Do you remember those “Most Wanted” posters from the old movie Westerns? Or the more modern FBI posters in the post office? Well the Inspector General of Health and Human Services has a most wanted list too. Believe it or not, there is a Medicare fraud most wanted list.
The typical Medicare fraudster rips off Medicare by charging for services never rendered or by double billing. Those activities are crimes and since Medicare and Medicaid is funded with tax dollars, these criminals are really stealing from us.
Stealing is bad enough and many of the people on this list are accused of stealing millions of dollars. But sometimes the stakes are even higher.
Not all Medicare fraud is simply an economic crime. Those who perform medically unnecessary procedures or overprescribe dangerous narcotics just to bilk more from Medicare are endangering lives. Look at Dr. Farid Fata who prescribed dangerous chemo drugs to patients that didn’t even have cancer!
In this feature we look at some of the folks currently on the Medicare Fraud Most Wanted list. The list is maintained by the Inspector General’s office of HHS. These are the gun carrying cops of the Medicare system.
Wanted Fugitive Betros Garabet
First is Betros Garabet. He has been on the lamb since his indictment on healthcare fraud charges in 2007. Prosecutors say that he orchestrated a scheme to bilk $260,842 from taxpayers. But that is the least of his problems.
According to the indictment he was operating a medical clinic in Los Angeles even though he wasn’t a doctor.
How did he get away with that? Apparently by finding a real doctor who let him use her medical license to provide services and bill Medicare.
Like so many fraudulent inner city clinics, Garabet used “patient recruiters” or “cappers” to find patients with insurance or Medicare. The patients would receive cash kickbacks in return for receiving medical treatment they didn’t even need.
If someone has offered you cash, gift cards, free Uber rides, food or alcohol in exchange for using your Medicaid or Medicare number, you are the victim of an illegal kickback scheme and may be eligible for cash reward – a real reward paid by the government and not some $25 gift card.
Under state and federal whistleblower laws, that award is usually between 15% and 30% of whatever the government recovers from the wrongdoer. Awards of $50,000 and more are common.
The real doctor that was letting Garabet use her license, Esther Foliente, as well as the two recruiters, Terry Hill and Natasha Walker, pleaded guilty for their role in Garabet’s scheme. We believe that Hill was also recruiting for other clinics.
And where is Betros Garabet? The feds would love to know. We want to know if you have any information about illegal patient recruitment or kickback schemes involving any healthcare provider.
Wanted Fugitive Ashot Sanamian
If you thought posing a doctor was bad, Ashot Sanamian is a really bad criminal. He was indicted on both healthcare fraud charges as well as conspiracy to distribute and divert oxycodone.
Drug overdose deaths are at record highs across the United States. And the Justice Department says that Sanamian was deeply involved in a multi-million dollar pill mill scheme responsible for over one million oxycodone pills hitting the street. We can’t even imagine how many families were ruined and lives lost because of Sanamian’s alleged actions.
We say alleged because Ashot Sanamian has not been convicted. He is instead a fugitive from justice.
Court records reveal that Sanamian was the owner and CEO of A & A Billing Services. He was also a “runner.”
Also involved in this scheme was a pain clinic that operated as the prescription mill. The clinic wrote prescriptions for patients who didn’t need narcotics. Sanamian then drove the patients to the pharmacy to fill them. Once filled, he and other runners then brought the drugs to another party who sold them on the street.
*The stories throughout this article are all based on Justice Department releases or court records. All persons on the Medicare Fraud Most Wanted list are presumed innocent despite being fugitives.
Wanted Fugitive David Kim
Unlike our first fugitive who is accused of impersonating a doctor, David Kim is the real deal. And he is wanted.
Dr. Kim was indicted in 2015 on charges of Medicare fraud, illegal remunerations and aggravated identity theft. Prosecutors say that Kim was involved in a scheme to bill $15.2 million for physical therapy services that were either not performed or were not eligible for Medicare reimbursement.
The indictment says that Kim lured Medicare recipients to his clinic in Los Angeles. Once there he would take their Medicare information and supply it to others. In less than two years he raked in $379,785 in kickbacks from their sale of their identities and was therefore responsible for millions of dollars of phony claims.
Kim remains at large and may be in South Korea.
Anytime you notice your Medicare number being used at a clinic you have never visited or for services that were never performed, report it. Not only is Medicare being ripped off, you have just become the victim of identity theft.
Wanted Fugitive Cornado Lopez
Cornado Lopez was indicted in December of 2014 for Medicare fraud, conspiracy to commit healthcare fraud, false claims and falsification of records. He was a licensed physical therapist and the owner of Total Rehab in Brooklyn at the time of his charges.
Prosecutors say that Lopez confessed to an elaborate scheme to defraud both Medicaid and Medicare. He allegedly submitted claims for physical therapy services that were not medically necessary. Some of the services that were billed were never even performed and many were not properly supervised or were performed by unlicensed people. The latter is a real danger to patient safety.
Lopez got so cocky that he began billing for services at his clinic even though flight records show he wasn’t even in the country at the time he allegedly performed those services.
In just two years, his clinic managed to bill taxpayers $9.8 million for his services!
