Medicare Fraud

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.

A businessman agreed Monday to plead guilty to Medicare fraud in which he netted more than $1 million by fabricating reimbursement claims for wheelchairs and other devices that he never delivered to patients or weren't medically necessary. Authorities said Vasu Deo, 43, owner of Vasu Wheelchair Repair in Van Nuys, also will plead guilty to paying kickbacks to physicians for signing off on false claims that he submitted. Assistant U.S. Atty.

A Van Nuys businessman agreed Monday to plead guilty to an elaborate Medicare fraud in which he netted more than $1 million by fabricating reimbursement claims for wheelchairs and other devices that he never delivered to patients or that weren't medically necessary. Authorities said that Vasu Deo, 43, owner of Vasu Wheelchair Repair, will also plead guilty to paying kickbacks to a physician for signing off on false claims he submitted.

HCA Inc. and Justice Department officials signed an agreement Thursday that calls for the hospital firm to pay $631 million in civil penalties and damages to settle Medicare fraud charges. The settlement, announced in December, resolves what federal officials called the department's most comprehensive health-care fraud investigation. It brings HCA's fines and penalties over the years to $1.7 billion.

Pharmaceutical giants Bayer and GlaxoSmithKline on Wednesday reached a record-setting Medicare fraud settlement over allegations they overcharged millions of dollars for popular prescription drugs. Bayer, based in Germany, agreed to pay $257 million to settle allegations that it overcharged Medicare for prescription drugs including Cipro, the popular antibiotic used during the U.S. anthrax scare. A Bayer spokesman said the company did not believe it had done anything illegal.

The owner of a Granada Hills medical equipment company was sentenced Monday to a year in prison and ordered to pay $38,000 restitution for defrauding the Medicare system, federal officials said. In 1998, Andrew Mazor, 36, owner of Countrywide Health Care, met with an undercover FBI agent who was posing as a medical clinic operator and showed him numerous ways to defraud the Medicare program.

ARV Assisted Living Inc. will be acquired by its largest shareholder, the company said Friday, shortly after settling Medicare fraud allegations by a subsidiary touched by a notorious Newport Beach murder case. Prometheus Assisted Living will pay $47 million, or $3.90 a share, for the 56.5% of Costa Mesa-based ARV that it doesn't already own. Prometheus also will pay off $7.2 million in ARV notes and assume $112 million in long-term debt.

A podiatrist with offices in Orange and Anaheim has been indicted on charges of fraudulently billing Medicare for more than $800,000 in procedures that were never performed, a federal prosecutor said Wednesday. Mark Douglas Little, 42, operator of the Astra Foot and Ankle Center, will be arraigned Jan. 6 in U.S. District Court on 34 counts of health care fraud, each punishable by up to 10 years in prison and a $250,000 fine.

Cigna Corp., one of the nation's largest health insurers, paid the federal government $24.5 million to resolve allegations that its hospital in New Mexico submitted a decade's worth of false cost reports to increase Medicare reimbursements, federal officials said Wednesday. The case was brought by an Orange County man who filed a whistle-blower lawsuit against Cigna's Lovelace Health Systems, a health plan and 225-bed hospital in Albuquerque.

Blue Cross of California and its parent company, Wellpoint Health Networks Inc., have agreed to pay $9.25 million to resolve a whistle-blower lawsuit accusing Blue Cross of defrauding the Medicare system, the U.S.Justice Department said Monday. The alleged abuses occurred during the 1990s while Blue Cross was operating under contract with the federal government to process and audit Medicare claims in the state.