Newport, KY Chiropractor convicted of health care fraud conspiracy NEWPORT. KY -The owner of a chiropractic clinic in Newport, Ky. has been convicted of a fraud scheme involving tens of thousands of dollars. A federal jury in Covington convicted 48-year-old Andrea Almond, of Cincinnati, for conspiracy to commit health care fraud late Friday afternoon. The jury returned the verdict after four days of trial and six hours of deliberation. According to evidence established at trial, from September 2008 through April 2010. Almond conspired with a co-defendant to bill the Kentucky Medicaid Program for chiropractic services rendered at the Newport Chiropractic Center. Court documents state that Almond never actually practiced at the Newport Chiropractic Center. The billed sen ices were instead provided bv other doctors, who had never been approved or enrolled in Kentucky Medicaid Program. Officials say Almond billed the Kentucky Medicaid Program using her National Provider Identification number, knowing that the Kentucky Medicaid Program would not have paid for any claims for treatment rendered by unapproved providers. Officials say Almond and her co-conspirator fraudulently submitted approximately 1.943 claims to the Kentucky Medicaid Program, which totaled $483,797. Documents state they received $95,098 in payment. Co-conspirator Elaine Legg lias already pled guilt} in the case. In a separate case. Dr. Nanci Allen, a former part owner in the Erlangcr Chiropractic Clinic, pled guilty to a similar scheme to defraud the Kentucky Medicaid Program. These individuals arc also awaiting sentencing. Almond will appear for sentencing on September 4. 2014. She faces a maximum of 10 years in prison. Source: http:, www.foxl 9. com Los Angeles Physician Assistant Pleads Guilty in Two Medicare Fraud Cases Erasmus Kotcy. 77. of Montcbcllo. Calif., pleaded guilty before U.S. District Judge Margaret M. Morrow in the Central District of California to one count of health care fraud and one count of conspiracy to commit health care fraud. Sentencing is scheduled for Sept. 8. 2014. According to court documents. Kotcy was a physician assistant who worked at medical clinics in and around Los Angeles County. From approximately November 2007 through February 2008. Kotcy engaged in a scheme to commit health care fraud through his work at a clinic located at 866 North Vermont Avenue in Los Angeles. In addition, from approximately April 2008 through December 2008. Kotcy engaged in a conspiracy to commit health care fraud through his work at a clinic located at 943 South Atlantic Boulevard. Suite 218. in Monterey Park. Calif. At both clinics. Kotcy signed prescriptions and other medical documents for medically unnecessary power wheelchairs and other durable medical equipment (DME). Kotcy and his co-conspirators then sold the prescriptions to DME supply companies, know ing that the prescriptions were fraudulent. Based on these fraudulent prescriptions, the DME supply companies then submitted false and fraudulent claims to Medicare. Combined, the two indictments allege that fraudulent prescriptions from Kotey were responsible for approximatch $7 million in false and fraudulent claims to Medicare, and Medicare paid approximately $3 million on those claims. The cases were investigated by the FBI. HHS-OIG and the IRS and brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Central District of California. The cases arc being prosecuted by Trial Attorney Fred Mcdick of the Fraud Section and Assistant U.S. Attorneys Kristcn Williams and Cathy Ostillcrof the Central District of California. Since its inception in March 2007. the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1.700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition. HHS"s Centers for Medicare and Mcdicaid Sen ices, working in conjunction with HHS-OIG. arc taking steps to increase accountability and decrease the presence of fraudulent providers.
