Kentucky

March 17, 2010

DME Owners Indicted for Submitting False Billings to Medicare (United States Attorney for The Third Judicial District of Kentucky)

Louisville, Kentucky - United States Attorney Candace G. Hill of the Western District of Kentucky announced on March 17, 2010, that a federal grand jury in Louisville returned a superseding indictment on March 15, 2010, against Leobaldo Perez Gonzalez, age 50, of Miami, Florida, and Alexander Castillo Dopico, age 31, on charges of conspiracy, health care fraud, submitting false claims, and wire fraud.

The Superseding Indictment alleges that between 2007 through August of 2008, Perez Gonzalez and Castillo Dopico through their corporations, Universal of Work Services and Steel Quality Medical, submitted false and fraudulent claims to the Centers for Medicaid and Medicare Services for products which were not authorized nor provided to patients. Specifically, the superseding  indictment alleges that, Perez Gonzalez and Castillo Dopico submitted claims on behalf of Florida patients or deceased patients that were purportedly treated by Kentucky physicians, when in fact neither the patients nor the physicians had any knowledge of one another.  Moreover, during their investigation, investigators learned that the products which Universal of Work Services and Steel Quality claimed they provided were never provided.  A search warrant was executed on both the businesses, and both businesses were almost devoid of any of the products it claimed to have been providing.

In the event of a conviction, the maximum potential penalties are 35 years imprisonment, a $1,500,000 fine, and supervised release for a period of up to 5 years.

The case is being prosecuted by Assistant United States Attorney Lettricea Jefferson-Webb, and it was investigated by Health and Human Services Office of Inspector General and the Federal Bureau of Investigation.

Perez Gonzalez and Castillo are scheduled to appear for arraignment before the United States Magistrate Judge on, Tuesday, April 20, 2010, at 9:30 a.m., in Louisville, Kentucky.

November 11, 2009

Former Nurse Pleads Guilty to Stealing Drugs from Patients: Former Nurse Took Patient Medications for Herself (U.S. Attorney for the Western District of Kentucky)

LOUISVILLE, KY - United States Attorney Candace G. Hill of the Western District of Kentucky announced that Deborah Sue Whitacre Brown, 56, of Radcliffe, Kentucky pled guilty yesterday to charges of making false statements related to health care matters and unlawfully possessing controlled substance by fraud.

The indictment alleged that between 2005 through 2008, Brown caused false information to be submitted to various insurance companies on behalf of patients at University of Louisville Hospital, where she was employed as a nurse. The patients were billed for drugs which they never received. The total amount of false billings was over $63,000. In addition, Brown pled guilty to obtaining these controlled substances by fraud and deception. Over 7,000 doses of controlled substances are believed to have been taken by Brown.

The case is being prosecuted by Lettricea Jefferson-Webb, and it was investigated by the Drug Enforcement Administration.

Brown is scheduled to be sentenced by Judge John G. Heyburn on March 8, 2010, in Louisville, Kentucky.

For more information, visit the website of the United States Attorney's Office for the Western District of Kentucky at: http://www.justice.gov/usao/kyw/

September 18, 2009

Med 1st of Middletown Sentenced For Submitting False Billings (U.S. Attorney for the Western District of Kentucky)

LOUISVILLE, KY -  Med 1st of Middletown, in Jefferson County, Kentucky was sentenced on September 2, 2009, by Judge Thomas B. Russell on charges of committing health care fraud, announced United States Attorney Candace G. Hill of the Western District of Kentucky.

An information had been filed which alleged that between 2002 and 2007, Med 1st submitted  false billings to Anthem for VAX-D treatment.  Vertebral Axial Decompression (VAX-D) is a procedure in which a patient lies prone on a table and is placed in a harness.  The device then creates traction and relaxation phases.  Although approved by the FDA, VAX-D is still considered experimental and most insurers will not pay for it.  Med 1st submitted false statements to Anthem and other providers indicating that they had performed an approved service  when in fact they had performed the unapproved VAX-D service.

An agreed order of restitution of $311,860.49 was entered in this matter.  The case was prosecuted by Lettricea Jefferson-Webb, and it was investigated by the Office of Personnel Management Office of the Inspector General, and Anthem's Special Investigation Unit.

More information on the U.S. Attorney’s for the Western District of Kentucky: http://www.usdoj.gov/usao/kyw/

September 15, 2009

More Defendants Sentenced In Health Care Fraud Scheme (U.S. Attorney for the Western District of Kentucky)

LOUISVILLE -Joseph Ivan Rouben, age 80, and George Deusner, age 58, both of Louisville, Kentucky in Jefferson County, were sentenced on September 2, 2009, on charges of health care fraud and prohibited drug acts by Judge Thomas B. Russell, United States Attorney Candace G. Hill of the Western District of Kentucky announced today.

