Medicaid/Medicare Fraud! So Goes Maine…So Goes Florida

Palm Beach Post reports “Owner of nursing home where 8 patients died linked to $1B Medicare fraud case.”

“The hospital co-owned by a Florida doctor whose nursing home was the site of eight deaths last week is linked to the biggest Medicare fraud case ever filed against individuals in U.S. history, court records show.

Neither Larkin Community Hospital nor its president, Dr. Jack Michel, is named or charged in the criminal fraud case filed last year in Miami federal court.

But in 2004, in a civil case also filed in Miami, federal prosecutors cited multiple links among Michel, Larkin and Michel’s former business associate, Philip Esformes, the man prosecutors say is the ringleader of a scheme that used elderly patients to bilk Medicare and Medicaid of about $1 billion.

Federal prosecutors alleged at that time that nursing home and assisted living patients were being admitted to Larkin for care that wasn’t needed, leaving Medicare and Medicaid to foot the bill.

When Jack Michel took the reins at the hospital, a series of kickbacks were coordinated with his brother, George, who was the admitting physician for virtually all of the nursing home referrals to the facility.” Read more HERE.

 

Repeated requests to Maine Legislators/other officials were made for a full investigation into Medicare and Medicaid payments that were paid out in excess for prescription drugs that were not needed, medical equipment that was not needed and stays (against the will of a person) at a local hospital and nursing home in Biddeford, Maine. The Maine Bureau of Corporations did not have any filing in the name of the nursing home. It was discovered through the Medicaid printout that North Country Health Care Assoc. received Medicaid payments for the nursing home in 1998, a corporation that was not licensed at the time of receipt of Medicaid funding. 

Medicaid printout, click here.

Behind Maine’s Long-term Care Curtain

Chris Orestis is CEO of Life Care Funding, a Portland company that converts life insurance policies to help consumers pay for long-term care.

The smell to this? John Orestis, nursing home(s) owner is a relative of Chris Orestis.

Another “layer to this onion” is Alan Casavant (former legislator) who was presented with the evidence. Who is Alan Casavant? Mayor of Biddeford where the frauds took place!

It’s a PUBLIC SCANDAL that Maine legislators/governors have turned a blind eye to what’s happening in Maine!

THIS WARRANTS INVESTIGATION!

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Published in: on September 20, 2017 at 5:06 pm  Comments (2)  

Baldacci v. LePage Re Medicaid: As The Swill Turns

Former Governor John Baldacci “condemned the Maine Democrats’ Medicaid expansion mudslinging campaign during a Thursday morning segment of WGAN’s Ken and Mike Show.” Read more HERE.

Interview with talk show host Mike Violette and John Baldacci, listen HERE.

John Baldacci states “It’s up to the governor to step up and show some maturity.”  Where was his maturity and leadership when he was governor?

Both parties have talked “a good piece” to the people giving an impression they are really work hard for Mainers. When will either party now “walk the walk” and “fix” the real problem! Who else is unlawfully financially gaining from Medicaid? Who else will die at the hands of unresponsive legislators?

This is Maine’s Healthcare, HERE, HERE.

Related:
CONTRADICTION TO CONVERSATION WITH GOVERNOR JOHN BALDACCI, click here.

It’s time for an investigation into the state of Maine, click here.

PREVENT TRUTH DECAY, click here.

Behind Maine’s Long-term Care Curtain – connect the dots, click here.

Published in: on March 21, 2014 at 12:03 pm  Leave a Comment  

Medicare Fraud Scheme Busted

ABC news reports “Federal officials say they have taken down the largest Medicare fraud scheme investigators have ever discovered: a $375 million dollar home healthcare scam operating in the Dallas, Texas area.

The alleged “mastermind” of the fraud, Dr. Jacques Roy, is charged with certifying hundreds of fraudulent claims for Medicare reimbursement, and pocketing millions in payments for services not needed, or never delivered.

According to the indictment, Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services, and billing Medicare for those services.

He allegedly hid much of his Medicare money in an offshore account in the Cayman Islands.”

Read more HERE.

It’s time for an investigation into the state of Maine.

Repeated requests were made for a full investigation into Medicare/Medicaid payments that were paid out in excess for prescription drugs that were not needed, medical equipment that was not needed and stays (against the will of a person) at a local hospital and nursing home in Biddeford.  This has been brushed under the rug. The Maine Bureau of Corporations did not have any filing in the name of the nursing home. It was discovered through the Medicaid printout that North Country Health Care Assoc. received Medicaid payments for the nursing home in 1998 and their license was cancelled in the 1980’s.

