Missouri Podiatrist pleads guilty (MO)

A St. Louis, Missouri podiatrist has plead guilty to obstructing a federal audit when she provided the Medicare program with a false and backdated treatment record, U.S.  said Thursday.

Bic Chau Stafford, D.P.M., 59, who practices at the Family Foot and Ankle Care Center in Maryland Heights, as well as assorted assisted living facilities in St. Louis County and St. Louis City, plead guilty to one felony count of obstruction of a federal audit.  When sentenced Dr. Stafford faces fines of up to $250,000 and  maximum penalty of five years in prison. 

Prosecutors said that Dr. Stafford allegedly billed Medicare for complex foot surgeries provided to 39  Medicare beneficiaries when she was really providing these patients with only routine foot care, such as toenail clippings

Prosecutors said, in response to a Medicare audit, Dr. Stafford created new treatment records for the 39 patients in 2007 and backdated them to 2004, and claimed that she had provided these patients with podiatric surgery.

Source: St. Louis Business Journal (April 2, 2009)

Podiatrist arrested for insurance fraud (MS)

Larry Cruel, D.P.M., a Mississippi podiatrist,  has been arrested following an insurance fraud investigation, announced Attorney General.

Larry Cruel, D.P.M. (age 44), is a podiatrist at Advanced Foot Care in Jackson, MS.  He was recently arrested  by investigators with the Attorney General's Office and charged with one count of insurance fraud and one count of wire fraud for allegedly submitting false claims to Blue Cross Blue Shield. Dr. Cruel faces up to three years for the insurance fraud charge and up to five years for the wire fraud charge .

As with all cases, the defendant is presumed innocent until proven guilty in a court of law.

Source: Compnewsnetwork, March 27, 2009 (workerscompensation.com)

Missouri podiatrist pleads guilty to health care fraud (MO)

A St. Louis County podiatrist, Dr. Denise Hardy, 45,  recently plead guilty to a health care fraud charge in federal court in St. Louis and has admitted to over billing Medicaid and Medicare for unnecessary treatments.

Prosecutors said that Denise Hardy, D.P.M.,  lied on treatment notes from 2000 through 2005 so that Medicaid and Medicare would pay for foot care that would not otherwise have been reimbursed.

Dr. Hardy worked for South St. Louis Orthopedic Group between 1998  and 2005 and provided podiatric services at their office as well as at nursing homes, such as Lafayette Habilitation and at senior service centers at St. Anthonys Medical Center and  St. Alexius Hospital.

Denise Hardy was paid a salary of  $55,000  plus between 50 to 60 percent of the revenue she had billed each month over $12,000.

Source: St. Louis Post Dispatch 3-13-2009

Podiatrist Guilty of Healthcare Fraud (Ohio)

Ohio  podiatrist, Dr. Harold M. Jones, DPM,   has been found guilty in a scheme to defraud Medicare and Medicaid. Dr. Jones, 45, recently went on trial in Cleveland on 22 counts of healthcare fraud, six counts of aggravated identity theft and 26 counts of mail fraud. The jury found him guilty on three of the counts, after three days of deliberations and not guilty on the remainder of the charges.

According to Assistant U.S. Attorney Justin Roberts, Dr. Jones had used improper billing codes, billed for services that were not rendered and also billed under a false provider number. The doctor was also accused of using another medicare provider number and person’s name in order to submit false claims for reimbursement.

Source: The News-Herald (2-24-09)

Podiatrist admits submission of fraudulent Medicare Claims (Pennsylvania)

A  podiatrist from Scranton, PA,  plead guilty  to taking between $10,000 and $30,000 in Medicare payments for services he did not provide.

Podiatrist Thomas Rittenhouse, DPM, entered a guilty plea to one count of making a false statement in a health care matter. These charge carry up to five years in prison and fines of up to $250,000.

At the plea hearing, the Assistant U.S. Attorney said doctor Rittenhouse had filed claims with Medicare between  2003 and  2008 and was paid for services he never provided to patients.  Dr. Rittenhouse is accused of claiming to have performed "nail avulsions", a procedure in which a toenail is removed, but actually just provided routine foot care.

Although the exact amount has not yet been calculated, Dr. Rittenhouse admitted the amount  was between $10,000 and $30,000, and in likely the doctor will be required to pay back the amount that he had received  through filing the fake claims.

Thomas Rittenhouse, DPM,  remains free while awaiting sentencing in Federal Court which is currently set for May 26.

Source: The Times Tribune - 2-18-09

Podiatrist Sentenced for Medicare and Medicaid Fraud (IL)

West Peoria podiatrist was sentenced Friday to one year in federal prison for bilking Medicare out of thousands of dollars over the past decade by writing bills for medical procedures he didn't perform. Dr. Ernest Nwani, 57, also was ordered to repay $109,127 to Medicare and Medicaid for the bogus operations, some 400 of them in all.