During their plea, the men admitted that between 2003 and 2006 they were engaged in the sale or trading of prescription drug samples and health care fraud.  Rouben was a pharmacist and the prior owner at Rouben's Pharmacy, while George Deusner, was employed as a pharmacy technician at Rouben's Pharmacy.  Rouben and Deusner purchased, and later sold prescription drug samples to patients of the pharmacy.  In addition, Deusner assisted in the removal of the sample drugs from their sample packages.  Both admitted that the purchased sample drugs were later sold by the pharmacy. 

During the course of the investigation, it was determined that Deusner had been paid by the current pharmacy owner, Brian Ullom, $171,660 for his role in assisting with the purchase and later sale of the samples.  Rouben was paid $58,090 by the current pharmacy owner, Brian Ullom, for his role.  Once the sample drugs were purchased, they were removed from their sample packaging and placed in the pharmacy's inventory.  These samples were later sold to consumers, whose insurance companies, including Medicare and Medicaid, were billed full price.   At today's sentencing hearing, Deusner received a sentence of 2 years' probation.  He previously agreed to forfeit the $171,660 he received from the scheme.  Rouben received a sentence of 2 years' probation, and was ordered to pay a fine of $2,000.  An agreed money judgment was entered in the amount of $58,090.

The owner of the pharmacy, Brian Ullom, was sentenced on August 17, 2009 to 15 months' imprisonment.  Ullom was ordered to pay $2.3 million in criminal restitution and $300,000 as part of a civil settlement.  Another defendant, Robert Nold, a physician who was selling drug samples to the pharmacy, was sentenced to 2 years' probation.  A fifth defendant, Michael Carney, a  pharmaceutical representative, is scheduled to be sentenced on October 7, 2009 before Judge Russell for his role in the scheme.

The case was prosecuted by Assistant United States Attorney Lettricea Jefferson-Webb, and it was investigated by the United States Food and Drug Administration Office of Criminal Investigations, Health and Human Services Office of the Inspector General, and the Federal Bureau of Investigation.

More information on the U.S. Attorney’s for the Western District of Kentucky: http://www.usdoj.gov/usao/kyw/

September 15, 2009

Doctor Who Prescribed Diet Drugs Over the Internet Sentenced in Federal Court (U.S. Attorney for the Western District of Kentucky)
Controlled substances sold over the internet in the United States and in foreign countries
LOUISVILLE, KY – Tufan Senler, age 50, of Louisville, Kentucky, was sentenced on Sept. 22 by U.S. District Judge John G. Heyburn, II, following his earlier guilty plea to dispensing and distributing controlled substances, exporting controlled substances to foreign countries without a permit, money laundering and misbranding of drugs, United States Attorney Candace G. Hill of the Western District of Kentucky announced today.

On March 10, 2009, Senler pled guilty to an Information in which he was charged with all four counts described above.  The information alleged that between 2002 and 2005, Senler, a physician, sold diet prescription drugs over the internet through his website dietprescriptions. com.

According to a factual basis contained in Senler’s plea agreement, Senler operated two businesses.  Kentucky Body Works, d/b/a Weight Loss Plus, was a business in which Senler operated his weight loss clinic, and Science of Better Living was a business which operated his website.  Senler admitted that he dispensed, distributed and exported diet prescription drugs through his website to customers who did not have valid prescriptions.  He further admitted he did not engage in a legitimate doctor-patient relationship with the customers since he had no face-to-face contact with the customers who ultimately purchased the drugs.  The prescription drugs were issued through the website and were not consistent with the professional practice of medicine.  Moreover, Senler agreed that the prescription drugs were being provided outside the standard legitimate practice of medicine.  Finally, the prescription drugs issued were not issued in compliance with Food and Drug Administration requirements, and thus they were adulterated and/or misbranded.

Senler admitted that did not have a valid exportation permit issued by the Attorney General of the United States during the relevant time period.  Thus, Senler could not legally dispense or distribute controlled non-narcotic drugs to other countries. 

Additionally, Senler admitted that he engaged in monetary transactions with the proceeds of this illegal activity.  Customers’ deposits were placed into a Kentucky Body Works’ bank account and then subsequently transferred to Senler’s personal bank account.  Some of these proceeds were used to make several purchases of property. 

Senler admitted that he received approximately $15 million from his role in the above offenses.  Senler received a sentence of 12 months' home incarceration, and was ordered to pay a fine of $5,000.  In addition, Senler forfeited $3,114,035.36 from his ill-gotten gain.

The case was prosecuted by Lettricea Jefferson-Webb and Amy Sullivan and was investigated by the Drug Enforcement Agency, Kentucky State Police, Food & Drug Administration - Office of Criminal Investigations, the Internal Revenue Service, and the United States Postal Inspection Service.      

