 19-count federal indictment in a long-running crop insurance fraud and money laundering scheme that allegedly netted them $2.7 million since 2007.
Milton Russ Barnhill, 46, and Sharon Turbeville Barnhill, 43, were arrested Wednesday on the indictment, which was sealed after being handed up Feb. 27 by a federal grand jury, and unsealed after their first appearance in U.S. District Court in Wilmington on Thursday morning, a spokesman for the U.S. Attorney's office said.
Russ Barnhill is a Tabor City area farmer. His wife has operated a part-time hair salon, the indictment said.
March 07, 2014, Blackfoot, ID -- A Blackfoot woman convicted of insurance fraud was placed on five years probation and sentenced Wednesday to serve 30 days jail.
The sentencing took place in Ada County.
Maria Pilar Ramirez, 42, pleaded guilty to the charge and admitted that she gave her Blue Cross of Idaho insurance information to a man she had a relationship, Juan David Rojas-Torres. Rojas-Torres used the information between November of 2009 and February of 2010, representing himself as Ramirez’s husband.
He had eight teeth removed, the extractions for which were billed to Blue Cross of Idaho. The fraud was discovered last April after Ramirez’s actual husband had
March 07, 2014, Las Vegas, NV -- A senior county human resources analyst was convicted in federal court Thursday in a scheme to steal $824,000 from a national auto insurance company.
Erik Holman, 49, who has worked for Clark County since 2002, was found guilty of one conspiracy count and 14 wire fraud counts in the scheme to defraud the Wisconsin-based American Family Insurance between October 2005 and April 2009.
He was accused of conspiring with his late “life partner,” former Henderson Municipal Judge John Provost, who ran the company’s claims litigation office in Las Vegas.
Provost, 48, who served on the Henderson bench from 1996 to 2003, committed suicide
March 07, 2014, Detroit, MI -- A former Detroit-area physician pleaded guilty today for his role in an $11.5 million health care fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office made the announcement.
Jose Mercado-Francis, 60, formerly of Brownstown Township, Mich., pleaded guilty before U.S. District Judge Nancy G. Edmunds in the
March 06, 2014, Cape Town, none -- A Cape Town couple who owned a jewellery business face a fraud charge for allegedly putting in a false insurance claim for a house robbery that never happened.
Denish Nathoo, 56, and his wife, Ferial Baboet, 52, appeared in the Bellville Specialised Commercial Crime Court on Thursday, before magistrate Sabrina Sonnenberg, who warned them to appear in court again on March 27.
According to the charge sheet, they owned the business Damjee Bros Jewellers, which specialised in jewellery design and manufacturing.
The wife ran an outlet in Rylands, while the husband operated a store in the Cavendish Square shopping centre, in Cape Town's
March 06, 2014, Washington, DC -- Like it or hate it, the Affordable Care Act is cutting down on fraudulent Medicare claims and saving taxpayers big money. That’s according to 3rd District Congressman Ron Kind.
Kind says when Obamacare was signed into law in 2010, there were tools built in to help fight fraud. “There’s been some attempts to crack down on fraudulent billing and fraudulent claims being submitted, but we’ve beefed up under the Affordable Care Act the tools and the regional enforcement agencies that can finally go out and crack down on that.”
Kind says federal investigators are now showing up on the doorsteps
March 05, 2014, Madison, WI -- Wisconsin officials are warning residents that fraudulent telemarketers and websites may try to take advantage of their attempts to enroll for health insurance.
“We suspect fraudsters may emerge in the final weeks of the Affordable Care Act’s enrollment,” Attorney General J.B. Van Hollen said in a news release Tuesday.
But there have been few complaints about scams so far, said Sandy Chalmers, an official with the state’s Department of Agriculture, Trade and Consumer Protection.
Enrollment for individual health insurance plans ends March 31.
In the news release, the Office of the Commissioner of Insurance recommended the following precautions:
Contact the insurance commissioner to make sure
March 05, 2014, Blackman Township, MI -- A Blackman Township chiropractor and his office manager are facing insurance fraud charges for allegedly billing Blue Cross Blue Shield for services that were not provided, a Michigan State Police detective said.
Dr. Vernie Cassity, 33, of Cassity Chiropractic Center, 2111 Wildwood Ave., is charged with conspiracy to defraud a health care insurer, making a false claim for payment of health care benefits, and intentionally falsifying medical records. His mother and office manager, Gloria Cassity, 66, is accused of the conspiracy charge and the making false claim offense.