An investigation is warranted into monies given to a corporation that was not licensed at the time of receipt of Medicaid funding , North Country Health Care Assoc.  Read more HERE.

Former Governor John Baldacci had nearly 20 years to work on health care issues to include Medicaid funding and elder abuse which continues today. However, he chose instead to further his personal agenda with the help of his campaign contributors, ie. North Country Associates, at the expense of taxpayers and the precious lives of our family members.

Medicaid printout, click here.

Baldacci campaign contributors

 

Published in: on March 3, 2014 at 1:19 am  Leave a Comment  

Maine Hires Controversial Medicaid Reformist For $925,000

Is this another “it’s looks good on its face”….but on the other hand……

PPH reports “Maine has hired the controversial former welfare chief of Pennsylvania to conduct a $925,000 review of its Medicaid program and the potential effects of expanding it through the federal health care law.

The Department of Health and Human Services announced Tuesday that it has contracted with The Alexander Group of Rhode Island to bolster ongoing “program integrity” efforts.”

The contract is worth $925,200, according to a copy of the document, and will employ the services of Gary D. Alexander, the former welfare chief in Pennsylvania who was criticized for policy initiatives that dramatically cut the state’s Medicaid rolls, eliminating health care coverage for 89,000 children.

DHHS Commissioner Mary Mayhew said in a media statement that Alexander’s firm brings much-needed expertise to evaluating social services that cost Maine $3.4 billion a year.

The emphasis on fraud has increased the number of prosecution referrals to the state Attorney General’s Office, from 10 cases in 2010 to 45 in 2012. The number of successful prosecutions has increased more gradually, from eight in 2010 to 15 in 2012. The amount of restitution that courts have ordered increased from $92,339 in 2010 to $104,341 in 2012.

The administration is also pursuing anti-fraud initiatives that it hasn’t publicly disclosed. Documents obtained by the Portland Press Herald show that the state has launched a special investigation that targets Maine’s approximately 500 licensed elver fishermen.

According to the contract, about $455,000 will be paid from the state’s general fund, and about $276,000 is “special revenue.” About $193,000 is federal matching funds.

In her media statement, Mayhew said the DHHS is “excited about the opportunity to work with such a knowledgeable group of experts.” It will be extremely helpful to have someone with significant Medicaid experience lending a hand to our program reform efforts,” she said.”

Rep. Jeff McCabe, D-Skowhegan, the assistant House majority leader, is concerned with “another gimmick to deny and delay health care for tens of thousands of Mainers, including nearly 3,000 veterans.”

“Alexander’s work has been hailed by conservatives who have called for a reduction in Medicaid rolls and a crackdown on fraud.

Sam Adolphsen, a former policy analyst for the Maine Heritage Policy Center, will oversee “programmatic aspects” of the contract. Adolphsen works for the DHHS as the strategic development director.”

“Republicans applauded the contract. House Minority Leader Kenneth Fredette, R-Newport, said in a prepared statement that he is glad to see the LePage administration “take yet another important step in bringing accountability.” Read more, click here.

There were repeated requests for a full investigation into Medicare and Medicaid payments that were paid out in excess for prescription drugs, that were not needed, medical equipment that was not needed all at the expense of the taxpayers. The refusal of Maine’s Attorney General, and elected officials, to seek an investigation is a disgraceful PUBLIC SCANDAL. How many more got away with it?

In her media statement, Mayhew said the DHHS is “excited about the opportunity to work with such a knowledgeable group of experts.” It will be extremely helpful to have someone with significant Medicaid experience lending a hand to our program reform efforts,” she said.”

How much “expertise” must one have to recognize “fraud, waste and abuse”? Apparently, this lacks within Maine government.  How competent is Maine’s Attorney(s) General? 

Notice and Demand to A.G. Janet Mills, click here. No response was received.

If nothing was done in the past, is the future any brighter? Will there be “accountability” at the expense of nearly $1 million dollars?

Most people know not to believe mainstream media. The full accounts of their reports are grossly flawed and misleading. You are getting the “rest of the story”.  

Is this another slight of hand at our expense?

Related:

Contradiction To Conversation With Governor John Baldacci, click here.

Maine Partners with Former Health and Human Services Leader for Medicaid and Program Integrity Improvements, click here.

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