Mafia, violent criminals turn to Medicare fraud

Schemes offer big payoff and carry shorter prison time than other offenses

Tues., Oct . 6, 2009

This story really angered me when I read it....

MIAMI
- Lured by easier money and shorter prison sentences, Mafia figures and
other violent criminals are increasingly moving into Medicare fraud and
spilling blood over what was once a white-collar crime.

Around
the nation, federal investigators have been threatened, an informant's
body was found riddled with bullets, and a woman was discovered dead in
a pharmacy under investigation, her throat slit with a piece of broken
toilet seat.

For
criminals, Medicare schemes offer a greater payoff and carry much
shorter prison sentences than offenses such as drug trafficking or
robbery.

"We've
seen more people that used to be involved in (dealing) drugs are
switching over to health care fraud because it's not as dangerous,"
Miami FBI spokeswoman Judy Orihuela said.

Medicare
scammers typically make their money by billing Medicare for medical
equipment and drugs that patients never receive — and never needed.
Some pay homeless people on Los Angeles' Skid Row for Medicare or
Social Security numbers to use in fake billing invoices. Others
intimidate elderly victims to use their Medicare numbers, federal
authorities say.

Most
Medicare schemes are based in cities such as Miami, Los Angeles,
Detroit and Houston. And rather than building an elaborate hierarchy
like the Mafia or other gangs, many Medicare con artists use common
street criminals to recruit patients and doctors, authorities said.

"Building
a Medicare fraud scam is far safer than dealing in crack or dealing in
stolen cars, and it's far more lucrative," said Lewis Morris, lead
attorney at the Department of Health and Human Services' inspector
general's office.

A
Medicare scammer could easily net at least $25,000 a day while risking
a relatively modest 10 years in prison if convicted on a single count.
A cocaine dealer could take weeks to make that amount while risking up
to life in prison.

It's
unclear how many violent crimes are tied to Medicare fraud because most
of them are carried out by someone within the hoax who attacks another
person taking part in the crime.

'Common criminals'

One Southern California criminal task force has arrested about 50 suspects for Medicare fraud in the last three years.

And
11 members of New York's Bonanno family were indicted in May in a
Medicare fraud scheme in South Florida. They were accused of stealing
patients' Medicare numbers and using them to submit false claims. Other
allegations included identity theft and conspiring to commit murder.

Even
criminals with violent records, including a convicted murderer, have
been able to obtain Medicare supplier licenses. Applicants with felony
records can only be rejected if their convictions are 10 years old or
less.

"It's
outrageous that those trusted to provide medical care are really
nothing but common criminals," said federal prosecutor Kirk Ogrosky,
who heads the Medicare Fraud Strike Force across the United States.

Gruesome cases

Guillermo
Denis Gonzalez spent 14 years in prison for second-degree murder, but
after his 2006 release, records showed he soon bought a business called
DG Medical in the Miami suburb of Hialeah and applied to be a Medicare
supplier.

Within
two months, federal investigators were alerted that the Medicare claims
the company were making were fraudulent and suspended its license. By
then, the sham company had illegally netted $31,000.

Last
month, he pleaded guilty to Medicare fraud and now awaits sentencing.
He is also charged in a gruesome killing in May 2008 in which police
say he repeatedly stabbed a man with a kitchen knife, crushed his face
with a mallet, then cut off the victim's head and dismembered the body
before stuffing the parts in trash bins. The killing might be related
to Medicare fraud, authorities said.

His attorney, Stephen Kramer, has declined to comment.

Medicare-fraud
investigations used to focus mainly on patient records and financial
papers, but now the crime scenes are increasingly bloody:

• In
  2007, authorities found Juana Gonzalez lying in a pool of blood on the
  floor of her Miami pharmacy. Her cousin was charged with second-degree
  murder, accused of taking a piece of a broken toilet and slitting
  Gonzalez's throat. Federal authorities said they were investigating the
  pharmacy for Medicare fraud and believe the crimes are related.


• In
  2004, a week after the FBI issued search warrants on more than 50
  fraudulent Medicare storefronts in Miami, the body of Ernesto Valdes
  was found in the back seat of his car, riddled with bullets. Federal
  authorities said he had information that could have linked players in
  the $148 million fraud scheme. No one has ever been charged in his
  slaying.


• In
  2006, members of a Russian-Armenian organized crime ring were indicted
  for allegedly bilking Medicare of more than $20 million through a group
  of medical clinics they ran in the Los Angeles area. The group included
  Konstantin Grigoryan, a former colonel in the Soviet army, family
  members and others with past criminal records.

"They
don't have the typical structure that we see in Italian mobs. They'll
work with whoever can make them money. And if they don't get their way,
they won't be ashamed to kidnap somebody, to shoot somebody," said
Glendale Police Lt. Steve Davey, who leads the Southern California
Eurasian Organized Crime Task Force.

'Nobody saw anything'

The violent crimes are mostly to settle a debt or silence a witness.

"It's
in-house. Typically professional hits, generally unsolved. Usually it's
just a bullet in the head, nobody saw anything," said Los Angeles
County Sheriff's Sgt. Stephen Opferman.

The
Armenian gangs have also aggressively pursued elderly patients,
intimidating them to obtain their Medicare numbers, Opferman said.
Police have received reports from family members who feared their
grandmother had been abducted, only to learn later that she was picked
up in a van and taken to a fake store where her Medicare number was
swiped.

The
groups have broken into computer banking systems or paid moles to
provide key information from court clerk's offices and various
government agencies, Davey said.

In
Los Angeles, two federal authorities investigating Medicare fraud say
colleagues have been threatened and had their cars followed.

Sometimes Medicare fraud turns violent without the involvement of organized crime.

Illinois
podiatrist Ronald Mikos was sentenced to death for the 2002 fatal
shooting of a patient to keep her from telling a federal grand jury how
he defrauded Medicare. He shot the woman six times as she sat in her
wheelchair at her home. Her subpoena was found on the floor next to her.



http://www.msnbc.msn.com/id/33196132/ns/us_news-crime_and_courts//