Here are some examples that California Watch culled from recent local prosecutions:
Two pastors of a now-defunct Los Angeles church were convicted this month for their role in a $14.2 million Medicare fraud scheme. The pastors were accused of recruiting parishioners at Arms of Grace Christian Center to help falsify prescriptions for power wheelchairs. The church, which operated medical supply firms, bought the chairs for $900 and billed Medicare $6,000 for them.
Orange County physician Glen Justice was sentenced in July to 18 months in prison for submitting bills for cancer medications that were never given to patients. He was accused of “upcoding” by submitting claims for more expensive medications than actually were given to patients.
Simi Valley Hospital settled civil fraud claims without admitting wrongdoing in November 2010 related to psychiatry and chemical dependence care. A whistleblower contended, among other claims, that the hospital admitted patients for psychiatric overnight stays even though patients didn’t meet the criteria for hospitalization.
A Whittier psychologist was arrested in June and accused of billing the government $1 million for treating postal workers with fabricated psychiatric conditions. According to prosecutors, psychologist Arnold Nerenberg treated an undercover federal officer posing as a postal employee for an “acute fear of dogs.”
One of the ways that the government has tried to save Medicare $27 billion over a decade is attempting to change the way it pays suppliers of power wheelchairs and prosthetic limbs, items that are frequently involved in health fraud prosecutions, according to California Watch.
Cracking down on health care fraud has been upheld as a (seemingly rare) bipartisan solution to saving the government money on health care costs, and Southern California is known as a health care fraud hotspot.