Arizona
Quick Reference: April 9, 2010 - Scottsdale Doctor Pleads Guilty To Health Care Fraud - Read More March 5, 2010 - Parker Physician to Pay Federal Government $430,000 for False Medicare Billings - Read More November 19, 2009 - United States Reaches $400,000 Settlement with Sierra Vista, Ariz., Doctor - Read More September 18, 2009 - U.S.Reaches $675,000 Settlement With Arizona Heart Hospital Over Medicare - Read More August 28, 2009 - Kayenta Health Center Employee Indicted For Taking Bribe - Read More | Search for News in Your Area
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Scottsdale Doctor Pleads Guilty To Health Care Fraud (U.S. Attorney for the District of Arizona)
Phoenix, Arizona - Stewart C. Mann, 58, of Scottsdale, Arizona, pled guilty Thursday to an Information charging him with one count of Health Care Fraud.
“Dr. Mann violated his oath to ‘first do no harm’ to his patients,” said Dennis K. Burke, U.S. Attorney for the District of Arizona. “His admission of guilt for fraud is the result of the partnership between HHS-OIG and this office to investigate and aggressively prosecute those who scam the Medicare system.”
Mann was charged with, and pled guilty to, one count of Health Care Fraud. Mann was a medical doctor specializing in internal medicine and pathology who had a private practice in Scottsdale, Arizona. During the plea hearing, Mann admitted that between March 2005 and January 2009 he billed Medicare Part B for at least $480,000 worth of malignant lesion excisions that were never performed.
“Dr. Mann put personal greed ahead of providing quality health care services. He took advantage of both his patients and the Medicare program by submitting false claims. The OIG and our team of Special Agents in Arizona will continue to pursue Federal prosecution of any health care provider who uses Medicare patients as pawns to pad their wallets,” said Glenn R. Ferry, Special Agent in Charge for the Los Angeles Region of the Office of Inspector General for the Department of Health and Human Services.
During visits for unrelated conditions, Mann told several of his patients that they had lesions on their backs that may be, or may become, cancerous and needed to be removed. Mann had these patients come to his office frequently for removals. On each of these visits Mann removed one or more of the purported lesions by curetting or shaving them off rather than excising them. Instead of billing Medicare for shaving or curetting, Mann billed for excisions because they paid more. Mann also falsely diagnosed most of the purported lesions as malignant because he received more money for excisions when malignancy was found. In addition, Mann billed Medicare for malignant lesion excisions on dates when the patients did not even see him. When audited by Medicare, Mann falsified patient records to make it appear that his billings were legitimate.
A conviction for Health Care Fraud carries a maximum penalty of 10 years in prison, a $250,000 fine or both. In determining an actual sentence, Judge Martone will consult the U.S. Sentencing Guidelines, which provide appropriate sentencing ranges. The judge, however, is not bound by those guidelines in determining a sentence.
Sentencing is set before Judge Martone on June 21, 2010 at 2:00 p.m.
The investigation in this case was conducted by the United States Department of Health and Human Services, Office of the Inspector General. The prosecution is being handled by Jennifer Levinson and Peter Sexton, Assistant U.S. Attorneys, District of Arizona, Phoenix.
Parker Physician to Pay Federal Government $430,000 for False Medicare Billings (U.S. Attorney for the District of Arizona)
PHOENIX – Kevin S. Klopfenstein, M.D., a physician practicing in Parker, has agreed to pay the federal government $430,000 to resolve allegations that he and his medical practice, Kevin S. Klopfenstein, M.D., P.C. (KSK), violated the federal False Claims Act by submitting false bills to Medicare.
On March 5, 2010, U.S. Attorney for the District of Arizona Dennis K. Burke said: “The integrity of our Medicare system depends on the honest practices of doctors and other Medicare providers. This settlement demonstrates how seriously we take false billing for Medicare services, and the costly consequences of gaming the system.”
The settlement agreement resolves allegations that Dr. Klopfenstein and KSK falsely billed Medicare for Thoracic Electrical Bioimpedance (TEB) (also known as Biothoracic Impedance (BTI) tests by representing that the patients receiving the tests met applicable Medicare coverage requirements when, in fact, the patients did not meet any of the requirements.
