KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Experienced Criminals Find New Opportunities In Medical Fraud

Gangsters are getting into the medical fraud business, CNN reports. "Experienced in running drug, prostitution and gambling rings, crime groups of various ethnicities and nationalities are learning it's safer and potentially more profitable to file fraudulent claims with the federal Medicare program and state-run Medicaid plans."

One case in Los Angeles, a medical fraud hot spot, turned up suspects from Russian and Eurasian gangs, among other groups. "Recent cases include crime boss Konstantin Grigoryan, a former Soviet army colonel who pleaded guilty to taking $20 million from Medicare. Karapet 'Doc' Khacheryan, boss of a Eurasian crime gang, was recently convicted with five lieutenants of stealing doctor identities in a $2 million scam."

The crooks steal doctors' billing information and patient's identifiers in order to fake medical transactions. One doctor's billing information was robbed during a fake job interview and used to bill for $800,000 worth of electric wheelchairs. When federal agents asked the doctor if he had prescribed those services, he recalls, "I said no. I am a psychiatrist" (Chernoff and Steffen, 10/22).

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