The conspiracy charge, the most serious of the alleged crimes, is punishable by a
March 05, 2014, Fort Stewart, GA -- The wife of a slain Fort Stewart soldier schemed with her brother to kill her husband in exchange for a $160,000 insurance policy payout, a federal prosecutor said Tuesday.
Lillie Eubank, 39, told investigators she arranged to have her brother, Carl Evan “Cowboy” Swain, travel from Alabama to Savannah, bought a T-ball bat and selected the site for the attack at a recreation park on Fort Stewart, Assistant U.S. Attorney Cameron Heaps Ippolito said.
The victim, Army Spc. John Joseph Beans Eubank, 29, was found badly injured Nov. 30 by another solider. He was taken to Winn Army Community Hospital, where he
March 05, 2014, Charnwood, none -- Nicholas Oettinger, 33, submitted an invoice to his insurance company for $20,000 after water damaged the kitchen of his Charnwood home.
He is facing two charges after he allegedly created a false invoice to try to defraud his insurer.
The invoice was under the name of a carpenter with whom he regularly worked when installing kitchens.
The carpenter has told the court he was asked to give a quote on repairing the damage and found only a shelf and cupboard were affected.
He says Oettinger then showed him a pre-prepared invoice using the carpenter's name and phone numbers which quoted a much larger figure
March 05, 2014, Las Vegas, NV -- Need to deal with a fender-bender in Las Vegas? You’re on your own now.
The Las Vegas Metro Police Department will no longer respond to auto crashes that don’t include an injury as of Monday, because police say minor collisions take officers away from responding to major emergencies.
“Currently an average of 250 man-hours per week is dedicated to investigations involving [zero-injury] property damage collisions,” Las Vegas police said in a statement announcing the change. “With fatalities a continued concern, traffic officers will be able to focus on enforcement from a proactive perspective.”
Other major cities, including Los Angeles, San Diego and San
March 05, 2014, Washington, DC -- Insurers are obsessed with cycle time. They count the days it takes to make a claim adjudication decision, the minutes it takes to complete the loss intake process and the seconds it takes to process a transaction. Especially in high-volume environments, time is money.
In the wisdom of insurance claims executives, faster claim payments generally equate to better customer satisfaction and loyalty. Anything that slows the process is burdensome and costly.
Of course, accuracy is important too. Just printing checks for anyone who calls in to the claim center would be quick, but not terribly accurate. So the key to all great
March 05, 2014, Boston, MA -- A Massachusetts physician found himself in the headlines in 2005 when his license was suspended after evidence emerged that he had prescribed about one-third of the state’s 922 985 OxyContin prescriptions in the previous year (http://bit.ly/1g2DCw1). Later convicted of drug dealing and Medicare fraud, the man remains a familiar example of the public health effect of risky prescribing.
But cases of inappropriate prescribing are often far more subtle. A physician may unwittingly prescribe to a doctor-shopping patient or simply prescribe too frequently without taking appropriate precautions. To help physicians and state officials identify dangerous prescribing patterns, all 50 states have created prescription
March 05, 2014, Scarborough, ME -- A Scarborough man was ordered to pay $120,000 in restitution and five months in prison after he was sentenced Wednesday in U.S. District Court by Judge Nancy Torreson.
Lawrence E. Moody, 63, was also ordered to serve five months of home detention and three years of supervised release for committing federal workers’ compensation fraud.
Moody pleaded guilty to the charges Sept. 30.
U.S. Attorney Thomas E. Delahanty II said Moody was formerly employed as a driver for the U.S. Postal Service in Portland. He injured his back loading mail.
Moody filed a claim for workers’ compensation benefits and for a period of seven years
March 05, 2014, Long Island, NY -- A former Long Island Rail Road train maintenance foreman was sentenced to more than three years in prison Wednesday for his role in a disability claims scheme at the railroad.
Fred Catalano of Nesconset was sentenced Wednesday in Manhattan federal court to three years and four months, Newsday reported.
Catalano also was ordered to pay back $62,000 to the federal Railroad Retirement Board.
Prosecutors obtained convictions or guilty pleas from all 33 doctors, consultants and retirees charged in the case.
