KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Investigators Tout Fraud Convictions In California, Florida and New York

Authorities are crediting their Medicare and Medicaid fraud initiatives for convictions and guilty pleas in California, Florida and New York.

The Associated Press/San Jose Mercury News: A Los Angeles man pleaded guilty to Medicare fraud Monday after making nearly a half million dollars in false claims. "Sylvester Ijewere, 49, who owns Arleta-based Maydads Medical Supply, pleaded guilty to one count of health care fraud in U.S. Central District Court in California, according U.S. attorneys office spokesman Thom Mrozek. He admitted to scheming to purchase fraudulent prescriptions and medical documents in order to submit false claims to Medicare for pricey power wheelchairs and other equipment between June 2007 and October 2009. Ijewere made false claims to Medicare by using doctor and beneficiary information from fraudulent medical clinics and patient recruiters." Ijewere's lawyer had no comment (Tayefe Mohajer, 4/12).

The Miami Herald: Another man pleaded guilty Monday to federal health care fraud charges alleging he made $55 million in false Medicare claims between 2005 and 2007. Ihosvany Marquez spent some of the money he got from the Medicare system on 19 luxury cars, expensive jewelry and thoroughbred horses. "Magistrate Judge Barry Garber was so troubled by his conspicuous consumption that in early January he refused to give Marquez, 38, a bond - citing his 'access to substantial wealth, including cash, to support his flight from the country if he chooses to do so.' Garber also noted that Marquez, a father of two, hadn't held a real job in years. Marquez was accused of operating six fraudulent Miami-Dade clinics - including one called Tender Loving Care - with partner Michel De Jesus Huarte." Huarte has also pleaded guilty (Weaver, 4/13).

The Associated Press/Business Week: The New York Medicaid fraud unit has recorded 148 convictions in recovering $283 million in 2009. "Attorney General Andrew Cuomo announced Monday that the Medicaid Fraud Unit has recovered more than $660 million in taxpayer funds in the past three years. … Among the more prominent cases was a $91 million civil settlement with Eli Lilly to resolve allegations that it illegally promoted Zyprexa for off-label uses" (4/12).

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