From: gemini23x@gmail.com   
      
   Greed Report: Obamacare was supposed to fight health care fraud. How’s that   
   working out?   
   Scott Cohn	| @ScottCohnTV  Friday, 19 Aug 2016 | 3:46 PM ET   
      
      
   President Barack Obama (R) signs the Affordable Health Care for America Act as   
   Marcelas Owens looks on during a ceremony with fellow Democrats in the East   
   Room of the White House March 23, 2010 in Washington, DC. Getty Images   
   President Barack Obama (R) signs the Affordable Health Care for America Act as   
   Marcelas Owens looks on during a ceremony with fellow Democrats in the East   
   Room of the White House March 23, 2010 in Washington, DC.   
   When asked in 1951 why he robbed banks, prolific thief Willie Sutton is said   
   to have replied matter-of-factly, "Because that's where the money is." That's   
   the same philosophy behind Medicare and Medicaid fraud.   
      
   The federal budget for the health care entitlements is more than $900 billion   
   this year. There's nothing like that kind of money to bring out the   
   fraudsters. And sweeping anti-fraud provisions in the Affordable Care Act can   
   only do so much to slow them    
   down.   
      
   Even before the law was passed in 2010, the Obama administration began   
   cracking down on health care fraud with a series of strike forces set up   
   across the country.   
      
   Since the federal crackdown began in 2009, authorities have charged more than   
   2,500 defendants, recovering $1.9 billion in fraudulent payments last year   
   alone, according to a joint report by the U.S. Justice and Health and Human   
   Services departments.   
      
   While $1.9 billion may sound impressive, the Office of Management and Budget   
   estimates Medicare and Medicaid related programs made nearly $89 billion in   
   improper payments last year, largely due to fraud.   
      
      
   Among the early takedowns in the enhanced effort under Obamacare were Irina   
   Shelikhova and her crew at Bay Medical in Brooklyn, New York, a scam operation   
   that recruited patients among her fellow Russian immigrants in exchange for   
   kickbacks.   
      
   The patient would walk into the clinic reporting some imaginary ailment, but   
   rather than having to pay the clinic, say, $35 to see the doctor, the clinic   
   would pay the patient $35—a kickback for the ability to bill Medicare under   
   his or her name. It    
   was a small price to pay for Bay Medical, which billed the taxpayers for some   
   $50 million in nonexistent medical procedures between 2005 and 2010.   
   Shelikhova is serving a 15-year prison sentence for money laundering.   
      
   The Affordable Care Act includes much tougher sentences for health care fraud,   
   and enhanced screening for doctors and other providers who bill the government   
   programs. It authorizes new technology to help investigators detect fraud, and   
   $350 million in    
   new funding for anti-fraud efforts over the next ten years. Officials say   
   every dollar spent on enforcement yields $6 returned to the taxpayers.   
      
   Yet the crime wave continues across the country.   
      
   Here are some of the more brazen scams broken up in the past couple of years,   
   according to that DOJ and HHS report.   
      
   Fraud Storm   
      
   Ahaoma Ohia, who owned a medical device business with offices in Texas and   
   Louisiana, already had a thriving scam going when Mother Nature and the   
   federal government came together to really move things along.   
      
   Taking advantage of relaxed rules designed to help victims of Hurricane   
   Katrina in 2005 and Hurricanes Gustav and Ike in 2008, Ohia's company—All   
   Star Medical—was able to bill the taxpayers hundreds of thousands of dollars   
   for wheelchairs he falsely    
   claimed were destroyed by the storms.   
      
   Ohia continued his scam even after the federal crackdown began, submitting   
   hundreds of other fraudulent claims, according to a federal indictment. They   
   include prosthetics and other expensive accessories for amputees, ordered for   
   patients with no    
   amputations. The feds caught on when Ohia repeatedly billed Medicare for arm   
   and leg braces in pairs—left and right—rather than wasting time billing   
   for one brace at a time.   
      
   Ohia blamed the mess on "administrative errors," but a federal jury in Baton   
   Rouge didn't buy it. After a four-day trial in 2014, he was convicted on seven   
   fraud counts and ordered to pay $1.2 million in restitution. He is serving a   
   13-year sentence at a    
   federal prison in Texas.   
      
   Photo: Image source | Getty Images   
   Unending Patients   
      
   Pulling off a large scale Medicare fraud requires patience, as well as lots of   
   patients on whose behalf you can bill the government.   
      
   For Dr. Kenneth Johnson and his crew at Manor Medical Imaging in Glendale,   
   California, that meant recruiting homeless people on L.A.'s Skid Row, veterans   
   in drug treatment programs, and elderly Vietnamese immigrants, according to a   
   federal indictment.    
   Johnson would write prescriptions for his "patients," and he and his cronies   
   could cash in big time.   
      
   "Dr. Johnson essentially sold his prescription pad when he became part of the   
   conspiracy that defrauded the government out of millions of dollars," said   
   United States Attorney Eileen Decker.   
      
   The fraud ring was able to obtain more than $9 million in fraudulent payments   
   from Medicare and California's Medicaid program, as well as millions of   
   dollars worth of anti-psychotic drugs that could then be resold on the black   
   market. The feds say the    
   case is the first large-scale bust involving the expensive and potentially   
   dangerous drugs.   
      
   A federal jury last year convicted Johnson on four felony counts. He is   
   serving a nine-year prison sentence.   
      
   Show Me the Love   
      
   Philadelphia is known as the City of Brotherly Love, but Feda Kuran took the   
   concept a little too far.   
      
   Her company, Brotherly Love Ambulance, didn't just transport people who were   
   sick or injured. It gave rides to people who were healthy—sometimes in   
   employees' personal vehicles—then sent the bills to Medicare, to the tune of   
   more than $2 million.   
      
   The scheme began to unravel when the supposedly incapacitated patients were   
   seen walking from Brotherly Love vehicles. Medicare regulations say that only   
   patients who are bedridden or unable to be transported by other means can get   
   ambulance rides at the    
   taxpayers' expense.   
      
   Prosecutors alleged that even after she got caught, Kuran kept the fraud going   
   by trying to obtain Social Security benefits for her son while trying to hide   
   the fact that he also worked at Brotherly Love.   
      
      
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