Doctors admitted to helping employees falsely claim they were unable to work, in order to collect disability pensions from the Federal Railroad Retirement Board
March 04, 2014, Brooklyn, NY -- A second doctor pleaded guilty last week to participating in a Medicare fraud scheme at two Flushing clinics, the U.S. attorney for the Eastern District in Brooklyn said.
Chang Ho Lee, of New Jersey, faced charges along with two others of fraudulently billing Medicare for more than $13 million in services they were not providing and were not medically necessary, according to the indictment filed by U.S. attorney Loretta Lynch.
Lee used the people who benefit from Medicare, a federal program that covers the medical costs of the disabled and elderly, to take advantage of the system, Lynch’s office said.
The defendants operated
March 04, 2014, Amador County, CA -- A half-dozen men illegally operating as contractors were cited during an undercover sting operation conducted last Tuesday in Pioneer by the Contractors State License Board with assistance from Amador County District Attorney's Office investigators and the California Department of Insurance.
During the eight-hour sting, officers held one suspect at gunpoint after he refused to cooperate, ran from investigators, locked himself in his vehicle and made threatening movements. Another suspect was found to be on probation for making terrorists threats, while still another was found to have a prior criminal history as a sex offender. Two suspects had been arrested in previous
March 04, 2014, Baltimore, MD -- A former Baltimore Department of Public Works employee has been charged with several counts of insurance fraud after officials said he stole nearly $14,000.
Donte Orlando Patterson, 39, of Baltimore, was arrested and charged with several counts of felony theft and fraud relating to a scheme to commit insurance fraud.
According to the indictment released by the Attorney General's Office, from mid-November 2009 through mid-October 2010, Patterson used fake documents to support a claim at American Family Life Assurance Company of Columbus (AFLAC) and was able to steal $13,793.
Patterson was an employee of the Department of Public Works at the time, officials
March 04, 2014, Massapequa, NY -- A suburban New York man who admitted helping his father fake his own drowning in a life insurance scam has been sentenced to a year in jail.
Jonathan Roth of Massapequa (mas-uh-PEEK'-wuh) apologized in court Tuesday. He admitted helping Raymond Roth fake his death in 2012.
The 23-year-old claimed his father had drowned at Long Island's Jones Beach. After a massive search, the elder Roth surfaced in Florida and got a speeding ticket in South Carolina.
Raymond Roth is awaiting sentencing.
He also is facing trial this week on separate charges that he impersonated a police officer and tried to abduct a woman.
March 04, 2014, Levittown, NY -- A Levittown couple paid restitution and will serve community service after pleading guilty to welfare fraud, announced the Nassau County District Attorney.
Harpreet Saini pleaded guilty to second-degree welfare fraud and her husband, Harjinder Singh pleaded guilty to disorderly conduct on Monday.
Saini, 30, paid full restitution of $92,571.14 to Nassau County before being conditionally discharged by a judge. Singh, 37, was ordered to complete 210 hours of community service.
The couple were charged in October after an investigation that resulted in eight arrests for a total of $157,428.48.
According to the DA, Singh and Saini received Medicaid benefits for five years by claiming
March 04, 2014, Los Angeles, CA -- A Los Angeles man has been sentenced to home confinement and ordered to pay back more than $400,000 for filing bogus Medicare claims to Fargo-based Noridian Healthcare Solutions LLC.
Robert Olie pleaded guilty in November to conspiracy to commit health care fraud. The plea deal came on the fifth day of a jury trial.
Authorities say Olie filed Medicare claims for expensive power wheelchairs and then provided patients with cheaper electric scooters or nothing at all.
U.S. District Judge Ralph Erickson on Monday sentenced Olie to one year of home confinement and ordered him to pay $417,811 to Noridian and forfeit $100,000 to
March 04, 2014, Zachary, LA -- A 36-year-old Zachary woman is accused of defrauding the state's Medicaid program out of thousands of dollars and laundering more than $100,000 through her Baton Rouge personal care agency.
Attorney General Buddy Caldwell says agents arrested Sekari Washington Davis this week following a joint investigation involving the Attorney General Office's Medicaid Fraud Control Unit and the FBI into Distinctive Healthcare Services LLC, a personal care agency.
Davis was booked with a total of seven felony counts: one count of criminal conspiracy to commit Medicaid fraud; two counts of Medicaid fraud; one count of theft by fraud of $1,500 or more; two counts