Nwani, the sole medical provider for Footworld Medical Center, which he operated out of his house, admitted he defrauded the government by billing for services he didn't provide or didn't provide to the level that he charged Medicare. A company hired by the U.S. Department of Health and Human Services to combat fraud last year noted irregular billing practices by the doctor. An investigation revealed patients did not have procedures or even surgeries for which Nwani had billed Medicare.

From 2002 until 2006, Nwani submitted claims, which Medicare paid, for 539 surgical procedures of various types regarding 442 patients and claims for the permanent removal of 1,082 toenails from 394 patients, according to court records. Medicare paid $171,760 for the surgeries and $100,180 for the toenail removals. Thirty-three patients were interviewed and of those, "none of the surgeries billed for these 33 patients and for which Medicare paid, could be verified as having been performed," court records state.


New Jersey Podiatrist admits involvment in fake Medicare Claims scheme (N.J.)

Authorities said that  podiatrist Michael Schmierer, D.PM. from Holmdel  ran clinics in Middlesex and Union counties in New Jersey has admitted to obstructing a federal health-care audit.

Dr. Michael Schmierer is a partner in Advantage Foot and Ankle Centers.  On August 7, he  plead guilty  in U.S. District Court in Trenton to one count of obstructing a federal audit.

Schmierer's podiatry practice had centers in Linden, South Amboy, East Brunswick,  Linden and Oldbridge. 

Advantage Foot and Ankle Center was audited by a Medicare contractor responsible for detecting Medicare fraud.  Medicare requested 25 original medical records of patients who had been treated at Advantage and had submitted claims for reimbursement for those treatments.

Authorities determined that Schmierer and co-conspirators re-wrote patient notes in 7 of the 25  files to in order to enhance the claims sent to Medicare. Schmierer admitted that the seven records had been altered to justify the billing.

Dr. Schmierer's sentence is scheduled for November 18 and he  faces a maximum of five years in prison and as much as a $250,000 fine, however sentencing guidelines call for a 12 to 18 months sentence in prison.

Source: mycenteraljersey.com [8/7/08]

Podiatrist Pleads Guilty to Medicare Health Care Fraud (Illinois)

A podiatrist from Illinois pleaded guilty Friday to bilking Medicare out of thousands of dollars over the past decade by writing bills for medical procedures not performed. The podiatrist's  attorney Ron Hamm contends the amount is less than $20,000, however the government is claiming the amount is closer to $270,000.

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Revocation of Medical License of Ming Tung, D.P.M. (New Jersey)

It is always desirable to research the background of any professional that you may consider engaging for professional services.  In New Jersey, physicians and podiatrists are regulated and governed by the New Jersey State Board of Medical Examiners. At their website you can research and obtain information about physicians and podiatrist who may have been disciplined by the Board.  While not always an indicator of the competence of the practitioner, it is often the case where a significant history can serve as barometer of the ethical and medical aptitude of the provider.   

For example, in the medical  license of podiatrist Dr. Ming Tung, D.P.M. was recently revoked  as a result of fraudulent insurance activity.  The FINAL ORDER OF REVOCATION OF LICENSE was filed September 26, 2007 and viewable at the site. This matter was presented to the Board by way of settlement of an investigation into the conduct of the Doctor. He was the subject of a federal civil and criminal investigation involving fraud on the Medicare Program. Dr. Tung agreed to pay $868,313.38 in settlement of civil claims alleged by the Department of Justice and the Office of Inspector General of the Department of Health and Human Services. He also pled guilty to a one Count Information, in the District Court of New Jersey. Dr. Tung in a plea agreement agreed to make restitution in the amount of $350,000.00.

NY Podiatrist Arrested For Allegedly Billing Dead Patients (New York)

A Long Island podiatrist was arrested and charged with bilking federal and state healthcare programs by billing them for treatments on patients who had died.

Dr. Alan Cantor was arraigned Wednesday on charges including grand larceny and scheming to defraud. Bail was set at $3,000 bond or $1,500 cash.

Nassau County District Attorney Kathleen Rice said that the East Meadow podiatrist had bilked Medicare and Medicaid programs of more than $30,000 over a year-and-a-half by billing them for treatments on patients who had died.

Source: Associated Press [3/13/08]

Podiatrist Charged with Drug Procurement and Insurance Fraud (Connecticut)

A podiatrist from Burlington faces multiple counts of illegal drug procurement and possession and insurance fraud for allegedly illegally filling prescriptions at a Simsbury pharmacy and then trying to pay for them using insurance, police said Wednesday. Dr. Robert Januska, 65, who police said is not licensed to prescribe drugs in Connecticut, turned himself in March 3 after police issued a warrant for his arrest, according to Sgt. Fred Sifodaskalakis, head of the detective division of the Simsbury police.

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