Medicare Fraud

Five Southern California healthcare providers have been indicted by a federal grand jury on charges that they billed Medicare more than $1.1 million for fraudulent exams. The group was reimbursed for tests and exams that were either not performed by a physician or not performed at all, according to the indictment. Two of those indicted have been arrested. Alexander Dzhuga, 27, of Encino and Vladimir Semenov, 47, of Sherman Oaks were scheduled to appear in U.S.

The owner of a health care agency who pleaded guilty in Fort Lauderdale, Fla., to Medicare fraud charges has been sentenced to six years in prison and ordered to repay $12.9 million. Ramon Dominguez, 56, was one of 34 at Amitan health care agency who were indicted on charges they billed the federal government for more than $14 million of unnecessary and unperformed treatment. Prosecutors said Amitan created false medical records that were signed by nurses and doctors as well as subcontractors.

Ending nearly eight years of legal wrangling, Apria Healthcare Group Inc. said late Tuesday that it had preliminarily agreed to pay the government $17.6 million, without admission of wrongdoing, to settle Medicare fraud allegations. Lake Forest-based Apria, one of the nation's largest providers of home healthcare services, was the subject of a privately filed whistle-blower lawsuit in 1997 alleging Medicare overbilling.

A dentist who illegally charged the government for unauthorized cancer screenings on elderly patients must pay nearly $19 million in the largest judgment ever in a Medicare fraud case. John Lorenzo, 56, of Bala Cynwyd, outside Philadelphia, was ordered to reimburse the federal government $18.8 million for filing 3,683 false claims for reimbursement under Medicare, according to a judgment filed Tuesday. U.S.

The nation's largest health-care company, Columbia-HCA Healthcare Corp., is being investigated for possible Medicare fraud, officials said Friday. Columbia, which has 350 hospitals across the nation, faces questions about whether it padded bills to the government. Federal regulators may also be looking into whether the company broke the law by getting doctors to invest indirectly in, and then refer patients to, its outpatient-care facilities, a newspaper reported.

In the second such case this week, a Los Angeles-area business owner has admitted bilking the federal Medicare program of more than $1 million by submitting bills for services never rendered. Ernesto Penaflorida, 57, owner of a now-defunct Glendale medical laboratory, pleaded guilty Monday before U.S. District Judge Ronald Lew to defrauding Medicare by collecting on claims totaling $1.3 million for blood tests that were not performed. "This is a fairly significant fraud," Assistant U.S. Atty.

Three Southern California men, including a 75-year-old doctor, pleaded not guilty Monday to charges of taking part in a scam that authorities say billed Medicare for $2.6 million in unnecessary and often undelivered medical equipment. Sumner Bohee, 75, of San Marino; Steve Jari, 53, of West Hollywood; and Keith Allison, 40, of Los Angeles were named in a 16-count federal indictment unsealed Friday after their arrests, according to the U.S. attorney's office.

Major research hospitals have routinely violated Medicare rules and jeopardized the lives of patients by using experimental medical devices in pursuit of illegal profits, a secret industry witness told a Senate hearing Wednesday. Seated behind a screen and talking through a voice modulator, the anonymous witness said that he watched one patient die when an experimental cardiac catheter unraveled inside the patient's heart and shredded an artery.

President Clinton on Monday announced a crackdown on Medicare fraud, targeting the burgeoning home health care market that accounts for a rapidly growing share of federal spending on the elderly. Under the president's plan, Medicare will stop signing up new home health care providers while the Health Care Financing Administration devises new regulations to better screen applicants.