“This civil settlement is significant because it puts physicians on notice that if they overbill the Federal health care programs they will face stiff penalties. False claims, such as those allegedly submitted by Dr. Klopfenstein, contribute to the billions of dollars lost to the Medicare program and tax payers each year.” said Glenn R. Ferry, Special Agent in Charge for the Los Angeles Region of the Office of Inspector General of the Department of Health of Human Services.
The case was handled by Lon R. Leavitt, Assistant U.S. Attorney, District of Arizona, Phoenix.
United States Reaches $400,000 Settlement with Sierra Vista, Ariz., Doctor (U.S. Attorney for the District of Arizona)
PHOENIX - The United States reached a settlement with Jaya H. Maddur, M.D., a gastroenterology specialist practicing in Sierra Vista, Ariz. The United States contended that, for the period January 4, 2005, to September 15, 2008, Dr. Maddur submitted, or caused to be submitted, claims for payment to TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services or CHAMPUS) that misrepresented the services rendered, resulting in false claims for payment being made to TRICARE. Dr. Maddur agreed to pay $400,000 to settle the matter.
The investigation leading to the settlement was conducted by the U.S. Department of Defense, DCIS Phoenix Resident Agency, and the Federal Bureau of Investigation. Robert K. Lu, Assistant U.S. Attorney, District of Arizona, handled the matter in federal court.
For more information, visit the website of the United States Attorney's Office for the District of Arizona at: http://www.justice.gov/usao/az/
U.S.Reaches $675,000 Settlement With Arizona Heart Hospital Over Medicare (U.S. Attorney for the District of Arizona)
PHOENIX - The United States reached a settlement with the Arizona Heart Hospital related to the payment of claims for carotid artery stenting procedures. The United States alleged that from July 2005 to March 2007, the hospital submitted claims for payment to the Medicare Program for carotid artery stenting procedures that were not reimbursable under Medicare. The United States contends this resulted in the hospital submitting false claims for payment to Medicare. The hospital agreed to pay $675,000 to settle the matter.
The investigation leading to the settlement was conducted by the U.S. Department of Health and Human Services, Office of Inspector General, and Robert K. Lu, Assistant U.S. Attorney, District of Arizona.
For more information, visit the website of the U.S. Attorney of the District of Arizona at: http://www.usdoj.gov/usao/az/
Kayenta Health Center Employee Indicted For Taking Bribe (U.S. Attorney for the District of Arizona)
PHOENIX – The U.S. Attorney for the District of Arizona announced on Aug. 28, 2009, that a Kayenta Health Center emergency room employee has been indicted by a federal grand jury for accepting a bribe. Ella Babbitt, 46, has been charged with one felony count of Receiving a Bribe by a Public Official. Babbitt has been served with a summons to appear in federal court on September 2, 2009, at 10:45 a.m. for arraignment.
The indictment alleges that on May 13, 2009, while working as a medical support assistant at the Indian Health Services’ Kayenta Health Center on the Navajo Nation, Babbitt accepted $6,000 for directing medical air transport business to AeroCare Medical Transport. The indictment further alleges that an investigation was launched in February 2009 into allegations of possible bribery and kickbacks being paid in connection with medical air transport from the Indian Health Services facility at Kayenta.
The indictment reveals that an employee of AeroCare cooperated with investigators from the U.S. Department of Health and Human Services Office of Inspector General. Conversations between the AeroCare employee and Babbitt were monitored and recorded, culminating in a meeting held on May 13, 2009, at a hotel in Kayenta at which $6,000 was allegedly paid to Babbitt. This meeting was both audio and video recorded, according to the indictment.
Receiving a Bribe by a Public Official is punishable by up to 15 years in federal prison, a fine of up to $250,000 or both. An indictment is the method by which a person is charged with criminal activity and raises no inference of guilt. An individual is presumed innocent until a jury determines that a defendant’s guilt has been proven beyond a reasonable doubt.
The investigation was conducted by agents of the U.S. Department of Health and Human Services, Office of the Inspector General, Office of Investigations. The prosecution is being handled by Frank T. Galati, Assistant U.S. Attorney, District of Arizona, Phoenix.
For more information, visit the website of the U.S. Attorney of the District of Arizona at: http://www.usdoj.gov/usao/az/