More information on the U.S. Attorney’s for the Western District of Kentucky: http://www.usdoj.gov/usao/kyw/

August 19, 2009

Local Pharmacist Sentenced to One Year and Three Months for Healthcare Fraud And Campaign Contribution Fraud; Also Enters (U.S. Attorney for the Western District of Kentucky)

LOUISVILLE, KY - Brian Ullom, age 38, of Louisville, Kentucky, in Jefferson County, was sentenced in federal court in Louisville, Kentucky to 1 year and 3 months’ imprisonment and ordered to pay $2.3 million in restitution today for health care fraud and making illegal campaign contributions, Acting United States Attorney Candace G. Hill of the Western District of Kentucky announced on Aug. 18, 2009. In June 2007, Ullom pleaded guilty to billing for prescriptions that were never filled and for illegally selling prescription drug samples, and for illegally making campaign contributions in the names of others through Rouben’s Pharmacy in Louisville.

As part of the plea agreement, Ullom agreed to forfeit $250,000 (which was paid prior to imposition of today’s sentence). Ullom also paid $1.6 million of the restitution into court prior to final sentencing. Ullom has agreed to pay the remaining $450,000 in criminal restitution within nine (9) months.

As part of Ullom’s sentence, he was ordered to serve 3 years’ supervised release following his incarceration. There is no parole in the federal judicial system.

In pleading guilty, Ullom admitted that, beginning in 2002 and continuing through October 2006, he sold, purchased, and traded prescription drug samples to the public. During that time, Ullom obtained prescription drug samples by purchasing the drug samples from others, including a local physician and a pharmaceutical company sales representative. After obtaining the drug samples, Ullom, with the help of others, removed the drug samples from their original sample packaging and sold the drug samples to the public through his pharmacy, operating as Rouben's Pharmacy. At the time of each sale of the drug samples, Ullom knew that the drugs were drug samples and resold the drugs with the intent to defraud and misled the purchaser by selling the sample drugs as drugs properly obtained and dispensed. Moreover, around the time of each sale, Ullom billed the patient and the patient's insurance provider, including Medicare and Medicaid, for the drug samples.

Ullom also admitted that he had billed insurance companies for prescriptions that were never filled. Specifically, beginning in 2001 and continuing through October 12, 2006, Ullom, along with others, knowingly, and with the intent to defraud, billed healthcare benefit programs, including Medicare and Medicaid, for prescriptions that were never filled.

Furthermore, Ullom had pled guilty to knowingly and willfully making campaign contributions to "Tony Miller for Congress" in the name of 7 other persons beginning on October 21, 2004, and continuing until October 28, 2004. In each instance, at Ullom's request, an individual, or a “straw” contributor, made a $2,000 campaign contribution to "Tony Miller for Congress". Ullom, the real contributor, in turn, reimbursed the “straw” contributor the entire $2,000 contribution with checks drawn from his business, Rueben's Pharmacy. In total, Ullom contributed $14,000 to "Tony Miller for Congress" in the name of 7 other people in violation of 2 United States Code 441f, 437g(D).

Regarding the fraudulent campaign contributions, Acting United States Attorney Hill stated that the charge came up during the criminal healthcare fraud investigation of Ullom and that there were no other violations brought to the attention of federal authorities. Consequently, there is no further investigation of this criminal matter.

Today, Ullom also entered into a settlement agreement requiring him to pay $300,000 to resolve the United States’ potential civil claims in connection with the above-described healthcare fraud. The criminal case was prosecuted by Assistant United States Attorneys Lettricea Jefferson-Webb and Eric Long, and it was investigated by the Federal Bureau of Investigation, the U.S. Food & Drug Administration - Office of Criminal Investigations, and the Office of Inspector General of the Department of Health and Human Services. The civil matter was handled by Assistant United States Attorneys Jay Gilbert, Ben Schecter and Joe Ansari.

More information on the U.S. Attorney’s for the Western District of Kentucky: http://www.usdoj.gov/usao/kyw/

August 4, 2009

Former Married Couple Charged With Committing Fraud Against Government Health Care Program (U.S. Attorney for the Western District of Kentucky)

PADUCAH, KY - Candace G. Hill, Acting United States Attorney for the Western District of Kentucky, announced today that a federal grand jury in Paducah returned an Indictment against Raymond W. Worden, age 55, of San Angelo, Texas, and Deborah D. Worden, age 53 years, of Hopkinsville, Kentucky, charging both with a single count of health care fraud.

The Indictment alleges that the Wordens defrauded Tricare, which provides medical coverage to active and retired members of the United States military and their dependents, including spouses, because they knowingly and intentionally concealed from Tricare their divorce and 2003, which would have limited the medical coverage offered to Deborah Worden, who prior to their divorce was married to Raymond Worden, an active member of the U.S. Air Force from 1975 through 1995, when he retired.

In the event of a conviction, the maximum potential penalties are 10 years’ imprisonment, a $250,000 fine, and supervised release for a period of 3 years.

The case is being prosecuted by Assistant United States Attorney Jim Lesousky, and it was investigated by the Defense Criminal Investigative Service.

The Wordens are scheduled to appear for arraignment before the United States magistrate judge on September 16, 2009, at 1:30 p.m., in Paducah, Kentucky.

More information on the U.S. Attorney for the Western District of Kentucky: http://www.usdoj.gov/usao/kyw/index.html