If you have any doubt that your therapist or clinician isn’t licensed ask them for a copy of their license. If are shy about asking, call the state professional licensing board. The licensing boads I all 50 states can help you get that information confidentially. In most states, that information is online and for free.
Cornado Lopez is believed to be in the Philippines or United Arab Emirates.
How can all these fugitives be suspected of living overseas? When you steal millions of dollars it is easy to flee. Unfortunately, the rest of us are stuck paying the freight.
Wanted Fugitive Errol Erlington
An arrest warrant was issued for Errol Erlington in 2013. He is charged with Medicare fraud and racketeering. Prosecutors say that he billed healthcare programs over $400,000 for services that were never performed.
Worse, the feds say he employed an unlicensed doctor at his Michigan based clinic who engaged in criminal sexual misconduct. Allegedly an unlicensed phony doctor was performing pelvic exams on female patients while Erlington was billing for those exams.
This is one guy we need off the streets. Agents say he fled to Belize less than 24 hours after being interviewed. Why he hasn’t been brought to justice yet may because of his political connections. Amandala, a leading Belize newspaper, reports he is the brother of Foreign Affairs Minister Wilfred “Sedi” Elrington and former minister of government, Hubert Elrington.
Wanted Fugitves … Daniel Guerra and Aiza Rodriguez. BUSTED!
Aiza Rodriguez and Daniel Guerra are no Bonnie and Clyde but prosecutors say they when it comes to money, they made like bandits.
The couple were indicted in 2006 on a wide variety of charges including conspiracy to defraud the United States, conspiracy to commit money laundering, conspiracy to commit healthcare fraud, and other charges.
Agents believe the duo bilked Medicare by over $9 million in a scheme involving durable medical equipment (DME). So called DME fraud remains a hot button issue for prosecutors 13 years later in 2019.
Each owned their own DME company in Miami. They are alleged to have sold equipment that was either not medically necessary or was never delivered. To sell this much stuff, the two relied on patient recruiters who were paid kickbacks. (Today, many of these scam artists rely on telemarketers to recruit people by promising free knee braces, CPAP supplies, motorized scooters, etc.)
Getting these products requires a doctor’s order or prescription but prosecutors say the couple simply forged doctors’ names on the paperwork.
As this article is being written, authorities in Spain have captured the couple. They are awaiting extradition to the United States to stand trial.
If you work at a scam DME company or have worked as a recruiter, we want to hear from you. Even if you are involved, you may still be eligible for a reward and get immunity if you come clean before getting caught.
Wanted Fugitives Miguel Hernandez and Maria Moreira
Miguel Hernandez and Maria Moreira are another couple that we need to get off our streets. This husband and wife couple operated East Point Medical Center and Family First Medical Center. Both provided pain management services and were located in Georgia.
In 2014 they were on indicted on charges of healthcare fraud and criminal conspiracy. They are believed to have submitted $7 million in claims before getting caught.
The two are accused of the typical billing for services not provided or services that were not necessary. The details, however, are not typical.
Both patients and Medicare thought they were getting expensive trigger point injections to relieve pain. Instead they were being injected with simple B-12 that cost the couple just pennies.
To increase their billings, the couple used runners and patient recruiters to bring in new patients. Patients were “offered massages, cash, gift cards, food, dollar prizes, and raffles for televisions to induce them to visit the clinic on a regular basis.”
If you are working at a clinic that pays for patients, report it. Kickbacks in any form are illegal and whistleblower rewards may be available to the first insider that reports it. Jump to the end to learn how to report and receive a reward.
Wanted Fugitive Nurista Grigoryan
Nurista Grigoryan is an evil and very dangerous woman. We can safely say this because she was convicted of multiple felonies including aggravated identity theft and healthcare fraud. U.S. Marshals believe she removed her ankle monitor and fled shortly before her June 2014 sentencing.
She along with several others operated Manor Medical Imaging, Inc. in Los Angeles. One of the co-conspirators was a doctor, Kenneth Johnson.
The business was really a prescription mill. Unlike many of the pill mill schemes that cater to peddling opioids, this one pushed expensive antipsychotic drugs.
Johnson didn’t even bother to take the time to see many of the clinic’s patients. He instead presigned thousands of blank prescription forms that his staff would fill out. Sometimes Grigoryan would see the patients and pretend to be a doctor.
We hate these cases because invariably, vulnerable people with real needs get sucked into these scams. Instead of getting much needed help, they are shuffled off to a phony doctor and get prescribed a drug that probably doesn’t work for them and may cause harm.
How to Report Medicare and Medicaid Fraud
Under the U.S. and state False Claims Acts, whistleblowers that report healthcare fraud involving Medicaid or Medicare could be entitled to a percentage of any verdict or settlement. Report fraud today, and you might earn a multimillion-dollar reward - hundreds of whistleblowers have already received rewards. We can help connect you with a qualified legal counsel who can confidentially review your facts and see if you qualify.
*The beginning of this piece started with a reference to Farid Fata, the disgraced physician that many call the Butcher of Detroit. Fata and many of the people on this list were caught because of whistleblowers. Brave healthcare workers or patients who stood up and spoke out.
If you have any reservations if reporting your boss / co-worker for Medicare fraud is the right thing to do, just listen to some of the victims from Dr. Fata. (Video footage from WXYZ TV Detroit)